Utility of narrowband imaging in the diagnosis of laryngeal leukoplakia: Systematic review and meta‐analysis

Abstract

This systematic review and meta-analysis evaluates the validity of narrowband imaging (NBI) in differentiating between low-risk leukoplakia and high-risk leukoplakia. Medline, EMBASE, Scopus, Cochrane Database of Systematic Reviews and Database of Abstracts of Reviews of Effects were searched. Studies evaluating the diagnostic accuracy of NBI in the assessment of laryngeal leukoplakia were included. Pooled sensitivity, specificity and diagnostic odds ratio were calculated. Seven studies met the inclusion criteria assessing a total of 586 lesions with laryngeal leukoplakia. In differentiating between low-risk and high-risk leukoplakia, NBI had a pooled sensitivity and specificity of 85.4% (95% CI [76-99.9]) and 94.9% (95% CI [91.1-97.2]) respectively. Pooled diagnostic odds ratio was 99.2 (95% CI [38.28-257.18]). NBI is a useful imaging modality in differentiating between low-risk leukoplakia and high-risk laryngeal leukoplakia. The high sensitivity, specificity and diagnostic odds ratio make NBI a useful tool in the workup of laryngeal leukoplakia.

Correlation of narrow-band imaging findings using the Ni and European Laryngeal Society classification systems during in-office flexible laryngoscopy with histopathology

“…10 In our study, using the Ni classification (2011 classification in cases without glottic leucoplakia and 2019 classification in cases with leucoplakia), we found that the sensitivity, specificity, positive predictive value, negative predictive value and accuracy for narrow-band imaging to identify vocal fold lesions as benign or malignant was 91.9 per cent, 93.8 per cent, 97.1 per cent, 83.3 per cent and 92.5 per cent, respectively. It is likely that the higher specificity found in our study, compared with that of Ahmadzada et al 17 In 2018, Šifrer et al studied 40 patients, and reported the sensitivity, specificity, positive predictive value, negative predictive value and accuracy for narrow-band imaging to predict malignancy using the European Laryngeal Society classification as 100 per cent, 95 per cent, 88 per cent, 100 per cent and 96 per cent, respectively. 18 In 2020, Šifrer et al conducted another study, with a larger sample size of 144 cases, to further investigate the effectiveness of the European Laryngeal Society classification.…”

“…In 2020, Ahmadzada et al reported the sensitivity, specificity, negative likelihood ratio and positive likelihood ratio of narrow-band imaging in diagnosing laryngeal cancer using the Ni 2011 classification as 95.0 per cent, 83.3 per cent, 0.06 and 5.76, respectively. 17 As per the Ni 2019 classification, the sensitivity, specificity, positive predictive value and negative predictive value for the diagnosis of suspicious lesions with leucoplakia under narrow-band imaging was 82.6 per cent, 92.8 per cent, 73.1 per cent and 95.7 per cent, respectively. 10 In our study, using the Ni classification (2011 classification in cases without glottic leucoplakia and 2019 classification in cases with leucoplakia), we found that the sensitivity, specificity, positive predictive value, negative predictive value and accuracy for narrow-band imaging to identify vocal fold lesions as benign or malignant was 91.9 per cent, 93.8 per cent, 97.1 per cent, 83.3 per cent and 92.5 per cent, respectively.…”

“…It is likely that the higher specificity found in our study, compared with that of Ahmadzada et al . 17 and Ni et al ., 10 is because we used both the Ni 2011 and Ni 2019 classifications, as appropriate.…”

Comparing suspension laryngoscopic mucosal dissection and plasma resection for laryngeal leukoplakia: prognostic outcomes

“…A higher score indicates more serious vocal fold vibration asymmetry. The vocal fold mucosal wave was divided into 0-5 points, and a higher score indicates more serious disappearance of vocal fold mucosal wave [11]. Based on electronic pathology and outpatient reexamination records, the cumulative recurrence rate of patients within one year was calculated.…”