White light, autofluorescence and narrow-band imaging bronchoscopy for diagnosing airway pre-cancerous and early cancer lesions: a systematic review and meta-analysis

Abstract

With higher sensitivity, advanced bronchoscopy could be valuable to avoid missed diagnosis. Combining strategy of AFB and WLB may contribute preferable diagnosis rather than their alone use for high-grade lesions. Studies of NBI warrants further investigation for precancerous lesions.

The technique of endoscopic airway tumor treatment

“…In the same study, the diagnostic performances of the two techniques were calculated selectively for high-grade lesions from moderate dysplasia to invasive carcinoma. Sensitivity of AFB + WLB was similar to that obtained in the entire data set (86%) but specificity increased to 71% (62).…”

“…The combination of AFI and NBI did not significantly improve the diagnostic performance, yielding a pooled sensitivity and specificity of 86% and 75%, respectively. In another meta-analysis which included six studies, NBI presented remarkable diagnostic performance with a 96% sensitivity and 84% specificity (62). However the diagnostic performance of NBI was lower for the high-grade lesions from moderate dysplasia to invasive carcinoma since the specificity decreased to 43% (62).…”

“…The pooled sensitivity and specificity of AFB and WLB were 0.90 and 0.56, 0.66 and 0.69, (61). Finally, in the most recent meta-analysis, 39 studies using WLB, 39 using AFB and 17 using AFB + WLB were selected (62). Sensitivity and specificity were 54% and 79% for WLB, 87% and 65% for AFB, and 88% and 59% for AFB + WLB, respectively.…”

Localized Bronchial Hyperemia in Cases of Iatrogenic Hemoptysis: Clinical Presentations and Pathophysiological Mechanisms

“…Autofluorescence bronchoscopy and narrow-band imaging bronchoscopy have shown significantly higher sensitivity in recognizing intraepithelial vascular abnormalities [10]. Narrow-band imaging particularly uses 2 different bandwidths of light, one absorbed by superficial capillaries and another that is absorbed by blood vessels below the mucosal capillaries, thus enabling enhanced visualization of blood vessels [11]. These technologies might have been of benefit in the more detailed and precise identification of mucosal and submucosal vascular abnormalities [12].…”

Twenty‐five years of Respirology: Advances in interventional pulmonology

“…Autofluorescence bronchoscopy and narrow‐band imaging —Stephen Lam showed that tissue autofluorescence to a blue light could be detected by highly sensitive cameras, and very subtle in situ changes in mucosa not visible in standard white light could also be detected, allowing biopsy. Narrow‐band imaging also used autofluorescence; however, the narrow band was that of the tissue fluorescence of haemoglobin.…”