Impact of Narrow Band Imaging in Pre-Operative Assessment of Suspicious Oral Cavity Lesions: A Systematic Review

Document Type : Systematic Review

Authors

1 ENT Clinic, Department of Biomedicine, Neurosciences and Advanced Diagnostic, University of Palermo, Palermo, Italy.

2 Department of Otorhinolaryngology-Head & Neck Surgery, Universiti Sains Malaysia, Health Campus 16150, Kubang Kerian, Kelantan, Malaysia.

Abstract

Introduction:
Narrow band imaging (NBI) is a powerful tool that allows visualizing the mucosal and submucosal vasculature. Among the available diagnostic techniques, NBI is one of the most valid for early detection of oral squamous cell carcinoma (OSCC).
Materials and Methods:
We carried out a bibliographic search in PubMed, Scopus and Web of Science databases using relevant keywords. Articles selected were screened by two independent authors based on inclusion and exclusion criteria. Nine papers were singled out according to the eligibility criteria and included in this review. We investigated the articles for pooled sensitivity, specificity, accuracy, positive predictive value and negative predictive value of pre-operative NBI.
Results:
The use of NBI examination in the oral cavity revealed higher specificity, sensitivity, positive and negative predictive values and accuracy compared to white light examination for the diagnosis of oral squamous cell cancer (OSCC). In addition, NBI has proved great utility in detecting malignancy features in oral pre-malignant lesions.
Conclusions:
This review shows that NBI is a powerful tool for examining oral suspicious lesions. Most of the articles examined revealed high values of sensitivity, specificity, positive predictive value, negative predictive value and accuracy in detection of oral malignant and pre-malignant lesions. Therefore, the use of NBI is highly recommended for the early detection of oral cancer and potentially malignant disorders. Future studies should seek to affirm the validity of NBI and in particular to standardize NBI classification.

Keywords


  1. Piazza C, Cocco D, Del Bon F, Mangili S, Nicolai P, Majorana A, et al. Narrow band imaging and high definition television in evaluation of oral and oropharyngeal squamous cell cancer: a prospective study. Oral Oncol. 2010;46(4):307-310.
  2. Piazza C, Dessouky O, Peretti G, Cocco D, De Benedetto L, Nicolai P. Narrow-band imaging: a new tool for evaluation of head and neck squamous cell carcinomas. Review of the literature. Acta Otorhinolaryngol Ital. 2008;28(2):49-54.
  3. Gono K, Yamazaki K, Doguchi N, Tetsuo N, Takashi O, Masahiro Y, et al. Endoscopic observation of tissue by narrowband illumination. Opt Rev 2003; 10:211-15.
  4. Piazza C, Del Bon F, Paderno A, Grazioli P, Perotti P, Barbieri D, et al. The diagnostic value of narrow band imaging in different oral and oropharyngeal subsites. Eur Arch Otorhinolaryngol 2016; 273:3347-3353.
  5. Farah CS. Narrow Band Imaging-guided resection of oral cavity cancer decreases local recurrence and increases survival. Oral Dis. 2018; 24:89-97.
  6. Takano JH, Yakushiji T, Kamiyama I, Nomura T, Katakura A, Takano N, et al. Detecting early oral cancer: narrowband imaging system observation of the oral mucosa microvasculature. Int. J. Oral Maxillofac. Surg. 2010; 39: 208-213.
  7. Vu AN, Farah CS. Efficacy of narrow band imaging for detection and surveillance of potentially malignant and malignant lesions in the oral cavity and oropharynx: a systematic review. Oral Oncol. 2014;50(5):413-20.
  8. Tirelli G, Piovesana M, Bonini P, Gatto A, Azzarello G, Boscolo Nata F. Follow-up of oral and oropharyngeal cancer using narrow-band imaging and high-definition television with rigid endoscope to obtain an early diagnosis of second primary tumors: a prospective study. Eur Arch Otorhinolaryngol. 2017 Jun;274(6):2529-2536..
  9. Yang SW, Lee YS, Chang LC, Hwang CC, Chen TA. Use of endoscopy with narrow-band imaging system in detecting squamous cell carcinoma in oral chronic non-healing ulcers. Clin Oral Investig. 2014;18(3):949-959
  10. Shibahara T, Yamamoto N, Yakushiji T, Nomura T, Sekine R, Muramatsu K, et al. Narrow-band Imaging System with Magnifying Endoscopy for Early Oral Cancer. Bull Tokyo Dent Coll 2014;55(2): 87-94.
  11. Ottaviani G, Gobbo M, Rupel K, D'Ambros M, Perinetti G, Di Lenarda R, et al. The diagnostic performance parameters of narrow band imaging: a preclinical and clinical study. Oral Oncol. 2016; 60:130-136.
  12. Sekine R, Yakushiji T, Tanaka Y, Takhiko S. A study on the intrapapillary capillary loops detected by narrow band imaging system in early oral squamous cell carcinoma. J Oral Maxillofac Surg Med Pathol. 2015;27:624-630.
  13. Upadhyay A, Saraswathi N, Mundra RK. Narrow Band Imaging: An Effective and Early Diagnostic Tool in Diagnosis of Oral Malignant Lesions. Indian J Otolaryngol Head Neck Surg. 2019;71(Suppl 1):967-971.
  14. Vu AN, Matias MAT, Farah CS. Diagnostic accuracy of Narrow Band Imaging for the detection of oral potentially malignant disorders. Oral Dis. 2015; 21:519-529.
  15. Yang SW, Lee YS, Chang LC, Chien HP, Chen TA. Light sources used in evaluating oral leukoplakia: broadband white light versus narrowband imaging. Int. J. Oral Maxillofac. Surg. 2013; 42:693-701.              
  16. Yang SW, Lee YS, Chang LC, Hwang CC, Chen TA. Diagnostic significance of narrow-band imaging for detecting high-grade dysplasia, carcinoma in situ, and carcinoma in oral leukoplakia. Laryngoscope 2012;122(12):2754-61.
  17. Yang SW, Lee YS, Chang LC, Hwang CC, Luo CM, Chen TA. Clinical characteristic of narrow-band imaging of oral erythroplakia and its correlation with pathology. BMC Cancer 2015; 15:406.
  18. Inoue H, Kaga M, Sato Y, Satoshi S, Shin-ei K. Magnifying endoscopy diagnosis of tissue atypia and cancer invasion depth in the area of pharyngo-esophageal squamous epithelium by NBI enhanced magnification image, IPCL pattern classification. In Comprehensive atlas of high resolution endoscopy and narrow band imaging, Cohen J (ed). 2007; pp.49–66, Blackwell Publishing, New York.
  19. Piazza C, Cocco D, Del Bon F, Mangili S, Nicolai P, Peretti G. Narrow Band Imaging and High Definition Television in the endoscopic evaluation of upper aero-digestive tract cancer. Acta Otorhinolaryngol Ital. 2011; 31:70-75.
  20. Tirelli G, Piovesana M, Gatto A, Torelli L, Boscolo Nata F. Is NBI-Guided resection a breakthrough for achieving adequate resection margins in oral and oropharyngeal squamous cell carcinoma?. Ann Otol Rhinol Laryngol. 2016; 125:596-601.
  21. Tirelli G, Piovesana M, Marcuzzo AV, Gatto A, Biasotto M, Bussani R, et al. Tailored resections in oral and oropharyngeal cancer using narrow band imaging. Am J of Otolaryngol. 2018; 39:197-203.