Clinical experience of narrow band imaging (NBI) usage in diagnosis of laryngeal lesions

Introduction: One of the most recent methods used in imaging of the larynx is NBI. NBI allows to detect specific patterns of pathological angiogenesis suggestive of premalignant or neoplastic lesions. Aim: The aim of the study was to compare imaging of laryngeal lesions in WLE and NBI in relation to histopathological examination. Material and methods: 333 patients with laryngeal lesions underwent endoscopic evaluation in WLE and NBI. Sensitivity, specificity, PPV, NPV for both methods were calculated. The diagnostic value for WLE and NBI was evaluated for two assumptions: a positive result indicates (1) severe dysplasia and cancer, or (2) only cancer. Results: Sensitivity, specificity, PPV, NPV for the first assumption were, respectively for white light compared to NBI: 95.4% vs 98.5%; 84.2% vs 98.5%; 79.6% vs 97.7% and 96.6% vs 99.0%. The values for the second assumption were: 97.4% vs 100%; 79.3% vs 93.5%; 72.6% vs 89.4% and 98.2% vs 100.0%. Higher sensitivity was observed for the second assumption, while higher specificity was recorded for the first assumption. Specificity was significantly higher for NBI than for WLE (p < 0.001). Conclusions: NBI allows to detect and differentiate laryngeal lesions, which are invisible in WLE. Endoscopic examination, especially in NBI mode, is non-invasive, repeatable and remains a useful tool in the daily practice and diagnosis of patients with pathological lesions in the larynx.