Narrow band imaging reveals field cancerisation undetected by conventional white light: Optical diagnosis versus histopathology

Jeroen M Westra; Manon A Zwakenberg; Gyorgy B Halmos; Bernard F A M van der Laan; Bert van der Vegt; Boudewijn E C Plaat

doi:10.1111/coa.14150

Narrow band imaging reveals field cancerisation undetected by conventional white light: Optical diagnosis versus histopathology

Clin Otolaryngol. 2024 Feb 24. doi: 10.1111/coa.14150. Online ahead of print.

Authors

Jeroen M Westra¹, Manon A Zwakenberg¹, Gyorgy B Halmos¹, Bernard F A M van der Laan^{1

2}, Bert van der Vegt³, Boudewijn E C Plaat¹

Affiliations

¹ Department of Otorhinolaryngology/Head and Neck Surgery, University of Groningen, University Medical Center Groningen, Groningen, The Netherlands.
² Department of Otorhinolaryngology/Head and Neck Surgery, Haaglanden Medical Center, The Hague, The Netherlands.
³ Department of Pathology, University of Groningen, University Medical Center Groningen, Groningen, The Netherlands.

PMID: 38400826
DOI: 10.1111/coa.14150

Abstract

Objective: To assess whether narrow band imaging (NBI) detects fields of cancerisation around suspicious lesions in the upper aerodigestive tract, which were undetected by white light imaging (WLI).

Methods: In 96 patients with laryngeal and pharyngeal lesions suspicious for malignancy, 206 biopsies were taken during laryngoscopy: 96 biopsies of suspicious lesions detected by both WLI and NBI (WLI+/NBI+), 60 biopsies adjacent mucosa only suspicious with NBI (WLI-/NBI+), and 46 biopsies of NBI and WLI unsuspicious mucosa (WLI-/NBI-) as negative controls. Optical diagnosis according to the Ni-classification was compared with histopathology.

Results: Signs of (pre)malignancy were found in 88% of WLI+/NBI+ biopsies, 32% of WLI-/NBI+ biopsies and 0% in WLI-/NBI- (p < .001). In 58% of the WLI-/NBI+ mucosa any form of dysplasia or carcinoma was detected.

Conclusion: The use of additional NBI led to the detection of (pre)malignancy in 32% of the cases, that would have otherwise remained undetected with WLI alone. This highlights the potential of NBI as a valuable adjunct to WLI in the identification of suspicious lesions in the upper aerodigestive tract.

Keywords: field cancerisation; head and neck cancer; histopathology; narrow band imaging; optical diagnosis; white light imaging.

Grants and funding

Olympus