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This Article Full Text (PDF) Free Supplementary Figures and NBI Abstract All Versions of this Article: chest.06-2794v1 131/6/1794    most recent Submit a response Alert me when this article is cited Alert me when eLetters are posted Alert me if a correction is posted Services Email this article to a friend Similar articles in this journal Similar articles in PubMed Alert me to new issues of the journal Add to My Personal Article Archive Download to citation manager Citing Articles Citing Articles via Google Scholar Google Scholar Articles by Vincent, B. D. Articles by Silvestri, G. A. Search for Related Content PubMed PubMed Citation Articles by Vincent, B. D. Articles by Silvestri, G. A.

A Pilot Study of Narrow Band Imaging Compared to White Light Bronchoscopy for Evaluation of Normal Airways, Pre-Malignant and Malignant Airways Disease

¹Medical University of South Carolina, Department of Internal Medicine, Division of Pulmonary and Critical Care, Allergy and Sleep Medicine ²Medical University of South Carolina, Department of Cellular and Molecular Pathology

silvestri{at}musc.edu

Abstract

BackgroundThe objectives of this study were to: Characterize the appearance of normal, dysplastic and frankly malignant airway lesion appearance under Narrow Band Imaging (NBI) and second to determine if NBI, when used in conjunction with white light bronchoscopy, could improve detection of dysplasia and malignancy.

Patients and methodsThis was a prospective, partially blinded study at a university teaching hospital. Bronchoscopy was performed on 22 patients with known or suspected bronchial dysplasia or malignancy. Full airway examination was carried out first under white-light and then under NBI. Directed endobronchial biopsies of likely dysplastic, malignant and normal (control) areas were then performed and sent for examination by a pathologist blinded to the gross description of the lesion. Results of pathologic interpretation were then compared to the corresponding white-light and NBI images.

ResultsThere were one malignant and four dysplastic lesions out of 22 patients detected by NBI where white light imaging was considered normal. In cases where the white light appearance was abnormal, NBI did not improve diagnostic yield. The increased rate of detection of dysplasia and malignancy by NBI was statistically significant (p=0.005).

ConclusionNBI identified dysplasia or malignancy that was not detected by white light inspection in 23% of subjects. Further studies are needed to determine the efficacy of NBI in detection of pre-malignant airways lesions in an at-risk population.