Evaluating Laryngopharyngeal Tumor Extension Using Narrow Band Imaging Versus Conventional White Light Imaging
Corresponding Author
Manon A. Zwakenberg MD
Department of Otorhinolaryngology, Head and Neck Surgery, University of Groningen, University Medical Center Groningen, Groningen, The Netherlands
Send correspondence to Manon A. Zwakenberg, Department of Otorhinolaryngology, Head and Neck Surgery, University of Groningen, University Medical Center Groningen, P.O. Box 30.001, 9700RB Groningen, The Netherlands. E-mail: [email protected].
Search for more papers by this authorGyorgy B. Halmos MD, PhD
Department of Otorhinolaryngology, Head and Neck Surgery, University of Groningen, University Medical Center Groningen, Groningen, The Netherlands
Search for more papers by this authorJan Wedman MD, PhD
Department of Otorhinolaryngology, Head and Neck Surgery, University of Groningen, University Medical Center Groningen, Groningen, The Netherlands
Search for more papers by this authorBernard F. A. M. van der Laan MD, PhD
Department of Otorhinolaryngology, Head and Neck Surgery, University of Groningen, University Medical Center Groningen, Groningen, The Netherlands
Department of Otorhinolaryngology, Head and Neck Surgery, Haaglanden Medical Center, The Hague, The Netherlands
Search for more papers by this authorBoudewijn E. C. Plaat MD, PhD
Department of Otorhinolaryngology, Head and Neck Surgery, University of Groningen, University Medical Center Groningen, Groningen, The Netherlands
Search for more papers by this authorCorresponding Author
Manon A. Zwakenberg MD
Department of Otorhinolaryngology, Head and Neck Surgery, University of Groningen, University Medical Center Groningen, Groningen, The Netherlands
Send correspondence to Manon A. Zwakenberg, Department of Otorhinolaryngology, Head and Neck Surgery, University of Groningen, University Medical Center Groningen, P.O. Box 30.001, 9700RB Groningen, The Netherlands. E-mail: [email protected].
Search for more papers by this authorGyorgy B. Halmos MD, PhD
Department of Otorhinolaryngology, Head and Neck Surgery, University of Groningen, University Medical Center Groningen, Groningen, The Netherlands
Search for more papers by this authorJan Wedman MD, PhD
Department of Otorhinolaryngology, Head and Neck Surgery, University of Groningen, University Medical Center Groningen, Groningen, The Netherlands
Search for more papers by this authorBernard F. A. M. van der Laan MD, PhD
Department of Otorhinolaryngology, Head and Neck Surgery, University of Groningen, University Medical Center Groningen, Groningen, The Netherlands
Department of Otorhinolaryngology, Head and Neck Surgery, Haaglanden Medical Center, The Hague, The Netherlands
Search for more papers by this authorBoudewijn E. C. Plaat MD, PhD
Department of Otorhinolaryngology, Head and Neck Surgery, University of Groningen, University Medical Center Groningen, Groningen, The Netherlands
Search for more papers by this authorAbstract
Objective/Hypothesis
Comparing detection and extension of malignant tumors by flexible laryngoscopy in the outpatient setting with laryngoscopy under general anesthesia using both White Light Imaging (WLI) and Narrow Band Imaging (NBI).
Study Design
Prospective study.
Methods
Two hundred and thirty-three patients with laryngeal and pharyngeal lesions underwent flexible and rigid laryngoscopy, with both WLI and NBI. Extension of malignant lesions (n = 132) was compared between both techniques in detail.
Results
Sensitivity of NBI during flexible endoscopy (92%), was comparable with that of WLI during rigid endoscopy (91%). The correlation of tumor extension between flexible and rigid laryngoscopy was high (rs = 0.852–0.893). The observed tumor extension was significantly larger when using NBI in both settings. The use of NBI during flexible laryngoscopy leads to upstaging (12%) and downstaging (2%) of the T classification.
Conclusions
NBI during flexible laryngoscopy could be an alternative to WLI rigid endoscopy. NBI improves visualization of tumor extension and accuracy of T staging.
Level of Evidence
3 Laryngoscope, 131:E2222–E2231, 2021
Supporting Information
| Filename | Description |
|---|---|
| lary29361-sup-0001-TableS1.docxWord 2007 document , 16.5 KB | Supporting Table 1. Overview of all “detailed subsites,” which are the official TNM sites and subsites further into smaller areas. |
Please note: The publisher is not responsible for the content or functionality of any supporting information supplied by the authors. Any queries (other than missing content) should be directed to the corresponding author for the article.
BIBLIOGRAPHY
- 1Cosway B, Drinnan M, Paleri V. Narrow band imaging for the diagnosis of head and neck squamous cell carcinoma: a systematic review. Head Neck 2016; 38:E2358-67.
- 2Ni XG, He S, Xu ZG, et al. Endoscopic diagnosis of laryngeal cancer and precancerous lesions by narrow band imaging. J Laryngol Otol 2011; 125: 288–296.
- 3Zwakenberg MA, Plaat BEC. A Photographic Atlas of Lesions in the Pharynx and Larynx: Conventional White Light Imaging Versus Narrow Band Imaging. 1st ed. Groningen: Olympus Europa SE & CO. KG/University Medical Center; 2019.
- 4Hosono H, Katada C, Okamoto T, et al. Usefulness of narrow band imaging with magnifying endoscopy for the differential diagnosis of cancerous and noncancerous laryngeal lesions. Head Neck 2019; 41: 2555–2560.
- 5Ansari UH, Wong E, Smith M, et al. Validity of narrow band imaging in the detection of oral and oropharyngeal malignant lesions: a systematic review and meta-analysis. Head Neck 2019; 41: 2430–2440.
- 6Bertino G, Cacciola S, Fernandes WB Jr, et al. Effectiveness of narrow band imaging in the detection of premalignant and malignant lesions of the larynx: validation of a new endoscopic clinical classification. Head Neck 2015; 37: 215–222.
- 7Piazza C, Cocco D, De Benedetto L, Del Bon F, Nicolai P, Peretti G. Narrow band imaging and high definition television in the assessment of laryngeal cancer: a prospective study on 279 patients. Eur Arch Otorhinolaryngol 2010; 267: 409–414.
- 8Kraft M, Fostiropoulos K, Gurtler N, Arnoux A, Davaris N, Arens C. Value of narrow band imaging in the early diagnosis of laryngeal cancer. Head Neck 2016; 38: 15–20.
- 9Garofolo S, Piazza C, Del Bon F, et al. Intraoperative narrow band imaging better delineates superficial resection margins during transoral laser microsurgery for early glottic cancer. Ann Otol Rhinol Laryngol 2015; 124: 294–298.
- 10Campo F, D'Aguanno V, Greco A, Ralli M, de Vincentiis M. The prognostic value of adding narrow-band imaging in transoral laser microsurgery for early glottic cancer: a review. Lasers Surg Med 2020; 52: 301–306.
- 11Tirelli 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.
- 12Vicini C, Montevecchi F, D'Agostino G, DE Vito A. Meccariello G. a novel approach emphasising intra-operative superficial margin enhancement of head-neck tumours with narrow-band imaging in transoral robotic surgery. Acta Otorhinolaryngol Ital 2015; 35: 157–161.
- 13Richards AL, Sugumaran M, Aviv JE, Woo P, Altman KW. The utility of office-based biopsy for laryngopharyngeal lesions: comparison with surgical evaluation. Laryngoscope 2015; 125: 909–912.
- 14Wellenstein DJ, de Witt JK, Schutte HW, et al. Safety of flexible endoscopic biopsy of the pharynx and larynx under topical anesthesia. Eur Arch Otorhinolaryngol 2017; 274: 3471–3476.
- 15Zalvan CH, Brown DJ, Oiseth SJ, Roark RM. Comparison of trans-nasal laryngoscopic office based biopsy of laryngopharyngeal lesions with traditional operative biopsy. Eur Arch Otorhinolaryngol 2013; 270: 2509–2513.
- 16Chan YH. Biostatistics 104: correlational analysis. Singapore Med J 2003; 44: 614–619.
- 17Lin YC, Wang WH, Lee KF, Tsai WC, Weng HH. Value of narrow band imaging endoscopy in early mucosal head and neck cancer. Head Neck 2012; 34: 1574–1579.
- 18Chu PY, Tsai TL, Tai SK, Chang SY. Effectiveness of narrow band imaging in patients with oral squamous cell carcinoma after treatment. Head Neck 2012; 34: 155–161.
- 19Zabrodsky M, Lukes P, Lukesova E, Boucek J, Plzak J. The role of narrow band imaging in the detection of recurrent laryngeal and hypopharyngeal cancer after curative radiotherapy. Biomed Res Int 2014; 2014:175398.
- 20Yang 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.
- 21Nonaka S, Saito Y, Oda I, Kozu T, Saito D. Narrow-band imaging endoscopy with magnification is useful for detecting metachronous superficial pharyngeal cancer in patients with esophageal squamous cell carcinoma. J Gastroenterol Hepatol 2010; 25: 264–269.
- 22Piazza C, Cocco D, De Benedetto L, Bon FD, Nicolai P, Peretti G. Role of narrow-band imaging and high-definition television in the surveillance of head and neck squamous cell cancer after chemo- and/or radiotherapy. Eur Arch Otorhinolaryngol 2010; 267: 1423–1428.
- 23Zhou H, Zhang J, Guo L, Nie J, Zhu C, Ma X. The value of narrow band imaging in diagnosis of head and neck cancer: a meta-analysis. Sci Rep 2018; 8: 515.
- 24Zwakenberg MA, Dikkers FG, Wedman J, van der Laan BFAM, Halmos GB, Plaat BEC. Detection of high-grade dysplasia, carcinoma in situ and squamous cell carcinoma in the upper aerodigestive tract: recommendations for optimal use and interpretation of narrow-band imaging. Clin Otolaryngol 2019; 44: 39–46.
- 25Watanabe A, Taniguchi M, Tsujie H, Hosokawa M, Fujita M, Sasaki S. The value of narrow band imaging for early detection of laryngeal cancer. Eur Arch Otorhinolaryngol 2009; 266: 1017–1023.
- 26Lukes P, Zabrodsky M, Lukesova E, et al. The role of NBI HDTV magnifying endoscopy in the prehistologic diagnosis of laryngeal papillomatosis and spinocellular cancer. Biomed Res Int 2014; 2014:285486.
- 27Lin YC, Watanabe A, Chen WC, Lee KF, Lee IL, Wang WH. Narrowband imaging for early detection of malignant tumors and radiation effect after treatment of head and neck cancer. Arch Otolaryngol Head Neck Surg 2010; 136: 234–239.
- 28Farah CS. Narrow band imaging-guided resection of oral cavity cancer decreases local recurrence and increases survival. Oral Dis 2018; 24: 89–97.
- 29Plaat BEC, Zwakenberg MA, van Zwol JG, et al. Narrow-band imaging in transoral laser surgery for early glottic cancer in relation to clinical outcome. Head Neck 2017; 39: 1343–1348.
- 30Mannelli G, Cecconi L, Gallo O. Laryngeal preneoplastic lesions and cancer: challenging diagnosis. Qualitative literature review and meta-analysis. Crit Rev Oncol Hematol 2016; 106: 64–90.
- 31Adolphs AP, Boersma NA, Diemel BD, et al. A systematic review of computed tomography detection of cartilage invasion in laryngeal carcinoma. Laryngoscope 2015; 125: 1650–1655.
- 32Becker M, Burkhardt K, Dulguerov P, Allal A. Imaging of the larynx and hypopharynx. Eur J Radiol 2008; 66: 460–479.
- 33Becker M. Diagnosis and staging of laryngeal tumors with CT and MRI. Radiologe 1998; 38: 93–100.
- 34Charlin B, Brazeau-Lamontagne L, Guerrier B, Leduc C. Assessment of laryngeal cancer: CT scan versus endoscopy. J Otolaryngol 1989; 18: 283–288.
- 35Little SG, Rice TW, Bybel B, et al. Is FDG-PET indicated for superficial esophageal cancer? Eur J Cardiothorac Surg 2007; 31: 791–796.
- 36Miyata H, Doki Y, Yasuda T, et al. Evaluation of clinical significance of 18F-fluorodeoxyglucose positron emission tomography in superficial squamous cell carcinomas of the thoracic esophagus. Dis Esophagus 2008; 21: 144–150.
- 37Sulfaro S, Barzan L, Querin F, et al. T staging of the laryngohypopharyngeal carcinoma. A 7-year multidisciplinary experience. Arch Otolaryngol Head Neck Surg 1989; 115: 613–620.
- 38Zbaren P, Christe A, Caversaccio MD, Stauffer E, Thoeny HC. Pretherapeutic staging of recurrent laryngeal carcinoma: clinical findings and imaging studies compared with histopathology. Otolaryngol Head Neck Surg 2007; 137: 487–491.
- 39Zbaren P, Weidner S, Thoeny HC. Laryngeal and hypopharyngeal carcinomas after (chemo)radiotherapy: a diagnostic dilemma. Curr Opin Otolaryngol Head Neck Surg 2008; 16: 147–153.
- 40van de Ven S, Bugter O, Hardillo JA, Bruno MJ, Baatenburg de Jong RJ, Koch AD. Screening for head and neck second primary tumors in patients with esophageal squamous cell cancer: a systematic review and meta-analysis. United Eur Gastroenterol J 2019; 7: 1304–1311.
- 41Rosen CA, Amin MR, Sulica L, et al. Advances in office-based diagnosis and treatment in laryngology. Laryngoscope 2009; 119:S185–212.
- 42Ishihara R, Takeuchi Y, Chatani R, et al. Prospective evaluation of narrow-band imaging endoscopy for screening of esophageal squamous mucosal high-grade neoplasia in experienced and less experienced endoscopists. Dis Esophagus 2010; 23: 480–486.
- 43Zwakenberg MA, Dikkers FG, Wedman J, Halmos GB, van der Laan BF, Plaat BE. Narrow band imaging improves observer reliability in evaluation of upper aerodigestive tract lesions. Laryngoscope 2016; 126: 2276–2281.
Citing Literature
