title: Does narrow band imaging improve preoperative detection of glottic malignancy? A matched comparison study.
abstract: The primary suspicion for glottic malignancy during office laryngoendoscopy is based on lesion appearance. Previous studies investigating laryngeal use of narrow band imaging (NBI) are mostly descriptive. The additive value of NBI relative to white light (WL) requires further investigation.
  
  
  
  Observational matched study.
  
  
  
  NBI was compared with WL images of 45 vocal fold lesions suspected for malignancy (21 carcinoma, 22 dysplasia, two benign). All images were presented randomly and evaluated by six independent otolaryngology specialists. The observers were asked to estimate lesion size, location, and pathology. The results for the two imaging modalities were compared with each other and with the final pathology.
  
  
  
  The observers estimated lesion size to be larger in the NBI images by an average of 9% (2.4 mm2; P =.04) compared to WL. In 64.6% of cases, the observers estimated similar pathology for NBI and WL. When there was a discrepancy, the estimated pathology was "malignant" in 24.3% by NBI, compared with 11.1% by WL. Overall, 44.7% of the lesions were estimated to be malignant by NBI, compared with 33.8% by WL (P =.001). The sensitivity and specificity rates for malignancy detection by NBI were 58.6% and 61.2%, respectively, compared to 48.7% and 76.1% by WL.
  
  
  
  Observers tend to estimate vocal fold lesions to be larger and more frequently suspect malignancy while assessing NBI images. Compared with WL, NBI demonstrates increased sensitivity and decreased specificity for detection of malignancy. Nevertheless, the specificity and sensitivity of NBI alone are considerably low.
  
  
  
  4 Laryngoscope, 127:894-899, 2017.
authors.affiliation: Department of Otolaryngology-Head and Neck Surgery, Kaplan Medical Center, Rehovot, Israel.|Hadassah Medical School, Hebrew University, Jerusalem, Israel.
authors.forename: Hagit
authors.initials: H
authors.lastname: Shoffel-Havakuk
authors.affiliation: Department of Otolaryngology-Head and Neck Surgery, Kaplan Medical Center, Rehovot, Israel.|Hadassah Medical School, Hebrew University, Jerusalem, Israel.
authors.forename: Yonatan
authors.initials: Y
authors.lastname: Lahav
authors.affiliation: Hadassah Medical School, Hebrew University, Jerusalem, Israel.
authors.forename: Barak
authors.initials: B
authors.lastname: Meidan
authors.affiliation: Department of Otolaryngology-Head and Neck Surgery, Kaplan Medical Center, Rehovot, Israel.
authors.forename: Yaara
authors.initials: Y
authors.lastname: Haimovich
authors.affiliation: Department of Otolaryngology-Head and Neck Surgery, Kaplan Medical Center, Rehovot, Israel.|Hadassah Medical School, Hebrew University, Jerusalem, Israel.
authors.forename: Meir
authors.initials: M
authors.lastname: Warman
authors.affiliation: Schneider Children's Medical Center, Petah Tikva, Israel.|Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel.
authors.forename: Moshe
authors.initials: M
authors.lastname: Hain
authors.affiliation: Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel.|Department of Otolaryngology-Head and Neck Surgery, Rabin Medical Center, Petah Tikva, Israel.
authors.forename: Yaniv
authors.initials: Y
authors.lastname: Hamzany
authors.affiliation: Department of Otolaryngology-Head and Neck Surgery, Bnai Zion Medical Center, Haifa, Israel.|Rappaport Faculty of Medicine, Technion-Israel Institute of Technology, Haifa, Israel.
authors.forename: Alexander
authors.initials: A
authors.lastname: Brodsky
authors.affiliation: Hadassah Medical School, Hebrew University, Jerusalem, Israel.|Department of Otolaryngology, Head and Neck Surgery, Hadassah Medical Center, Jerusalem, Israel.
authors.forename: Tali
authors.initials: T
authors.lastname: Landau-Zemer
authors.affiliation: Department of Otolaryngology-Head and Neck Surgery, Kaplan Medical Center, Rehovot, Israel.|Hadassah Medical School, Hebrew University, Jerusalem, Israel.
authors.forename: Doron
authors.initials: D
authors.lastname: Halperin
mesh_terms: D016022:Case-Control Studies; D018572:Disease-Free Survival; D005260:Female; D005931:Glottis / Q000000981:diagnostic imaging / Q000473:pathology*; D006801:Humans; D007822:Laryngeal Neoplasms / Q000000981:diagnostic imaging* / Q000401:mortality / Q000473:pathology / Q000601:surgery; D007825:Laryngectomy / Q000379:methods / Q000401:mortality; D007828:Laryngoscopy / Q000379:methods*; D008027:Light; D008297:Male; D062048:Narrow Band Imaging / Q000379:methods*; D015588:Observer Variation; D011300:Preoperative Care / Q000379:methods; D018570:Risk Assessment; D012680:Sensitivity and Specificity; D015996:Survival Rate; D016896:Treatment Outcome; D014827:Vocal Cords / Q000000981:diagnostic imaging* / Q000473:pathology / Q000601:surgery
keywords: Laryngoscopy; early glottic cancer; larynx; narrow band imaging; vascularization