Narrow-Band Bronchoscopy Assists in Early Lung Cancer Detection

Narrow-band imaging increases the specificity of bronchoscopic early lung cancer detection, and can serve as an alternative detection device, according to a new study.

Researchers from the University of Heidelberg (Germany) conducted a 10-month review of 62 patients in need of airway screening and surveillance. The patients were randomized into groups receiving white light bronchoscopy (WLB), autofluorescence imaging (AFI), or narrow-band imaging (NBI) bronchoscopy; any observed abnormal airway mucosa was biopsied. Five of the patients had invasive cancers and they were excluded from the analysis.

The researchers found that of the remaining 57 patients, 30% were diagnosed with intraepithelial neoplasia. The sensitivity of WLB was 0.18 and the specificity was 0.88. The relative sensitivities of AFI and NBI to WLB were 3.7 and 3.0, respectively, significantly superior to WLB alone. Combining AFI and NBI did not increase diagnostic yield significantly, and the sequence of performing AFI and NBI did not affect findings. NBI also provided relatively high levels of specificity when compared to AFI. The study was published in the September 2009 issue of the Journal of Thoracic Oncology.

"This research shows that when diagnosing early stage lung cancer, using NBI may be a better option than AFI because it increases specificity without compromising sensitivity,” said lead author Felix Herth, M.D., of the department of pneumology and critical care medicine. "Continued research on these detection methods is necessary to further understand the best, most accurate ways to increase early diagnosis in lung cancer.”

Bronchoscopic technologies such as WLB, AFI, and NBI assist in the detection of non-small-cell lung cancer (NSCLC) while still localized to the surface of the lung (at a preinvasive stage), thus improving cure rates. NBI enhances blood vessel morphology within the bronchial airway mucosa by using narrow-bandwidth filters in a red-green-blue sequential illumination system; this results in increases in the contrast between the epithelial surface and the subjacent vascular network.

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