A meta-analysis of narrow-band imaging for the diagnosis of primary nasopharyngeal carcinoma

Background: Narrow band imaging (NBI), an endoscopic technique featuring an augmented definition of microvasculature and mucosal patterns. NBI is increasingly advocated as a tool to characterize neoplasia and intestinal metaplasia in endoscopic standards, such as for colorectal polyps and tumors. Recently NBI has also been studied in the detection of Nasopharyngeal Carcinoma (NPC). Here we aimed to assess the diagnostic utility of NBI for the diagnosis of NPC. Methods: A meta-analysis of studies comparing narrow-band imaging and white light endoscopy in the diagnosis of primary nasopharyngeal carcinoma was performed. The review process involved two independent investigators. The databases used were MEDLINE, PubMed, the Cochrane library, Embase, and the Web of Science. Statistical analysis was performed with OpenMetaAnalyst, MetaDiSc version 1.4, and Medcalc version 17.9.7. Results: Five studies including 2480 patients were included. The sensitivity and specificity for narrow-band imaging were 0.90 (0.73-0.97) and 0.95 (0.81-0.99) respectively. The positive likelihood ratio and negative likelihood ratio were 18.82 (0.31-82.1) and 0.08 (0.02-0.31). For white light endoscopy, the sensitivity and specificity were 0.77 (0.58-0.89) and 0.91 (0.79-0.96). The positive likelihood ratio was 7.61 (3.61-16.04), and the negative likelihood ratio was 0.21 (0.11-0.39). The odds ratio for detection rates between narrow-band imaging and white light endoscopy was 4.29 (0.56-33.03, p = 0.16). Area under the curve for narrow-band imaging was 0.98 (SE: 0.02), and for white light it was 0.93 (SE: 0.03). There was no significant difference in the receiver operating characteristic curves between the two modalities (p = 0.14). Conclusion: Narrow-band imaging showed a higher sensitivity and positive likelihood ratio for the diagnosis of nasopharyngeal carcinoma. However, there was no significant difference in detection rates compared to white light endoscopy. Further investigation with a uniform diagnostic criteria and terminology is needed for narrow-band imaging in the diagnosis of nasopharyngeal carcinoma.

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White-light endoscopy versus magnifying narrow-band imaging for diagnosis of the histological subtype of gastric cancer

10.1101/2020.09.21.20198846 ◽

2020 ◽

Author(s):

Takashi Kanesaka ◽

Noriya Uedo ◽

Hisashi Doyama ◽

Naohiro Yoshida ◽

Takashi Nagahama ◽

...

Keyword(s):

Gastric Cancer ◽

Likelihood Ratio ◽

White Light ◽

Narrow Band ◽

Narrow Band Imaging ◽

Tertiary Care ◽

Positive Likelihood Ratio ◽

White Light Endoscopy ◽

Significant Difference ◽

Undifferentiated Type

Objective: Distinguishing undifferentiated-type (diffuse-type) from differentiated-type (intestinal-type) cancer is crucial for determining the indication of endoscopic resection for gastric cancer. This study aimed to evaluate on-site diagnostic performance of conventional white-light endoscopy (WLE) and magnifying narrow-band imaging (M-NBI) in determining the subtype of gastric cancer. Design: We conducted a multicenter prospective single-arm trial. Patients who planned to undergo treatment for histologically proven cT1 gastric cancer were recruited from six tertiary care institutions. The primary and key secondary endpoints were diagnostic accuracy and specificity, respectively. The diagnostic algorithm of WLE was based on lesion color. The M-NBI algorithm was based on the microsurface and microvascular patterns. Results: A total of 208 patients were enrolled. After protocol endoscopy, 167 gastric cancers were included in the analysis. The accuracy, sensitivity, specificity, and positive likelihood ratio of WLE for undifferentiated-type cancer were 80% (95% CI 73%-86%), 69% (53%-82%), 84% (77%-90%), and 4.4 (2.8-7.0), respectively. Those of M-NBI were 82% (75%-88%), 53% (38%-68%), 93% (87%-97%), and 7.2 (3.6-14.4), respectively. There was no significant difference in accuracy between WLE and M-NBI (p = 0.755), but specificity was significantly higher with M-NBI than with WLE (p = 0.041). Those of M-NBI combined with WLE were 81% (74%-87%), 38% (24%-54%), 97% (92%-99%), and 11.5 (4.1-32.4), respectively. Conclusion: M-NBI is more specific than WLE in distinguishing undifferentiated-type from differentiated-type gastric cancer and M-NBI combined with WLE is highly reliable (positive likelihood ratio >10). Trial registration number UMIN000032151.

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Diagnostic Performance of Narrow Band Imaging for Nasopharyngeal Cancer: A Systematic Review and Meta-analysis

Otolaryngology ◽

10.1177/0194599818758302 ◽

2018 ◽

Vol 159 (1) ◽

pp. 17-24 ◽

Cited By ~ 1

Author(s):

Changling Sun ◽

Yayun Zhang ◽

Xue Han ◽

Xiaodong Du

Keyword(s):

Likelihood Ratio ◽

White Light ◽

Odds Ratio ◽

Narrow Band Imaging ◽

Meta Analysis ◽

Nasopharyngeal Cancer ◽

Positive Likelihood Ratio ◽

Negative Likelihood Ratio ◽

Diagnostic Odds Ratio ◽

White Light Endoscopy

Objective The purposes of this study were to verify the effectiveness of the narrow band imaging (NBI) system in diagnosing nasopharyngeal cancer (NPC) as compared with white light endoscopy. Data Sources PubMed, Cochrane Library, EMBASE, CNKI, and Wan Fang databases. Review Methods Data analyses were performed with Meta-Disc. The updated Quality Assessment of Diagnostic Accuracy Studies–2 tool was used to assess study quality and potential bias. Publication bias was assessed with a Deeks asymmetry test. The registry number of the protocol published on PROSPERO is CRD42015026244. Results This meta-analysis included 10 studies of 1337 lesions. For NBI diagnosis of NPC, the pooled values were as follows: sensitivity, 0.83 (95% CI, 0.80-0.86); specificity, 0.91 (95% CI, 0.89-0.93); positive likelihood ratio, 8.82 (95% CI, 5.12-15.21); negative likelihood ratio, 0.18 (95% CI, 0.12-0.27); and diagnostic odds ratio, 65.73 (95% CI, 36.74-117.60). The area under the curve was 0.9549. For white light endoscopy in diagnosing NPC, the pooled values were as follows: sensitivity, 0.79 (95% CI, 0.75-0.83); specificity, 0.87 (95% CI, 0.84-0.90); positive likelihood ratio, 5.02 (95% CI, 1.99-12.65); negative likelihood ratio, 0.34 (95% CI, 0.24-0.49); and diagnostic odds ratio, 16.89 (95% CI, 5.98-47.66). The area under the curve was 0.8627. The evaluation of heterogeneity, calculated per the diagnostic odds ratio, gave an I2 of 0.326. No marked publication bias ( P = .68) existed in this meta-analysis. Conclusion The sensitivity and specificity of NBI for the diagnosis of NPC are similar to those of white light endoscopy, and the potential value of NBI for the diagnosis of NPC needs to be validated further.

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Narrow band imaging endoscopy of the nasopharynx is not more useful than white light endoscopy for suspected nasopharyngeal carcinoma

European Archives of Oto-Rhino-Laryngology ◽

10.1007/s00405-016-3940-6 ◽

2016 ◽

Vol 273 (10) ◽

pp. 3363-3369 ◽

Cited By ~ 5

Author(s):

Alexander C. Vlantis ◽

John K. S. Woo ◽

Michael C. F. Tong ◽

Ann D. King ◽

William Goggins ◽

...

Keyword(s):

Nasopharyngeal Carcinoma ◽

White Light ◽

Narrow Band ◽

Narrow Band Imaging ◽

White Light Endoscopy

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The Impact of Narrow-band Imaging on the Pre- and Intra- operative Assessments of Neoplastic and Preneoplastic Laryngeal Lesions. A Systematic Review

International Archives of Otorhinolaryngology ◽

10.1055/s-0040-1719119 ◽

2020 ◽

Author(s):

Carmelo Saraniti ◽

Enzo Chianetta ◽

Giuseppe Greco ◽

Norhafiza Mat Lazim ◽

Barbara Verro

Keyword(s):

White Light ◽

Diagnostic Tool ◽

Narrow Band ◽

Narrow Band Imaging ◽

Resection Margins ◽

Predictive Values ◽

White Light Endoscopy ◽

Laryngeal Lesions ◽

Sensitivity Specificity ◽

The Impact

Introduction Narrow-band imaging is an endoscopic diagnostic tool that, focusing on superficial vascular changes, is useful to detect suspicious laryngeal lesions, enabling their complete excision with safe and tailored resection margins. Objectives To analyze the applications and benefits of narrow-band imaging in detecting premalignant and malignant laryngeal lesions through a comparison with white-light endoscopy. Data Synthesis A literature search was performed in the PubMed, Scopus and Web of Science databases using strict keywords. Then, two authors independently analyzed the articles, read the titles and abstracts, and read completely only the relevant studies according to certain eligibility criteria. In total, 14 articles have been included in the present review; the sensitivity, specificity, positive and negative predictive values, and accuracy of pre- and/or intraoperative narrow-band imaging were analyzed. The analysis showed that narrow-band imaging is better than white-light endoscopy in terms of sensitivity, specificity, positive and negative predictive values, and accuracy regarding the ability to identify cancer and/or precancerous laryngeal lesions. Moreover, the intraoperative performance of narrow-band imaging resulted more effective than the in-office performance. Conclusion Narrow-band imaging is an effective diagnostic tool to detect premalignant and malignant laryngeal lesions and to define proper resection margins. Moreover, narrow-band imaging is useful in cases of leukoplakia that may cover a possible malignant lesion and that cannot be easily assessed with white-light endoscopy. Finally, a shared, simple and practical classification of laryngeal lesions, such as that of the European Laryngological Society, is required to identify a shared lesion management strategy. Key Points

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Qualitative Alpha-defensin Versus The Main Available Tests For The Diagnosis Of Periprosthetic Joint Infection: Best Predictor Test?

Journal of Bone and Joint Infection ◽

10.7150/jbji.26401 ◽

2018 ◽

Vol 3 (3) ◽

pp. 156-164 ◽

Cited By ~ 11

Author(s):

Giovanni Riccio ◽

Luca Cavagnaro ◽

Wassim Akkouche ◽

Giuliana Carrega ◽

Lamberto Felli ◽

...

Keyword(s):

Likelihood Ratio ◽

Periprosthetic Joint Infection ◽

Joint Infection ◽

Positive Likelihood Ratio ◽

Negative Likelihood Ratio ◽

Diagnostic Methods ◽

Minimal Amount ◽

Musculoskeletal Infection ◽

Infection Diagnosis ◽

Significant Difference

Abstract. Introduction: Biomarkers such as α-defensin demonstrated to be a potentially useful option in periprosthetic joint infection (PJI) diagnosis. Recently, a new point-of-care test for α-defensin level detection in synovial fluid has been commercialized in Europe. The aim of this study is to compare the α-defensin test (SynovasureTM) diagnostic ability with the main available clinical tests for periprosthetic joint infection diagnosis in a practical clinical setting of a Bone Infection Unit.Methods: Between 2015 and 2017, 146 patients with suspected chronic PJI were screened with SynovasureTM. Seventy-three of these met the Musculoskeletal Infection Society (MSIS) criteria and were included in the analysis. According to MSIS criteria, 40 patients (54.7%) were classified as infected and 33 (45.3%) as not infected. The results obtained with SynovasureTM were recorded and compared with standard diagnostic methods for PJI diagnosis.Results: SynovasureTM showed a sensitivity of 85.0 % (95% CI 70.2 to 94.3) and a specificity of 96.9 % (95% CI 83.8 to 99.9) for PJI detection. The positive likelihood ratio of SynovasureTM was 27.2 (95% CI 3.9 to 188.1) and the negative likelihood ratio was 0.2 (95% CI 0.1 to 0.3). The diagnostic odds ratio was 181.3 (95% CI 20.7 to 1590.4). SynovasureTM demonstrated a statistical significant difference when compared to Erythrocyte Sedimentation Rate (ESR) and C-reactive Protein (CRP) specificity (at least one positive test) and preoperative culture sensitivity (1 positive culture).Conclusion: Our findings show that SynovasureTM sensitivity is lower than quantitative α-D test, but when compared to the main available tests shows a good specificity and the highest DOR. On the SF it is the easier test to do, due to the fact that it needs a minimal amount of SF and it is not limited by blood contamination or antibiotic use. Whereas there is no single standalone test, SynovasureTM should be considered a reliable additional test for periprosthetic joint infection diagnosis in everyday clinical practice.

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