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Annals of Surgical Oncology
Published in: Annals of Surgical Oncology 4/2018

01-04-2018 | Gynecologic Oncology

Prospective Comparative Study of Laparoscopic Narrow Band Imaging (NBI) Versus Standard Imaging in Gynecologic Oncology

Authors: Alessia Aloisi, MD, Yukio Sonoda, MD, Ginger J. Gardner, MD, Kay J. Park, MD, Sarah L. Elliott, MD, Qin C. Zhou, MS, Alexia Iasonos, PhD, Nadeem R. Abu-Rustum, MD

Published in: Annals of Surgical Oncology | Issue 4/2018

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Abstract

Background

Narrow band imaging (NBI) is an optic filtration enhancement for endoscopy that uses two wavelengths of light (415 and 540 nm) to highlight superficial microvascular patterns. It has been successfully utilized to improve identification of lesions with abnormal vasculature, which is associated with endometriosis and endometrial cancer. Case studies suggest it may also facilitate surgical staging of gynecologic cancer, which is critical in determining appropriate adjuvant therapies. A technology that enhances the ability to identify metastatic disease during minimally invasive surgery (MIS) could make an important difference in patient outcomes.

Methods

A prospective comparative study was conducted to evaluate patients with clinical indication for diagnostic or operative laparoscopy. All received white light imaging followed by NBI during the same procedure. Suspicious lesions were examined and photographed, using both modalities, before excision. The two techniques were compared. Positive predictive value, negative predictive value, and diagnostic accuracy in identifying histologically confirmed metastatic lesions were assessed, using appropriate statistical methods.

Results

Of 124 patients enrolled in the study, 94 were evaluable; 30 did not undergo MIS and were therefore excluded. A significantly higher number of peritoneal abnormalities were identified with NBI versus white light imaging (P = 0.0239). However, no statistically significant difference (P = 0.18, patient level) was observed in identification of histologically confirmed metastatic disease.

Conclusions

NBI imaging provides a unique contrast between peritoneal surface and microvascular patterns. However, the results of this study suggest that NBI-enhanced laparoscopy does not provide superior detection of peritoneal surface malignancy compared with standard white light high-definition laparoscopy.
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Metadata
Title
Prospective Comparative Study of Laparoscopic Narrow Band Imaging (NBI) Versus Standard Imaging in Gynecologic Oncology
Authors
Alessia Aloisi, MD
Yukio Sonoda, MD
Ginger J. Gardner, MD
Kay J. Park, MD
Sarah L. Elliott, MD
Qin C. Zhou, MS
Alexia Iasonos, PhD
Nadeem R. Abu-Rustum, MD
Publication date
01-04-2018
Publisher
Springer International Publishing
Published in
Annals of Surgical Oncology / Issue 4/2018
Print ISSN: 1068-9265
Electronic ISSN: 1534-4681
DOI
https://doi.org/10.1245/s10434-017-6314-4

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