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Michael C F Tong - One of the best experts on this subject based on the ideXlab platform.
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Narrow Band Imaging Endoscopy of the Nasopharynx for Malignancy: An Inter- and Intraobserver Study.
The Laryngoscope, 2018Co-Authors: Alexander C Vlantis, Eddy Wy Wong, Jason Yk Chan, Michael C F TongAbstract:OBJECTIVE To assess interobserver agreement and intraobserver reproducibility when assessing the nasopharynx for malignancy under white light and Narrow Band Imaging endoscopy because the decision to biopsy hinges on the examiner's perceived chance of malignancy. METHODS An interobserver and intraobserver agreement study utilizing white light and Narrow Band endoscopic images of the nasopharynx. The setting was an academic referral hospital. Participants were 156 adults with suspected nasopharyngeal carcinoma who underwent white light and Narrow Band Imaging endoscopy and biopsy. Images of the nasopharynges were subsequently scored for malignancy by four otolaryngologists. The nasopharynx was scored on 4-point scales under white light and Narrow Band Imaging endoscopy for the likelihood of malignancy or abnormality, respectively. RESULTS Intraclass correlation coefficients for intraobserver agreement for nasopharyngeal malignancy for four observers under white light were 0.86, 0.89, 0.79 and 0.88 (mean 0.855), respectively; and under Narrow Band Imaging they were 0.64, 0.68, 0.64, and 0.66 (mean 0.655), respectively (all P values
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A meta-analysis of Narrow-Band Imaging for the diagnosis of primary nasopharyngeal carcinoma
F1000Research, 2018Co-Authors: David C. M. Yeung, Alexander C Vlantis, Michael C F Tong, Eddy Wy Wong, Jason Yk ChanAbstract: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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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, 2016Co-Authors: Alexander C Vlantis, John K S Woo, Michael C F Tong, Ann D King, William B Goggins, Andrew C Van HasseltAbstract:Endoscopy is often used to screen for nasopharyngeal carcinoma. A normal nasopharynx on white light endoscopy may yet harbor subclinical or occult malignancy. This study assessed whether the vascular pattern seen on Narrow Band Imaging endoscopy could indicate this and thus be useful for detecting suspected nasopharyngeal carcinoma. The nasopharynx of 156 patients who failed serological screening for or presented with symptoms of nasopharyngeal carcinoma was graded under white light and Narrow Band Imaging endoscopy and a biopsy taken. The accuracy of assessing the nasopharynx as being probably or definitely malignant on white light endoscopy was high (area under the curve = 0.924), as it was of being normal on Narrow Band Imaging endoscopy (=0.799). The sensitivity and specificity of white light and Narrow Band Imaging endoscopy for nasopharyngeal carcinoma was 93 and 22 %, and 92 and 98 %, respectively. Significantly associated with nasopharyngeal carcinoma was a high index of suspicion or definitely malignant grade on white light endoscopy (p < 0.0005, odds 58.978) and vascular tufts on Narrow Band Imaging endoscopy (p = 0.020, odds 41.210). Narrow Band Imaging endoscopy of vasculature alone for suspected nasopharyngeal carcinoma is not more useful than white light endoscopy of nasopharyngeal morphology, nor does it add to or surpass the diagnostic accuracy of white light endoscopy in this regard.
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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 : official journal of the European Federation of Oto-Rhino-Laryngological Societies (EUFOS) : affiliated wi, 2016Co-Authors: Alexander C Vlantis, John K S Woo, Michael C F Tong, Ann D King, William B Goggins, C. Andrew Van HasseltAbstract:Endoscopy is often used to screen for nasopharyngeal carcinoma. A normal nasopharynx on white light endoscopy may yet harbor subclinical or occult malignancy. This study assessed whether the vascular pattern seen on Narrow Band Imaging endoscopy could indicate this and thus be useful for detecting suspected nasopharyngeal carcinoma. The nasopharynx of 156 patients who failed serological screening for or presented with symptoms of nasopharyngeal carcinoma was graded under white light and Narrow Band Imaging endoscopy and a biopsy taken. The accuracy of assessing the nasopharynx as being probably or definitely malignant on white light endoscopy was high (area under the curve = 0.924), as it was of being normal on Narrow Band Imaging endoscopy (=0.799). The sensitivity and specificity of white light and Narrow Band Imaging endoscopy for nasopharyngeal carcinoma was 93 and 22 %, and 92 and 98 %, respectively. Significantly associated with nasopharyngeal carcinoma was a high index of suspicion or definitely malignant grade on white light endoscopy (p
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Reversal of pale-to-dark nasopharyngeal follicle ratio on Narrow-Band Imaging
Hong Kong medical journal = Xianggang yi xue za zhi, 2010Co-Authors: Alexander C Vlantis, John K S Woo, Michael C F Tong, Amy B.w. Chan, H. S. Chan, C. Andrew Van HasseltAbstract:Normal nasopharyngeal mucosa contains varying amounts of lymphoid tissue, which in adults may be minimal or absent. Nasopharyngeal mucosa with minimal lymphoid tissue has a regular follicular pattern on Narrow-Band Imaging; pale follicles have thin, dark borders and the ratio of the pale follicle to the dark border (pale-to-dark ratio) is roughly 90%. In some patients undergoing routine nasopharyngeal endoscopy, the pale-to-dark ratio is reversed on Narrow-Band Imaging, with dark centres surrounded by pale borders and a pale-to-dark ratio of roughly 50%. These dark follicles may represent abnormal capillary loops, as they have the same appearance as microvascular changes seen on Narrow-Band Imaging of the oesophageal mucosa which indicate dysplasia or malignancy. While this observed change in the follicular pattern may be an early event in the evolution of nasopharyngeal carcinoma, the significance of this finding remains to be confirmed by a larger-scale study.
Alexander C Vlantis - One of the best experts on this subject based on the ideXlab platform.
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Narrow Band Imaging Endoscopy of the Nasopharynx for Malignancy: An Inter- and Intraobserver Study.
The Laryngoscope, 2018Co-Authors: Alexander C Vlantis, Eddy Wy Wong, Jason Yk Chan, Michael C F TongAbstract:OBJECTIVE To assess interobserver agreement and intraobserver reproducibility when assessing the nasopharynx for malignancy under white light and Narrow Band Imaging endoscopy because the decision to biopsy hinges on the examiner's perceived chance of malignancy. METHODS An interobserver and intraobserver agreement study utilizing white light and Narrow Band endoscopic images of the nasopharynx. The setting was an academic referral hospital. Participants were 156 adults with suspected nasopharyngeal carcinoma who underwent white light and Narrow Band Imaging endoscopy and biopsy. Images of the nasopharynges were subsequently scored for malignancy by four otolaryngologists. The nasopharynx was scored on 4-point scales under white light and Narrow Band Imaging endoscopy for the likelihood of malignancy or abnormality, respectively. RESULTS Intraclass correlation coefficients for intraobserver agreement for nasopharyngeal malignancy for four observers under white light were 0.86, 0.89, 0.79 and 0.88 (mean 0.855), respectively; and under Narrow Band Imaging they were 0.64, 0.68, 0.64, and 0.66 (mean 0.655), respectively (all P values
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A meta-analysis of Narrow-Band Imaging for the diagnosis of primary nasopharyngeal carcinoma
F1000Research, 2018Co-Authors: David C. M. Yeung, Alexander C Vlantis, Michael C F Tong, Eddy Wy Wong, Jason Yk ChanAbstract: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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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, 2016Co-Authors: Alexander C Vlantis, John K S Woo, Michael C F Tong, Ann D King, William B Goggins, Andrew C Van HasseltAbstract:Endoscopy is often used to screen for nasopharyngeal carcinoma. A normal nasopharynx on white light endoscopy may yet harbor subclinical or occult malignancy. This study assessed whether the vascular pattern seen on Narrow Band Imaging endoscopy could indicate this and thus be useful for detecting suspected nasopharyngeal carcinoma. The nasopharynx of 156 patients who failed serological screening for or presented with symptoms of nasopharyngeal carcinoma was graded under white light and Narrow Band Imaging endoscopy and a biopsy taken. The accuracy of assessing the nasopharynx as being probably or definitely malignant on white light endoscopy was high (area under the curve = 0.924), as it was of being normal on Narrow Band Imaging endoscopy (=0.799). The sensitivity and specificity of white light and Narrow Band Imaging endoscopy for nasopharyngeal carcinoma was 93 and 22 %, and 92 and 98 %, respectively. Significantly associated with nasopharyngeal carcinoma was a high index of suspicion or definitely malignant grade on white light endoscopy (p < 0.0005, odds 58.978) and vascular tufts on Narrow Band Imaging endoscopy (p = 0.020, odds 41.210). Narrow Band Imaging endoscopy of vasculature alone for suspected nasopharyngeal carcinoma is not more useful than white light endoscopy of nasopharyngeal morphology, nor does it add to or surpass the diagnostic accuracy of white light endoscopy in this regard.
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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 : official journal of the European Federation of Oto-Rhino-Laryngological Societies (EUFOS) : affiliated wi, 2016Co-Authors: Alexander C Vlantis, John K S Woo, Michael C F Tong, Ann D King, William B Goggins, C. Andrew Van HasseltAbstract:Endoscopy is often used to screen for nasopharyngeal carcinoma. A normal nasopharynx on white light endoscopy may yet harbor subclinical or occult malignancy. This study assessed whether the vascular pattern seen on Narrow Band Imaging endoscopy could indicate this and thus be useful for detecting suspected nasopharyngeal carcinoma. The nasopharynx of 156 patients who failed serological screening for or presented with symptoms of nasopharyngeal carcinoma was graded under white light and Narrow Band Imaging endoscopy and a biopsy taken. The accuracy of assessing the nasopharynx as being probably or definitely malignant on white light endoscopy was high (area under the curve = 0.924), as it was of being normal on Narrow Band Imaging endoscopy (=0.799). The sensitivity and specificity of white light and Narrow Band Imaging endoscopy for nasopharyngeal carcinoma was 93 and 22 %, and 92 and 98 %, respectively. Significantly associated with nasopharyngeal carcinoma was a high index of suspicion or definitely malignant grade on white light endoscopy (p
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Reversal of pale-to-dark nasopharyngeal follicle ratio on Narrow-Band Imaging
Hong Kong medical journal = Xianggang yi xue za zhi, 2010Co-Authors: Alexander C Vlantis, John K S Woo, Michael C F Tong, Amy B.w. Chan, H. S. Chan, C. Andrew Van HasseltAbstract:Normal nasopharyngeal mucosa contains varying amounts of lymphoid tissue, which in adults may be minimal or absent. Nasopharyngeal mucosa with minimal lymphoid tissue has a regular follicular pattern on Narrow-Band Imaging; pale follicles have thin, dark borders and the ratio of the pale follicle to the dark border (pale-to-dark ratio) is roughly 90%. In some patients undergoing routine nasopharyngeal endoscopy, the pale-to-dark ratio is reversed on Narrow-Band Imaging, with dark centres surrounded by pale borders and a pale-to-dark ratio of roughly 50%. These dark follicles may represent abnormal capillary loops, as they have the same appearance as microvascular changes seen on Narrow-Band Imaging of the oesophageal mucosa which indicate dysplasia or malignancy. While this observed change in the follicular pattern may be an early event in the evolution of nasopharyngeal carcinoma, the significance of this finding remains to be confirmed by a larger-scale study.
Masaki Murayama - One of the best experts on this subject based on the ideXlab platform.
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Endocytoscopy and Narrow Band Imaging for Superficial Extension of Squamous Cell Carcinoma
The Annals of thoracic surgery, 2014Co-Authors: Seishi Nosaka, Noriaki Kurimoto, Katsuhiko Morita, Masaki MurayamaAbstract:60-year-old man presented with cough. Chest Acomputed tomography revealed a nodule in right S2 (Fig 1A). By conventional bronchoscopy, the orifice of B2 was obstructed with tumor (squamous cell carcinoma; Fig 1B). Tumor extension was assessed in greater detail using autofluorescence Imaging, Narrow-Band Imaging and ultra-high-magnification bronchoscopy (endocytoscopy; ECS) [1]. Autofluorescence Imaging revealed magenta-colored epithelium at the orifice of the upper lobe bronchus (Fig 1C). Several dotted vessels were detected with Narrow-Band Imaging at the same lesion (Fig 1D). Sleeve upper lobectomy was performed according to these bronchoscopic findings. ECS with methylene blue staining was performed in the resected bronchus intraoperatively. On these images of the bronchial epithelium, one could
Paulo Sakai - One of the best experts on this subject based on the ideXlab platform.
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Narrow-Band Imaging without magnification for detecting early esophageal squamous cell carcinoma.
World journal of gastroenterology, 2011Co-Authors: Edson Ide, Fauze Maluf-filho, Dalton Marques Chaves, Sergio E. Matuguma, Paulo SakaiAbstract:Narrow-Band Imaging without magnification for detecting early esophageal squamous cell carcinoma
Claude S. Farah - One of the best experts on this subject based on the ideXlab platform.
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Diagnostic accuracy of Narrow Band Imaging for the detection of oral potentially malignant disorders
Oral diseases, 2015Co-Authors: M. A. Matias, Claude S. FarahAbstract:Objective: To determine the clinical diagnostic accuracy of Narrow Band Imaging™ for the detection of oral potentially malignant disorders in a prospective series of patients. Materials and Methods: New and existing patients referred to an oral medicine and pathology specialist clinic for assessment of at least one white, red or red-white oral mucosal lesion underwent conventional oral examination, followed by examination with the white light mode and then Narrow Band Imaging mode of a Narrow Band Imaging™ system. The clinical presentation, microvascular architecture and relevant histopathology of all lesions were recorded. Results: A total of 272 lesions from 95 patients were observed. The sensitivity, specificity, positive predictive value, negative predictive value and accuracy for the detection of oral potentially malignant disorders or worse by Narrow Band Imaging™ were 100%, 74.63%, 92.38%, 100% and 93.77%, respectively, when compared with conventional oral examination. Narrow Band Imaging™ aided the detection of 24 lesions undetected by conventional oral examination and 13 lesions undetected by white light endoscopy. Conclusion: Narrow Band Imaging™ demonstrates great utility as a visualisation adjunct for detecting and monitoring oral potentially malignant diseases, particularly lesions not identified by conventional oral examination or white light examination alone.
