Narrow-band imaging pattern classification in oral cavity

Oral Dis. 2018 Nov;24(8):1458-1467. doi: 10.1111/odi.12940. Epub 2018 Aug 14.

Abstract

Objective: Narrow-band imaging is widely used in the diagnostic work-up of oral lesions. Different oral subsites present three epithelial types (1, 2a and 2b), each with a different structure and function. The aim of this study was to analyse and describe the different vascular patterns seen on narrow-band imaging according to oral epithelial type and histology.

Materials and methods: The narrow-band imaging photographs of healthy, dysplastic and neoplastic oral mucosa were retrospectively reviewed and divided according to epithelial type and histology. The different narrow-band imaging patterns were analysed, related to the clinical appearance of the specific area, accurately described and drawn by a professional designer.

Results: The photographs of 302 patients were considered. Six patterns were identified: Normal mucosa exhibited different appearance in each type of epithelium; dysplastic mucosa presented the same pattern in type 1 and 2a epithelia, which differed from that of type 2b epithelium; in cancer, mucosal appearance was identical irrespective of epithelial type, due to complete vascular destruction.

Conclusions: The proposed classification could serve as a guide for clinicians approaching narrowband imaging, especially at early stages of the learning curve, to differentiate normal mucosa from malignant lesions and possibly reduce the number of unnecessary biopsies.

Keywords: early diagnosis; narrowband imaging; oral cancer; oral diagnosis; oral mucosa; precancerous conditions.

MeSH terms

  • Adult
  • Aged
  • Aged, 80 and over
  • Capillaries / diagnostic imaging*
  • Female
  • Humans
  • Male
  • Middle Aged
  • Mouth Mucosa / blood supply
  • Mouth Mucosa / diagnostic imaging*
  • Mouth Mucosa / pathology*
  • Mouth Neoplasms / blood supply
  • Mouth Neoplasms / diagnostic imaging*
  • Narrow Band Imaging*
  • Retrospective Studies