The value of narrowband imaging using the Ni classification in the diagnosis of laryngeal cancer

Sejad Ahmadzada; Evan Tseros; Niranjan Sritharan; Narinder Singh; Mark Smith; Carsten E Palme; Faruque Riffat

doi:10.1002/lio2.414

The value of narrowband imaging using the Ni classification in the diagnosis of laryngeal cancer

Laryngoscope Investig Otolaryngol. 2020 Jun 26;5(4):665-671. doi: 10.1002/lio2.414. eCollection 2020 Aug.

Authors

Sejad Ahmadzada^{1

2}, Evan Tseros¹, Niranjan Sritharan^{1

2}, Narinder Singh^{1

2}, Mark Smith^{1

2}, Carsten E Palme^{1

2}, Faruque Riffat^{1

2}

Affiliations

¹ Department of Otolaryngology, Head and Neck Surgery Westmead Hospital Westmead New South Wales Australia.
² The University of Sydney Sydney Australia.

Abstract

Introduction: Narrowband imaging (NBI) is a special endoscopic optical enhancement setting allowing better visualization of mucosal microvasculature compared to white light endoscopy. This study evaluates the validity of NBI using the Ni classification in the detection and differentiation of severe dysplasia (SD) and glottic squamous cell carcinoma (SCC).

Methods: Patients with suspicious vocal cord lesions underwent conventional white light endoscopy followed by clinically indicated biopsy. At the same time, NBI images were obtained and graded independently. Lesions were graded from I to V according to the Ni classification and compared to histopathological findings.

Results: Fifty-two patients were included in this study (40 SCC and 12 SD). The sensitivity and specificity of NBI in diagnosing laryngeal cancer was 95.0% (CI, 83.9%-99.4%) and 83.3% (CI, 51.6%-97.9%), respectively. The negative likelihood ratio was 0.06. Higher Ni grades correlated very strongly with more advanced disease.

Conclusions: NBI using the Ni classification is a sensitive diagnostic tool for the detection and differentiation of early neoplastic and preneoplastic glottic lesions. As higher Ni classification correlates strongly with advanced disease, it serves as a useful adjunct to white light endoscopy in the diagnosis of laryngeal cancer.Level of Evidence: Level IV.

Keywords: NBI; Ni classification; glottic cancer; laryngeal cancer; narrowband imaging.