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ORIGINAL RESEARCHINTERVENTIONAL PULMONOLOGYA Pilot Study of Narrow-Band Imaging Compared to White Light Bronchoscopy for Evaluation of Normal Airways and Premalignant and Malignant Airways Disease
Section snippets
Materials and Methods
This was a prospective, partially blinded study conducted at an academic medical center in the United States over a 6-month period. The study was approved by our investigational review board, and informed consent was obtained from each participant prior to the study.
Patient Characteristics
There were 8 men and 14 women (mean age, 59 years; range, 28 to 77 years). All participants were either current or former smokers (mean, 38 pack-years [packs per day times the number of years smoked]; range, 5 to 100 pack-years). Fifty percent of the participants had a diagnosis of lung cancer, and all of these had received treatment for lung cancer. Three patients underwent surgical resection only, and eight patients underwent chemotherapy and radiation. Patient characteristics are shown in
Discussion
It is estimated that squamous cell carcinoma of the central airways represents up to one third of all lung cancers diagnosed in the United States,22 yet the natural history of bronchial dysplasia is not as well understood. Previous studies232425 estimated that invasive carcinoma will develop in 40 to 83% of patients with severely dysplastic lesions. It has been demonstrated in animal studies2627 that many of these lesions can regress spontaneously, and it has also been suggested that invasive
Conclusions
The addition of NBI to WL bronchoscopy significantly improved detection of bronchial dysplasia compared to WL bronchoscopy alone. NBI requires closer examination both as a stand-alone technology and in comparison with other imaging strategies including AF bronchoscopy in the setting of clinical trials. Future directions include combining NBI with molecular markers in those at high risk for lung cancer.4243
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This work was supported by a research grant provided by Olympus America Inc.
The authors have no conflicts of interest to disclose.