Narrow Band Imaging: An Effective and Early Diagnostic Tool in Diagnosis of Oral Malignant Lesions

  • Aparaajita UpadhyayEmail author
  • N. Saraswathi
  • R. K. Mundra
Original Article


The management of oral carcinoma leads to both cosmetic and functional deficit to the patient and the confirmatory histopathology is a time consuming process which may be a reason for a reduced follow up and compliance of the patient. We hereby use this study as an opportunity to tell that narrow band imaging (NBI) serves both the above purposes in an earlier period and in a non-invasive manner and thereby improving the lifestyle of the patients. To find out a better non-invasive and time saving diagnostic tool in the management of premalignant and malignant oral lesions in its earlier period. A prospective cross sectional study of 38 patients presenting to the department of ENT, MGMMC, MYH, Indore was taken with suspicious lesions and subjected to endoscopic examination by both white light and NBI and samples were sent to histopathological examination for confirmation. The Intrapapillary Capillary Loop were identified through NBI with Type I (50%) and Type II (31%) to be the most common pattern both correlating with the histopathological squamous cell carcinoma. The sensitivity and specificity of White Light Endoscopy is to be 75.75% and 76.43% respectively and of NBI to be 93.93% and 80% respectively. Narrow band imaging is found to be an optical diagnostic tool in the diagnosis of the lesions at an earlier stage and preventing from further functional and structural deterioration by the disease progression.


White light endoscopy Narrow band imaging Intrapapillary capillary loops Histopathology 


Compliance with Ethical Standards

Conflict of interest

The authors hereby disclose that they have no conflict of interest.

Ethical Approval

All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards.

Informed Consent

Informed consent was obtained from all individual participants included in the study.

Human and Animal and Rights

This article does not contain any studies with animals performed by any of the authors.


  1. 1.
    Ghantous Y, Yaffi V, Abu-Elnaaj I (2015) Oral cavity cancer: epidemiology and early diagnosis article in Hebrew. Refuat Hapeh Vehashinayim 32(3):55–63Google Scholar
  2. 2.
    Coelho KR (2012) Challenges of the oral cancer burden in India. J Cancer Epidemiol 2012:701932CrossRefGoogle Scholar
  3. 3.
    Gono K (2015) narrow band imaging: technology basis and research and development history. Clin Endosc 48:476–480CrossRefGoogle Scholar
  4. 4.
    Lee MM, Enns R et al (2009) Narrow band imaging in gastroesophageal reflux disease and barrett’s esophagus. Can J Gastroentrol 23(2):84–87CrossRefGoogle Scholar
  5. 5.
    Yang S, Lee Y, Chang L, Hwang C, Luo C, Chen T (2015) Clinical characteristics of narrow-band imaging of oral erythroplakia and its correlation with pathology. BMC Cancer 15:406CrossRefGoogle Scholar
  6. 6.
    Krishna A, Singh RK, Singh S, Verma P, Pal US, Tiwari S (2014) Demographic risk factors, affected anatomical sites and clinicopathological profile for oral squamous cell carcinoma in a north indian population. Asian Pac J Cancer Prev 15(16):6755–6760CrossRefGoogle Scholar
  7. 7.
    Aroquiadasse M, Daniel MJ, Srinivasan SV, Jimsha VK (2016) Correlation of degree of dysplasia in potentially malignant disorders with tobacco use: a cross-sectional study. Clin Cancer Investig J 5:398–402CrossRefGoogle Scholar
  8. 8.
    Kandath S, John B, Shobitha G (2017) Oral cancer profile among patients who underwent oral biopsy in a tertiary referral center in central kerala. Indian J Multidiscip Dent 7:14–20CrossRefGoogle Scholar
  9. 9.
    Znaor A, Brennan P, Gajalakshmi V, Mathew A, Shanta V, Varghese C, Boffetta P (2003) Independent and combined effects of tobacco smoking, chewing and alcohol drinking on the risk of oral, pharyngeal and esophageal cancers in indian men. Int J Cancer 105:681–686CrossRefGoogle Scholar
  10. 10.
    Vu AN, Farah CS (2014) Efficacy of narrow band imaging for detection and surveillance of potentially malignant and malignant lesions in the oral cavity and oropharynx: a systematic review. Oral Oncol 50(5):413–420. CrossRefGoogle Scholar
  11. 11.
    Garofolo S et al (2015) Intraloperative narrow band imaging better delineates superficial resection margins during transoral laser microsurgery for early glottis cancer. Ann Otol Rhinol Laryngol 124(4):294–298CrossRefGoogle Scholar
  12. 12.
    Tirelli G, Piovesana M, Gatto A, Torelli L, Di Lenarda R, Boscolo Nata F (2017) NBI utility in the pre-operative and intra-operative assessment of oral cavity and oropharyngeal carcinoma. Am J Otolaryngol 38(1):65–71. CrossRefGoogle Scholar
  13. 13.
    Piazza C, Dessouky O, Peretti G, Cocco D, De Benedetto L, Nicolai P et al (2008) Narrow-band imaging: a new tool for evaluation of head and neck squamous cell carcinomas. Review of the literature. Acta Otorhinolaryngol Italica 28:49–54Google Scholar
  14. 14.
    Gono K, Obi T, Yamaguchi M et al (2004) Appearance of enhanced tissue features in narrow-band endoscopic imaging. J Biomed Opt 9:568–577CrossRefGoogle Scholar
  15. 15.
    Hamamoto Y, Endo T, Nosho K et al (2004) usefulness of narrow-band imaging endoscopy for diagnosis of barrett’s esophagus. J Gastroenterol 39:14–20CrossRefGoogle Scholar
  16. 16.
    Muto M, Nakane M, Katada C, Sano Y, Ohtsu A, Esumi H et al (2004) squamous cell carcinoma in situ at oropharyngeal and hypopharyngeal mucosal sites. Cancer 101:1375–1381CrossRefGoogle Scholar
  17. 17.
    Watanabe A, Tsujie H, Taniguchi M, Hosokawa M, Fujita M, Sasaki S (2006) Laryngoscopic detection of pharyngeal carcinoma in situ with narrowband imaging. Laryngoscope 116:650–654CrossRefGoogle Scholar
  18. 18.
    Lin Y, Watanabe A, Chen W-C, Lee K-F, Lee I-L, Wang W-H (2010) Narrowband imaging for early detection of malignant tumors and radiation effect after treatment of head and neck cancer. Arch Otolaryngol Head Neck Surg 136(3):234–239CrossRefGoogle Scholar
  19. 19.
    Zhou H, Zhang J, Guo L, Nie J, Zhu C, Ma X (2018) The value of narrow band imaging in diagnosis of head and neck cancer: a meta-analysis. Sci Rep 8:515CrossRefGoogle Scholar

Copyright information

© Association of Otolaryngologists of India 2019

Authors and Affiliations

  1. 1.Department of ENTMGM Medical College and MY HospitalIndoreIndia

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