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Park, Jo, Jang, Park, and Choi: Clinical Benefits of Narrow Band Imaging Bronchoscopy in Central Lung Cancer
Original Article
Tuberculosis and Respiratory Diseases

Tuberculosis and Respiratory Diseases 2010; 68(1): 16-21.

Published online: 31 January 2010

DOI: https://doi.org/10.4046/trd.2010.68.1.16

Clinical Benefits of Narrow Band Imaging Bronchoscopy in Central Lung Cancer

Jin Kyeong Park, M.D.1, Young Sun Jo, R.N.1, Sae Jin Jang, M.D.2, Young Soo Park, M.D.2, Chang Min Choi, M.D.1

1Divison of Pulmonary and Critical Care Medicine, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea.

2Department of Pathology, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea.

Address for correspondence: Chang Min Choi, M.D. Department of Pulmonary and Critical Care Medicine, Asan Medical Center, University of Ulsan College of Medicine, 86, Asanbyeongwon-gil, Songpa-gu, Seoul 138-736, Korea. Phone: 82-2-3010-5902, Fax: 82-2-3010-6968, ccm@amc.seoul.kr

Received 3 December 2009       Accepted 15 December 2009

Copyright © 2010. The Korean Academy of Tuberculosis and Respiratory Diseases. All rights reserved.

Abstract

Background

Lung cancer is usually diagnosed at an advanced stage, resulting in a poor prognosis. The detection of these lesions at an earlier stage would be a clear benefit to patients. However, it is extremely difficult to detect carcinomatous lesions in the bronchial mucosal sites during a routine bronchoscopy.

Methods

This study employed a novel optical technique, known as narrowband imaging (NBI), which allows noninvasive visualization of the microvascular structure of an organ's surface using reflected light.

Results

Narrow band imaging was performed on 10 patients who were radiologically suspicious or had a high risk of lung cancer. The median age of the patients was 57.5 years (range, 44~81 years), and 80% of the patients were male. All lesions showed a microvascular proliferation pattern (dotted, tortuous and abruptly ending vessel) on the magnified NBI. Two lesions were confirmed histologically to be adenocarcinoma and the remaining lesions were squamous cell carcinomas. Two lesions were confirmed histologically to be a carcinoma in situ.

Conclusion

NBI is a promising and potentially powerful tool for identifying carcinomas at an earlier stage or a central lesion during a routine bronchoscopy examination.

Keywords: Narrow band imaging, Lung Neoplasms, Bronchoscopy

Figures and Tables

Figure 1
Multiple elevated nodular lesions in trachea were seen under white light (A) and narrow band imaging (B), more clearly visible with dotted vascularity in the narrow band imaging. Fungating mass without invasion in right upper lobe bronchus was seen under white light (C) and narrow band imaging (D). Peripheral margins of the abnormal neoangiogenetic vascularization are clearly visible and located well beyond the limits of the lesion as identified by white light bronchoscopy. It was easy to distinguish bleeding to neoangiogenetic vascularization under narrow band image (E).
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Figure 2
Mucosal irregularity in the superior segment of left lower lobe bronchus was seen under white light (A) and narrow band imaging (B). Dotted lesion under narrow band imaging was seen in right side of spur (C). Biopsy was performed at 3 sites (left, spur, right). Only dotted lesion on right revealed the squamous cell carcinoma. Other site was normal.
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Figure 3
Tortous vascular lesion with abrupt ending was seen under white light (A) and narrow band imaging (B).
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Table 1
Patients' characteristics
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Notes

Supported by ASAN institute for life science (No. 2009-467).

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