Head and neck squamous cell carcinoma is a common type of cancer, with 3.200 new cases diagnosed annually in the Netherlands. Risk factors include tobacco use, alcohol consumption, HPV, and EBV. Early detection is crucial to improve prognosis, as early-stage tumors require less aggressive treatments. Narrow Band Imaging (NBI) is an optical imaging technique that uses specific light filters to provide detailed visualization of superficial blood vessels. There is a strong correlation between these vascular patterns and histopathological diagnoses. NBI is more effective at detecting (pre)malignant lesions than conventional ‘white light’ methods, with a high sensitivity (92%) and accuracy (77%). NBI identifies mucosal abnormalities indicative of dysplasia or malignancy that often go unnoticed with white light. The Ni vascular pattern classification (2011) reliably supports this assessment. NBI enhances observer reliability, regardless of the observer’s experience level. Tumor margins are more clearly visible with NBI, leading to more reliable tumor staging. Flexible laryngoscopy with NBI is often a suitable alternative to rigid laryngoscopy under anesthesia, especially for fully visible tumors. However, rigid techniques remain necessary for large tumors. During transoral laser surgery for small glottic laryngeal carcinomas, NBI significantly reduces the number of positive resection margins and improves the recurrence-free survival (96% versus 84% after 18 months).
In summary, NBI improves diagnostic accuracy and tumor staging, with significant implications for diagnosis, treatment, and prognosis. Based on this research by Manon Zwakenberg, it is recommended to use NBI as the standard instrument for the diagnosis and treatment of patients with head and neck cancer.
