Narrow band imaging in head and neck cancer

Visualization by (flexible) endoscopy of the mucosa of oral cavity, nasal cavity, pharynx and larynx is the hallmark in detection and diagnosis of mucosal benign and malignant lesions of the upper aerodigestive tract. Technical improvements resulted in distal chip endoscopes with digital image processing making blood vessels more visible using a technique called Narrow Band Imaging (NBI). NBI is a relatively new imaging technique (developed by Olympus Corporation, Tokyo, Japan) which increases the diagnostic potential of conventional white light imaging (WLI) endoscopy. NBI highlights abnormalities in the superficial vasculature of mucosal lesions by using narrow-bandwidth filters in a sequential red-greenblue illumination system. Although in other fields of medicine NBI has confirmed itself as an important diagnostic and prognostic instrument, in otorhinolaryngology and head and neck oncology, it has not yet been evaluated as an important reliable diagnostic or prognostic tool. We believe NBI should be used as a standard tool in diagnosis and treatment of patients with a (suspected) malignancy of the upper aero-digestive tract, but only after establishing its diagnostic and prognostic value in a large cohort of patients. Therefore, we planned to establish the role of NBI in improving diagnosis, clinical outcome and prognosis in head and neck cancer in six different substudies.

Detection, diagnosis, staging, treatment outcome and prognosis of patients with a malignancy of the upper aerodigestive tract improve when Narrow Band Imaging in combination with standard (White Light) endoscopy is used.

1. when patients arive in the outpatient clinic with complaints for the first time

2. during surgery

3. follow up: every 3-6 months, depending on diagnosis.

Observational cohort study, partially randomized controlled sub-studies.



The intervention itself is not part of the study.