NBI and Patient Care
NBI is rapidly being adopted as a diagnostic tool, and this is supported by regulators including European Society for Gastrointestinal Endoscopy (ESGE), European Association of Urology (EAU) and European Laryngological Society (ELS) among others, who have integrated NBI into their diagnostic guidelines. Here we will look at the three clinical fields where NBI is making the greatest impact.
NBI technology has been adapted for gastroenterology, where NBI has proven to be a reliable tool for targeted biopsy in Barrett’s esophagus
, a condition that carries a high risk of developing into esophageal adenocarcinoma. When diagnosed at a late stage, prognosis is poor for patients with Barrett’s esophagus. With NBI, clinicians are able to identify neoplastic changes earlier to enable more treatment options and improved patient outcomes. Another esophageal disease, squamous cell carcinoma, is too being detected with greater reliability with the use on NBI
. NBI is also aiding the assessment of colorectal lesions. With colorectal cancers, the detection and removal of polyps remains the most effective form of prevention, and using WLI these can often be missed
. NBI not only improves polyp detection rate, but the image quality also allows for highly accurate optical predictions of polyp histology – reducing the need for costly pathological analysis
NBI is reshaping urology diagnostics, where increased visualization of superficial structures is providing urologists with the best chance of obtaining optical diagnosis for non-muscle invasive bladder cancer (NMIBC)
and upper tract urinary cancer (UTUC)
. For example, whether used in initial screening or follow up procedures such as cystoscopy, the implementation of NBI is detecting NMIBC earlier and having a significant impact upon the reduction of recurrence
In urology, NBI is proving useful beyond diagnosis: In the treatment of NMIBC, transurethral resection of bladder tumor is often required. With NBI, lesion limits can be visualized better, enabling the clinician to precisely mark and perform resection with visualization levels not previously possible.
Ear, Nose and Throat (ENT)
In ENT medicine, NBI can be used throughout a patient’s journey from diagnosis to follow-up procedures, and can be used in the operating room as well as during outpatient visits. NBI is suitable for numerous endoscopic procedures in ENT including as laryngoscopy, oral cavity examination, sinus surgery as well as for procedures in otology leading to the improved detection of carcinoma in situ and other diseases. In such settings, NBI’s advanced visualization allows for smaller margins, leaving less unwanted damage to healthy mucosa tissues, which is especially important when operating upon delicate structures like the vocal folds.
NBI allows ENT specialists to diagnose and treat early laryngeal cancer even more precisely and reliably
. With more early-stage detection coupled with more precise surgical excision of malignant lesions, it has been shown to significantly reduce recurrence rates.
NBI Benefits Patients and HCOs: Improving Outcomes while Reducing Costs
The benefits of NBI towards better patient outcomes is clear: Detecting malignant lesions earlier enables treatment options with better efficacy and improved patient prognosis. But this benefits not just the patient, but also the cost burden fronted by hospital organizations – if cancer is detected earlier, the cost of treatment can be reduced, e.g. if fewer rounds of chemotherapy or radiation treatment are required or if surgery can be avoided. NBI enables lower incidences of cancer recurrence, and this also cuts costs associated with multiple rounds of treatment.
Since fewer biopsies are required with NBI, the time of each endoscopy procedure will be reduced, plus overall fewer recurrent endoscopic procedures will be undertaken, also reducing costs. A reduction in the number of biopsies also reduces the workload within histology departments, and reduces costs associated with histological sample analysis. Overall, the versatility of NBI makes for a great cost-saving method for healthcare organizations (HCOs) due to less specialized equipment and expensive treatment plans being required. The graphic below shows an example of the cost per year of WLI versus NBI.