Comparison of narrow-band imaging with autofluorescence imaging for endoscopic detection of squamous cell carcinoma of the tonsil

Sep 24, 2026

The study evaluates how effectively narrow band imaging (NBI) and autofluorescence imaging (AFI) visualize tonsillar squamous cell carcinoma during endoscopic pharyngeal examinations. Patients with confirmed tonsillar SCC underwent NBI and AFI, and 57 lesion video sequences were independently assessed by three reviewers. AFI significantly improved visualization of tumor spread, while both modalities showed no significant difference for malignancy-determining endoscopic signs.

LanguageEnglish

CategoryHealthcare

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Pages8

Reading Time20 min

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Abstract

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European Archives of Oto-Rhino-Laryngology (2023) 280:5073–5080 [https://doi.org/10.1007/s00405-023-081](https://doi.org/10.1007/s00405-023-081)11-9 Comparison of narrow‑band imaging with autofluorescence imaging for endoscopic detection of squamous cell carcinoma of the tonsil J. Syba1,2 · K. Trnkova2 · L. Dostalova1 · M. Votava1 · E. Lukesova1 · S. Novak1 · M. Kana1 · M. Tesarova1 · M. Zabrodsky1 · J. Plzak1 · P. Lukes1 Received: 17 March 2023 / Accepted: 3 July 2023 / Published online: 18 July 2023 © The Author(s) 2023 Abstract Purpose Early detection of mucosal neoplastic lesions is crucial for a patient’s prognosis. This has led to the development of effective optical endoscopic diagnostic methods such as narrow band imaging (NBI) and autofluorescence (AFI) . Independent of each other, both of these methods were proven useful in the detection of mucosal neoplasias. There are limited reported data comparing both methods for oropharyngeal cancer diagnostics. The aim of the study was to compare NBI and AFI endoscopic visualization of signs in identifying tonsillar squamous cell carcinoma (SCC) and assessing its extent and to determine whether the score was related to the evaluator’s experience. Methods Patients with tonsillar SCC underwent endoscopic pharyngeal examination using NBI and AFI. Fiftyseven video sequences of examinations of lesions proven to be SCC were evaluated by three reviewers. The accuracy of determination of lesion extent and visualization of its endoscopic signs of malignancy were evaluated. Results Endoscopic visualization of tumour spread was significantly better using AFI than NBI (p = 0.0003) . No significant difference was found between NBI and AFI in the visualization of endoscopic malignancy determining signs (p = 0.1405) . No significant difference was found among the three reviewers in the visualization of tumour spread and for identifying malignancy-determining signs in NBI endoscopy or AFI endoscopy. Conclusions The results show that AFI obtained better results for assessing the extent of tonsillar cancers than NBI. Both methods were proven to be equal in the visualization of endoscopic malignancy-determining signs. Both are useful even for less experienced evaluators. Keywords Narrow band imaging · NBI · Autofluorescence · AFI · Tonsillar carcinoma · Oropharyngeal cancer Introduction The incidence of oropharyngeal squamous cell carcinoma (SCC) is increasing significantly in developed countries [1–3] . The UK has seen a doubling in incidence between 1990 and 2006. There was a further doubling in incidence * P. Lukes [petr.lukes@fnmotol.cz](petr.lukes@fnmotol.cz) [J. Syba](J. Syba) [jaroslav.syba@seznam.cz](jaroslav.syba@seznam.cz) 1 Department of Otorhinolaryngology and Head and Neck Surgery, First Faculty of Medicine, Charles University, University Hospital Motol, Prague, Czech Republic 2 Department of Otorhinolaryngology, Third Faculty of Medicine, Charles University, University Hospital Kralovske Vinohrady, Prague, Czech Republic between 2006 and 2010. Tobacco smoking and alcohol consumption are already well-known risk factors for the development of head and neck cancers. The increasing incidence of oropharyngeal SCC has been attributed to changes in social behaviour and mainly to the increase in the prevalence of the Human Papilloma Virus (HPV) [4–6] . It is usually difficult to detect the early stage of SCC, and diagnosis is often performed at a late stage. The extent of the large lesion is associated with a large surgical resection, larger postoperative morbidity and shortened survival time. The treatment of locally advanced oropharyngeal tumours often worsens swallowing and is associated with severe voice disorders [7] . Therefore, it is crucial to make an early diagnosis of head and neck SCC. Examination procedures for cancer patients generally have two main goals: early detection and accurate determination of the extent of the disease. Orophar

FAQs

What was the purpose of comparing NBI and AFI in this study?

The study aimed to compare endoscopic visualization by NBI and AFI for identifying tonsillar squamous cell carcinoma and assessing its extent, and to evaluate whether the scoring related to evaluator experience.

How were the endoscopic evaluations performed and by whom?

Patients with tonsillar SCC had endoscopic pharyngeal examination using NBI and AFI. Fifty-seven video sequences were evaluated by three reviewers.

Which imaging method better visualized tumor spread and were malignancy signs different between methods?

AFI significantly better visualized tumor spread than NBI. There was no significant difference between NBI and AFI in visualization of malignancy-determining endoscopic signs.

Sep 24, 2026

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