NEW YORK (Reuters Health) – Hysteroscopy using narrow-band imaging (NBI) technology may be more sensitive than white-light imaging (WLI) for diagnosing endometrial cancer and hyperplasia, hint results of a multicenter controlled study.

“NBI permits enhanced visualization of the vascular network and surface texture of the mucosa in an effort to improve tissue characterization, differentiation and diagnosis,” the study team notes in a report in the journal Menopause, available online now.

In a previous study of 395 women who underwent fluid minihysteroscopy with WLI and NBI exploration, the researchers found that the number of correct diagnoses with NBI (based on histology) was significantly higher than that with WLI.

In their latest study, 801 women (mean age, 41.9 years) underwent fluid minihysteroscopy with WLI followed by an NBI exploration with endometrial biopsy.

As in the previous study, NBI had advantages over WLI, report Dr. Raffaele Tinelli from University of Bari, Italy and colleagues.

“NBI showed significantly higher values in sensitivity for the detection of low-risk and high-risk hyperplasia, and this could be useful for reducing the risk of missing severe pathologies at hysteroscopy, and improving the diagnosis of preneoplastic and neoplastic pathologies,” they write.

The sensitivity for diagnosing endometrial cancer was 93% with NBI and 81% for WLI (P < 0.05); the positive predictive value was 98% and 88%, respectively (P < 0.05).

For detecting low-risk hyperplasia, NBI had a sensitivity of 82% versus 56% for WLI (P < 0.005); the positive predictive values were 79% and 71%, respectively (P < 0.05).

For detecting high-risk hyperplasia, sensitivities were 60% and 20% (P < 0.005), respectively; for NBI and WLI and positive predictive values were 67% and 25% (P < 0.0001).

No difference between NBI and WLI was seen for specificity (99% for both), negative predictive value (99% for both) and accuracy (99% and 98%, respectively).

“NBI hysteroscopy showed a very high diagnostic accuracy for the exploration of the uterine cavity, reducing the number of biopsies performed in wrong areas,” the researchers report.

They say multicenter randomized trials are needed to “establish the true value of this interesting technological advancement.”

Menopause 2011