Narrow-band imaging (NBI), an on-demand, real-time endoscopic imaging technique enhances visualization of the mucosal vascular network and surface texture. A systematic review assessed the use of NBI in gynecological endoscopy by searching the relevant studies in the electronic databases.

The following observations were made-

• A total of 31 studies were included in the systematic review, where 32% were case reports, 61.2% were prospective studies and 6.4% were randomized controlled trials with control groups. The selected studies documented the use of NBI in hysteroscopy, laparoscopy and colposcopy.
• NBI utilization in hysteroscopy showed an increase in accuracy, sensitivity and specificity in detecting malignant and premalignant lesions.
• NBI was also shown to improve the specificity and sensitivity in detecting endometriotic lesions and cervical lesions. 

Thus, conventional WL imaging in gynecological endoscopy is now recognized as a highly sensitive and specific technique for diagnosing intrauterine diseases and this study pointed out that the NBI system, when applied by an expert and experienced surgeon can enhance the diagnostic accuracy. Furthermore, it may also increase the diagnostic skills of trainees. 

Further studies with larger cohorts and improved design are needed to gain more reliable results. However, utilization of this method requires expensive apparatus, long training and experience of staff and a long learning curve.

Source- Peitsidis P, Vrachnis N, Sifakis S, Katsetos C, Tsikouras P, Antonakopoulos N, Alexopoulos E and Kalmantis K. Improving tissue characterization, differentiation and diagnosis in gynecology with the narrow-band imaging technique: A systematic review. Exp Ther Med. 2022; 23(1).