What is NBI?

NBI depicts distribution of blood vessels in the superficial layer of the mucosa

In normal observation, an endoscopic light source irradiates wide spectrum light in order to ensure that the colors in the reproduced images of mucosal tissues are as natural as possible. The downside of using wide spectrum light is that it reduces the contrast generated by blood vessels in the superficial layer of the mucosa or by subtle alterations in the mucosa called pit patterns. In order to detect this contrast which is essential for diagnosis, NBI uses narrow spectrum light (narrow-band light) specifically suited to the optical characteristics of mucosal tissues and hemoglobin in blood. This improves the contrast of the image relevant to diagnosis and delivers images with excellent visualization capability.

Chromoendoscopy-type images at the touch of a button

Like chromoendoscopy, NBI can emphasize pit patterns. However, because NBI is an optical image enhancement technology, there is little interference from mucus and there is no need to spray dye on the target tissues. The viewing mode can be switched to NBI at the touch of button, and high-contrast images can be obtained at any time.

No need to change scopes

NBI is made possible by a dedicated filter incorporated in the light source unit and by a dedicated controlling/processing function on the video processor. That means you don't need a new scope to take advantage of NBI. You can use the one you already have.

How it is useful?

Through the accumulated research that followed, it was understood that early stage lesions could be found through slight differences in the color of mucosal surfaces within the digestive tract.
Olympus Narrow Band Imaging (NBI) is an optical technology available for a variety of medical disciplines which helps to visualize the most minute vascular and mucosal patterns. A number of studies highlight the clinical value of NBI, especially with regard to the detection of cancer and characterization of suspicious mucosal areas.

Colon

Esophagus

Esophagus

Technology Principle

Practical advantages

• One platform throughout a hospital
• Increased quality of outcomes due to support for early detection of cancer and mucosal changes
• No preparation required - technology available at the touch of a button at no extra cost
• The one stop within the clincial Process

Clinical Advantage and Research Area

How does NBI help medical specialists?

Thanks to a large amount of clinical evidence, NBI really opens up many possibilities for diagnosis throughout a hospital*. The high contrast between vessels and the surrounding mucosa means NBI facilitates the detection and characterization of tumors and even displays highly vascularized suspect lesions in deeper tissue layers. Compared with white light endoscopy, the images of capillaries are less blurred and the probability of missing a lesion is reduced. As such, NBI improves specialists' ability to reach an early and precise optical diagnosis.

To date, clinical application and efficacy in different specialties have been studied.
NBI has clinical applications throught the anatomy including gastroenterology,pulmonary, urology and rhinolaryngology (ENT).

* Learn More about NBI in Gastroenterology, Urology and ENT of this page.

The key technologies associated with NBI endoscopy

HDTV

Reproduction of lifelike images that depict the subtlest nuances
The accuracy of the results obtained with NBI and AFI depends on the quality of the original images captured by the scope. To ensure the highest possible quality, we naturally incorporated today's most advanced video technology in new generation video system — HDTV or high-definition television.* Composed of more than double the number of scanning lines and horizontal pixels used in conventional video systems, HDTV images offer a 100 percent increase in image information that produces a sharp, detailed picture with virtually no detectable pixelation or artifacts. HDTV's true-to-life imaging power enables even minute capillaries and subtle mucosal structures to be rendered accurately throughout the screen area. This enhanced image quality may improve diagnostic capability and procedural efficiency, while possibly reducing the miss ratio.

Pre-freeze Functions

When capturing a still image, this function automatically selects the sharpest image of the desired view.
A new pre-freeze function saves time and helps eliminate the physician's frustration when capturing still images. The new generation video processor automatically buffers a continuous, rapid series of procedural images. When capturing a still image, the pre-freeze function analyzes the previous images and displays and saves the sharpest image of the desired view. This function helps physicians obtain a clear visual record of the procedure in the shortest possible time.

Dual Focus

New two-stage optical lens technology allows physicians to switch from normal focus mode to near focus mode with a single button.
Dual focus two-stage optical lens technology from Olympus allows physicians to switch from normal focus mode to near focus mode with a single button, so they can conduct close examination of mucosal tissue and capillary networks. The new technology lets physicians select the desired depth of field and obtain high-quality images at the same time, bringing a new level of visualization to routine examinations.

Advancing visualization - Achieve more with NBI

NBI is the world's only patented endoscopic light technology that enables effective targeting of biopsies not seen under white light without the need for dyes or drugs.
*NBI is not intended to to replace histopathological sampling as a means of diagnosis.

Olympus developed narrow band imaging technology to enhance the examination and characterization of healthy and abnormal mucosal tissue. NBI has set a new standard in endoscopy.

Now with the cutting-edge EVIS EXERA III system, the improved NBI takes HDTV imaging to a completely new level. Each component has been enhanced to achieve the best possible images. Combining a brighter light source, a more sensitive CCD, and 3D noise reduction, the whole system provides up to twice the viewable distance as compared to EVIS EXERA II, which opens up new clinical applications and reinforces NBI's acceptance as a standard of care.

More Accurate for Diagnosis

*1: Clinical images courtesy of Horst Neuhaus, MD
*2: Clinical image courtesy of Douglas Rex, MD
*3: Clinical images courtesy of Roy Soetikno, MD/Tonya Kaltenbach, MD

NBI in Urology

Fighting Bladder Cancer - NBI

Narrow Band Imaging (NBI) is the world's only patented endoscopic light technology that enables effective targeting of biopsies not seen under white light without the need for dyes or drugs. Narrow Band Imaging (NBI) is a powerful optical image enhancement technology that improves the visibility of blood vessels and other structures on the bladder mucosa.

High-Definition NBI in Non-Muscle Invasive Bladder Cancer

The challenge in NMIBC management:

Reviewing the literature, 50-70% of NMIBC patients suffer from recurrences after the initial treatment in form of superficial tumours^*1. Missing small papillary tumours or CIS is an acknowledged risk, at an estimated rate of 10-20%^*2. Superficial tumours of the mucosa are typically indicated by specific capillary and vessel structures.

Identifying these structures - especially small tumours under white light conditions - is possible, but could be improved. This is where the HD-NBI technology helps by enhancing the contract of vessels.

NBI technology has potenital to improve visualization of lesion boundaries in Non-Muscle-Invasive Bladder Cancer (NMIBC)

How HD-NBI works

• HD-NBI enhances the contrast of vessels and papillary structures to help identify tumours
• HD-NBI enhances the fact that haemoglobin has an increased absorption rate for light at wavelengths of blue and green colour
• HD-NBI light is generated by a patented filter, eliminating all other disturbing wavelengths with the exception of blue and green

Potential Clinical Advantages

• HD-NBI provides increased accuracy to not miss lesions
• Significantly higher tumour detection rate for Narrow Band Imaging versus conventional cystoscopy (94.7 % versus 79.2 %^*1 and 94.8 % versus 83.9 %^*2)
• Substantially more tumours found (35.9-38 %^*1)
• NBI reduces the recurrence risk of NMIBC by at least 10 % at one year^*3

Where HD-NBI can be used

The Bladder Cancer Management (NMIBC)

• Rigid and flexible cystoscopy
• TUR-B resection

Flexible Ureteroscopy

• Flexible Ureteroscopy for Upper tract tumor management

Flexible Cystoscopy

HD-NBI for advanced diagnostic option in Follow up Cystoscopy

HD-NBI is an extremely valuable help during your follow-up cystoscopies. Being able to switch on NBI by a push of a button during the ambulatory flexible cystoscopy can add great benefits to your diagnosis preciseness.
The combination of HD and Brighter NBI opens a new chapter in advanced bladder cancer follow up diganosis using flexible cystoscopy.

HD and Full - screen capabilties- Flexible Cystoscopy

• Increase in brightness by 20% compared with the previous generation for optimized imaging
• Enhanced visibility of superficial capillary and mucosal vessel system
• Potentially higher and improved detection rate of cartinoma in situ

TUR-B Resection

HD-NBI for accurate tumor resection

Using the latest generation of HD-NBI camera heads in combination with rigid cystoscopes and resectoscopes enables you to make use of the NBI-related detection benefits during your TUR-BT surgery.

HD Camera ead with NBI - a unique combination for bladder cancer resection

• Combination of HD and NBI delivers 20% brighter light compared to prior camera head system
• HD-NBI has potential to reduces the recurrence risk of NMIBC

Flexible Ureteroscopy

When being confronted with upper tract tumours, using videoscope technology is already a significant step forward.

NBI Solution in Urology

NBI - available for all endo-urological procedure

Publications

Naselli A, Introini C, Timossi L, Spina B, Fontana V, Pezzi R, Germinale F, Bertolotto F, Puppo P.
A randomized prospective trial to assess the impact of transurethral resection in narrow band imaging modality on non-muscle-invasive bladder cancer recurrence.
Eur Urol. 2012 May;61(5):908-13.

Kaiwen Li, Tianxin Lin, Xinxiang Fan, Yu Duan, and Jian Huang
Diagnosis of narrow-band imaging in non-muscle-invasive bladder cancer: A systematic review and meta-analysis.
Int J Urol. 2013 Jun;20(6):602-9

NBI in ENT

During endoscopic observation, NBI enhances visualization of the capillary network and mucosal morphology.

Potential Clinical Advantages

NBI is a potentially useful technique for diagnosis, treatment and follow-up of laryngeal and hypopharyngeal disease. The Narrow Band Imaging (NBI) technology allows for the enhanced visibility of vessel structures leading to support the improved detection of carcinoma in situ in the larynx* as well as saving healthy mucosa due to more precisely defined borders.

• The use of NBI supports the detection of tumors in comparison to conventional white light imaging.*
• The improved visualization of capillary networks possible with NBI may support analysis of tumor progression.*
• It has potential to identify small tumors using NBI and support for detection at an earlier stage.*

HD-NBI

Taking a new step of combination of HDTV and NBI in ENT

High-resolution HDTV image deliver sharp and clear details, boosting observation capabilities when viewing mucosal structures and other vessel patterns. This superior performance will the potential of endoscopy to a new level. This advanced visualization technology potentially reduced unceccesay biopsies and improves examination quality. The combination of HDTV and NBI in ENT are now available to support to optimal diagnsis and treatment. The brilliant HD resolution is the basis for the high accuracy in ENT diagnostic and therapeutic procedures.

According to the prospective studies,

• especially the combination of HDTV and NBI significantly improves positive and negative predictive rates.*
• NBI is expected to provides better definition of tumour staging and surgical margins in pre- and intraoperative settings.*
• NBI is also valuable in post-operative setting due to the potential to support early detection of persistences, recurrences, and metachronous tumours.*

NBI Solution in ENT

Publications

Piazza C, Cocco D, Del Bon F, Mangili S, Nicolai P, Peretti G.
Narrow band imaging and high definition television in the endoscopic evaluation of upper aero-digestive tract cancer.
Acta Otorhinolaryngol Ital.2011 Apr;31(2):70-5.

Gastroenterology

Pulmonology

Urology

ENT

Technology Principle

UGI

LGI

Urology