The Use of Narrowband Imaging for Identification of Endometriosis

A pilot study was designed to evaluate whether a narrowband imaging (NBI) endoscopic light source could detect endometriosis implants that were not identifiable with a visible light spectrum laparoscope. In all, 21 consecutive patients who were undergoing pelviscopy for pelvic pain and possible endometriosis were enrolled in the study. Endoscopic evaluation was performed using an endoscope that was fitted with a NBI light source using 415- and 540-nm filters. Endometriosis was first documented and photographed using visible light and then re-evaluated with NBI. Implants newly found with NBI were documented and photographed. All noted lesions were excised using a harmonic scalpel. In all, 21 consecutive patients (age range 20–40 years) were enrolled in the study with a preoperative diagnosis of pelvic pain and possible pelvic endometriosis. One patient was excluded after evaluation with NBI did not provide additional biopsy specimens. Fourteen of the 20 patients had lesions identified with NBI that were not identified with visible light. A total of 38 biopsy specimens were taken using NBI; 20 (53%) of them were identified histologically as endometriosis. Seven patients did not have endometriosis identified with white light; however, 4 of these patients had lesions identified with NBI that were confirmed endometriosis. This pilot study is a promising start in the process to evaluate NBI endoscopy as an effective tool for evaluating and identifying endometriosis implants that are not visible with white light endoscopy.