Histopathological and Quantitative Correlates of Intraoperative Narrow Band Imaging in Brain Metastasis Surgery.
- 1Department of Neurological Surgery, Nippon Medical School Musashi-Kosugi Hospital, 1-383 Kosugi-machi, Nakahara-ku, Kawasaki 211-8533, Kanagawa, Japan.
- 2Department of Neurological Surgery, Nippon Medical School, 1-1-5 Sendagi, Bunkyo-ku, Tokyo 113-8603, Japan.
- 3Department of Neurological Surgery, Nippon Medical School Chiba-Hokusoh Hospital, 1715 Kamagari, Inzai 270-1694, Chiba, Japan.
Abstract
Background/objectives
Accurate intraoperative identification of the tumor-brain interface is important in brain metastasis surgery, but visual assessment under white light is subjective. Narrow-band imaging (NBI) enhances hemoglobin-dependent optical contrast without an exogenous agent; whether its intraoperative appearance corresponds to tumor tissue, and whether it measurably increases tumor-to-normal image contrast, has not been established in this setting.Methods
In this retrospective, single-center, exploratory study, we evaluated 25 consecutive patients with brain metastases resected using a 4K three-dimensional exoscope equipped with NBI. In three selected patients, spatially adjacent specimens were separately sampled from grayish-appearing and whitish-appearing regions and assessed histopathologically in a non-blinded, descriptive manner. In all 25 patients, paired white-light and NBI images were retrospectively analyzed in Fiji/ImageJ using regions of interest drawn over tissue visually judged to be tumor or normal brain.Results
In the three patients with paired histology, grayish-appearing specimens contained metastatic tumor cells and whitish-appearing specimens did not; this observation derives from a small, selectively sampled subset and should be regarded as preliminary. Across all 25 patients, absolute tumor-to-normal gray-value contrast was significantly greater under NBI than white light (69.628 ± 45.338 vs. 44.287 ± 29.640; mean paired increase, 25.342; 95% CI, 9.169-41.514; p = 0.0035; Cohen's dz = 0.647), although this increase was not observed in all patients.Conclusions
In this exploratory, non-blinded, retrospective study, NBI increased objective image contrast between visually identified tumor and normal brain relative to white light, and its grayish appearance corresponded to tumor tissue in a small histologically sampled subset. These findings support NBI as a feasible, agent-free adjunct that warrants prospective, blinded validation before its diagnostic accuracy or clinical benefit can be assessed.
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BibTeX
@article{higuchi2026histopathological,
title = {{Histopathological and Quantitative Correlates of Intraoperative Narrow Band Imaging in Brain Metastasis Surgery.}},
author = {Tadashi Higuchi and Shinsuke Abe and Satsuki Imaoka and Taisei Aoki and Yohei Nounaka and Atsushi Tsukiyama and Fumihiro Matano and Shigeyuki Tahara and Yasuo Murai},
journal = {Cancers},
year = {2026},
month = oct,
doi = {10.3390/cancers18193171},
url = {https://europepmc.org/article/MED/42882863},
note = {CC BY},
}
RIS
TY - JOUR
TI - Histopathological and Quantitative Correlates of Intraoperative Narrow Band Imaging in Brain Metastasis Surgery.
AU - Tadashi Higuchi
AU - Shinsuke Abe
AU - Satsuki Imaoka
AU - Taisei Aoki
AU - Yohei Nounaka
AU - Atsushi Tsukiyama
AU - Fumihiro Matano
AU - Shigeyuki Tahara
AU - Yasuo Murai
PY - 2026
DA - 2026/10/01
JO - Cancers
DO - 10.3390/cancers18193171
UR - https://europepmc.org/article/MED/42882863
AB - Background/objectives Accurate intraoperative identification of the tumor-brain interface is important in brain metastasis surgery, but visual assessment under white light is subjective. Narrow-band imaging (NBI) enhances hemoglobin-dependent optical contrast without an exogenous agent; whether its intraoperative appearance corresponds to tumor tissue, and whether it measurably increases tumor-to-normal image contrast, has not been established in this setting.Methods In this retrospective, single-center, exploratory study, we evaluated 25 consecutive patients with brain metastases resected using a 4K three-dimensional exoscope equipped with NBI. In three selected patients, spatially adjacent specimens were separately sampled from grayish-appearing and whitish-appearing regions and assessed histopathologically in a non-blinded, descriptive manner. In all 25 patients, paired white-light and NBI images were retrospectively analyzed in Fiji/ImageJ using regions of interest drawn over tissue visually judged to be tumor or normal brain.Results In the three patients with paired histology, grayish-appearing specimens contained metastatic tumor cells and whitish-appearing specimens did not; this observation derives from a small, selectively sampled subset and should be regarded as preliminary. Across all 25 patients, absolute tumor-to-normal gray-value contrast was significantly greater under NBI than white light (69.628 ± 45.338 vs. 44.287 ± 29.640; mean paired increase, 25.342; 95% CI, 9.169-41.514; p = 0.0035; Cohen's dz = 0.647), although this increase was not observed in all patients.Conclusions In this exploratory, non-blinded, retrospective study, NBI increased objective image contrast between visually identified tumor and normal brain relative to white light, and its grayish appearance corresponded to tumor tissue in a small histologically sampled subset. These findings support NBI as a feasible, agent-free adjunct that warrants prospective, blinded validation before its diagnostic accuracy or clinical benefit can be assessed.
SN - 2072-6694
ER -