Evaluation of Spectra A and B Modes in Diagnosis of Suspicious Bladder Lesions

Mulawkar, Prashant Motiram; Sharma, Gyanendra; Garge, Pradyot D

doi:10.1089/end.2020.0291

Cited by 4 publications

(6 citation statements)

References 14 publications

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“…This study, however, neither compared the performance of image 1S or PDD with that of histological diagnosis, nor did the abstract mention which of the image enhancements was used in the recordings ( 116 ). Mulawkar et al published their findings of a web-based survey on cystoscopy images in WLI and SA and SB modes ( 118 ). Cystoscopy images from patients with known or suspected bladder cancer and some patients with recurrent urinary infections, invisible hematuria, and storage or voiding symptoms were included.…”

Section: Resultsmentioning

confidence: 99%

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Role of Macroscopic Image Enhancement in Diagnosis of Non-Muscle-Invasive Bladder Cancer: An Analytical Review

Mulawkar

Sharma²,

Tamhankar

et al. 2022

Front. Surg.

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Early diagnosis of non-muscle-invasive bladder cancer (NMIBC) is of paramount importance to prevent morbidity and mortality due to bladder cancer. Although white light imaging (WLI) cystoscopy has long been considered the gold standard in the diagnosis of bladder cancer, it can miss lesions in a substantial percentage of patients and is very likely to miss carcinoma in situ and dysplasia. Tumor margin detection by WLI can be inaccurate. Moreover, WLI could, sometimes, be inadequate in distinguishing inflammation and malignancy. To improve the diagnostic efficacy of cystoscopy, various optical image enhancement modalities have been studied. These image enhancement modalities have been classified as macroscopic, microscopic, or molecular. Photodynamic diagnosis (PDD), narrow band imaging (NBI), and Storz image 1 S enhancement (formerly known as SPIES) are macroscopic image enhancement modalities. A relevant search was performed for literature describing macroscopic image enhancement modalities like PDD, NBI, and image 1 S enhancement. The advantages, limitations, and usefulness of each of these in the diagnosis of bladder cancer were studied. Photodynamic diagnosis requires intravesical instillation of a photosensitizing agent and a special blue light cystoscope system. PDD has been shown to be more sensitive than WLI in the detection of bladder cancer. It is superior to WLI in the detection of flat lesions. Bladder tumor resection (TURBT) by PDD results in more complete resection and reduced recurrence rates. PDD-guided TURBT may have some role in reducing the risk of progression. Narrow band imaging provides increased contrast between normal and abnormal tissues based on neovascularization, thereby augmenting WLI. NBI requires a special light source. There is no need for intravesical contrast instillation. NBI is superior to WLI in the detection of bladder cancer. The addition of NBI to WLI improves the detection of flat lesions like carcinoma in situ. NBI is not useful in predicting invasive tumors or grades of tumors. NBI-directed TURBT reduces recurrence rates and recurrence free survival. But its efficacy in retarding progression is unproven. Image 1 S-enhancement utilizes software-based image enhancement modes without the need for a special light source or intravesical contrast instillation. This system provides high-quality images and identifies additional abnormal-looking areas. Another advantage of this system is simultaneous side-by-side visualization of WLI and enhanced image, providing WLI images as the control for comparison. As with PDD, S-enhancement produces a lower rate of a missed bladder cancer diagnosis. The system significantly improves the diagnosis of NMIBC. The sensitivity and negative predictive value of image 1 S enhancement increase with the increase in cancer grade. A negative test by S-enhancement effectively rules out NMIBC. All the image enhancement modalities have proven their utility in improving detection and short-term cancer control. But none of these modalities have proven their utility in delaying progression, or in long-term cancer control. Cancer progression and long-term control are governed by the biological nature of cancer cells. Early detection by optical enhancement may not be of utility in this regard. Well-designed studies are needed to establish the efficacy of these modalities in the evaluation of patients with bladder cancer. The last word, in this regard, is yet to be written.

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Section: Resultsmentioning

confidence: 99%

“…But in patients with cancer, SA and SB added significantly to the diagnostic accuracy of WLI. Negative SA and SB ruled out bladder cancer more effectively than WLI ( 118 ).…”

Section: Resultsmentioning

confidence: 99%

Role of Macroscopic Image Enhancement in Diagnosis of Non-Muscle-Invasive Bladder Cancer: An Analytical Review

Mulawkar

Sharma²,

Tamhankar

et al. 2022

Front. Surg.

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show abstract

“…In our work, sensitivity was 95.33% for SPECTRA A and 78.80% for white light (p = 0.001). In study conducted by P Mulawakr, Spectra A had sensitivity of 91.15% and white light had 89.81% [10]. According to numerous studies, the tumor detection rate for narrow-band imaging and white light cystoscopy is 94-97% vs. 79-83%, respectively [14,22].…”

Section: Discussionmentioning

confidence: 99%

“…The Storz professional image enhancement system has just been added to the arsenal of urologists which uses software-based image enhancement method without special light source or intravesical contrast [10]. It creates contrast for better tissue imaging by filtering red light from white light (as in narrow-band imaging) using software at the point of image processing.…”

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confidence: 99%

“…Though there are many studies on the efficacy of narrow-band imaging, there is a scarcity of the literature on the SPECTRA A of Storz professional image enhancement; only few studies state better diagnosis by SPECTRA A [10], so we conducted a prospective observational study to observe whether professional image enhancement system (SPECTRA A) enhances bladder cancer detection in addition to white light.…”

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confidence: 99%

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Storz professional image enhancement system (SPECTRA A) enhancing detection of carcinoma urinary bladder by white light cystoscopy

Gnyawali,

Sigdel,

Rai

et al. 2024

Afr J Urol

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Background SPECTRA A filters red light from white light through software to create contrast for better tissue visualization and light penetration. We aim to find whether the detection rate of bladder cancer is enhanced by SPECTRA A in adjunct to White Light Cystoscopy (WLC). Methods This was a prospective observational study among 66 patients in the Department of Urology and Kidney Transplant Surgery, Tribhuvan University Teaching Hospital. All patients undergoing TURBT for suspected/diagnosed bladder tumor were evaluated with WL, followed by SPECTRA A mode, and findings were recorded using visual bladder mapping. Resection of the tumor was done on WL, margins were again reevaluated using SPECTRA A mode, and a biopsy was taken in cases of suspicious findings confirmed on SPECTRA A. Tumor detection rate (sensitivity), extra lesion detection, false positive rate, and margin status were evaluated through 2 × 2 tables, McNemar chi-square test on patient level as well as lesion level. Results A total of 64 patients were included in the study. The mean age was 62.20 ± 13.98 with a sex ratio of M:F 4.3:1. SPECTRA A and WL had a detection rate of 95.33% and 78.80% (p = 0.001), respectively, and positive biopsy of detected lesions was 78.8% and 84.13% (p = 0.041), respectively, for SPECTRA A and WL. The false positive rate of SPECTRA A and WL was 21.19% and 15.86% (p = 0.006), respectively, whereas the false negative rate was 4% and 19.2% (p = 0.001), respectively. The number of extra lesions detected by SPECTRA A was 39, out of which 29 were histologically proven tumors. Conclusion SPECTRA A enhances the detection rate of bladder cancer when used with WL. We can increase the detection of bladder cancer by using a combination of white light and SPECTRA A.

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Endoscopic vs microscopic facial nerve decompression for traumatic facial nerve palsy: a randomized controlled trial

Das

Janweja

Mitra

et al. 2023

Eur Arch Otorhinolaryngol

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Evaluation of Spectra A and B Modes in Diagnosis of Suspicious Bladder Lesions

Cited by 4 publications

References 14 publications

Role of Macroscopic Image Enhancement in Diagnosis of Non-Muscle-Invasive Bladder Cancer: An Analytical Review

Role of Macroscopic Image Enhancement in Diagnosis of Non-Muscle-Invasive Bladder Cancer: An Analytical Review

Storz professional image enhancement system (SPECTRA A) enhancing detection of carcinoma urinary bladder by white light cystoscopy

Endoscopic vs microscopic facial nerve decompression for traumatic facial nerve palsy: a randomized controlled trial

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