Narrow-band imaging flexible cystoscopy in the detection of primary non-muscle invasive bladder cancer: a “second look” matters?

Shen, Yi; Zhu, Yi Ping; Ye, Ding Wei; Yao, Xu; Zhang, Shi Lin; Dai, Bo; Zhang, Hai Liang; Zhu, Yao

doi:10.1007/s11255-011-0036-5

Cited by 47 publications

(56 citation statements)

References 19 publications

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“…Lastly, it is unclear whether these technologies simply provide an added effect, such that second look WLC alone would also improve tumor detection. 33 …”

Section: Resultsmentioning

confidence: 99%

New Optical Imaging Technologies for Bladder Cancer: Considerations and Perspectives

2012

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Purpose Bladder cancer presents as a spectrum of different diatheses. Accurate assessment for individualized treatment depends on initial diagnostic accuracy. Detection relies on white light cystoscopy accuracy and comprehensiveness. Aside from invasiveness and potential risks, white light cystoscopy shortcomings include difficult flat lesion detection, precise tumor delineation to enable complete resection, inflammation and malignancy differentiation, and grade and stage determination. Each shortcoming depends on surgeon ability and experience with the technology available for visualization and resection. Fluorescence cystoscopy/photodynamic diagnosis, narrow band imaging, confocal laser endomicroscopy and optical coherence tomography address the limitations and have in vivo feasibility. They detect suspicious lesions (photodynamic diagnosis and narrow band imaging) and further characterize lesions (optical coherence tomography and confocal laser endomicroscopy). We analyzed the added value of each technology beyond white light cystoscopy and evaluated their maturity to alter the cancer course. Materials and Methods Detailed PubMed® searches were done using the terms “fluorescence cystoscopy,” “photodynamic diagnosis,” “narrow band imaging,” “optical coherence tomography” and “confocal laser endomicroscopy” with “optical imaging,” “bladder cancer” and “urothelial carcinoma.” Diagnostic accuracy reports and all prospective studies were selected for analysis. We explored technological principles, preclinical and clinical evidence supporting nonmuscle invasive bladder cancer detection and characterization, and whether improved sensitivity vs specificity translates into improved correlation of diagnostic accuracy with recurrence and progression. Emerging preclinical technologies with potential application were reviewed. Results Photodynamic diagnosis and narrow band imaging improve nonmuscle invasive bladder cancer detection, including carcinoma in situ. Photodynamic diagnosis identifies more papillary lesions than white light cystoscopy, enabling more complete resection and fewer residual tumors. Despite improved treatment current data on photodynamic diagnosis do not support improved high risk diathetic detection and characterization or correlation with disease progression. Prospective recurrence data are lacking on narrow band imaging. Confocal laser endomicroscopy and optical coherence tomography potentially grade and stage lesions but data are lacking on diagnostic accuracy. Several emerging preclinical technologies may enhance the diagnostic capability of endoscopic imaging. Conclusions New optical imaging technologies may improve bladder cancer detection and characterization, and transurethral resection quality. While data on photodynamic diagnosis are strongest, the clinical effectiveness of these technologies is not proven. Prospective studies are needed, particularly of narrow band imaging, confocal laser endomicroscopy and optical coherence tomography. As each technology matures and new ones emerg...

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“…Lastly, it is unclear whether these technologies simply provide an added effect, such that second look WLC alone would also improve tumor detection. 33 …”

Section: Resultsmentioning

confidence: 99%

New Optical Imaging Technologies for Bladder Cancer: Considerations and Perspectives

2012

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“…The residual tumor rate after the first electro-TUR is approximately 33.8-36% [18, 19]. Among cases of NMIBC, 17.1% tumors were detected by NBI only, whereas 1.9% tumors were found by WLI only [20]. Additionally, 42% patients with positive urine cytology and negative WLI cystoscopy presented with BCs when undergoing NBI cystoscopy [21].…”

Section: Introductionmentioning

confidence: 99%

Narrow band imaging-assisted transurethral resection reduces the recurrence risk of non-muscle invasive bladder cancer: A systematic review and meta-analysis

et al. 2016

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“…Since the first report about cystoscopy using NBI by Bryan et al . in 2008, NBI compared with WLI for detecting NMIBC has been reported by several medical centers, but with conflicting results …”

Section: Introductionmentioning

confidence: 99%

Diagnosis of narrow‐band imaging in non‐muscle‐invasive bladder cancer: A systematic review and meta‐analysis

Lin

Fan

et al. 2012

Int J of Urology

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Abbreviations & Acronyms ADR = additional detection rate CIS = carcinoma in situ CONSORT = Consolidated Standards of Reporting Trials DR = detection rate Inc nor = including normal-looking lesion for biopsy NA = data not available NBI = narrow-band imaging NMIBC = non-muscle-invasive bladder cancer pri = patients with primary tumor pro = prospectively collected data R = randomized Random = random-effect model RD = rate difference rec = patients with recurrent tumor STARD = Standards for Reporting of Diagnostic Accuracy TUR = transurethral resection W = weight WLI = white-light imaging Objectives: The objective was to evaluate the diagnostic accuracy of cystoscopy assisted by narrow-band imaging compared with white-light imaging for non-muscleinvasive bladder cancer. Methods: An electronic database search of PubMed, Embase, the Cochrane Library, Ovid and Web of Science was carried out for all articles comparing narrow-band imaging with white-light imaging cystoscopy in the detection of non-muscle-invasive bladder cancer. The review process followed the guidelines of the Cochrane Collaboration. Results: Seven studies with prospectively collected data including a total of 1040 patients were identified, and 611 patients with 1476 tumors were detected by biopsy. In the patient-and tumor-level analysis, an additional 17% of patients (95% confidence interval, 10-25%) and an additional 24% of tumors (95% confidence interval, 17-31%) were detected by narrow-band imaging, respectively. In the patient-and tumor-level analysis, significantly higher detection rates using narrow-band imaging (rate difference 11%; 95% confidence interval 5-17%; P < 0.001; and rate difference 19%; 95% confidence interval 12-26%; P < 0.001, respectively) rather than white-light imaging were found. On the tumor level, an additional 28% of carcinoma in situ was detected (95% confidence interval 14-45%) by narrow-band imaging, and a significantly higher detection rate (rate difference 11%; 95% confidence interval 1-21%; P = 0.03) was found. The false-positive detection rate of tumor level did not differ significantly between the two techniques. Conclusions: Cystoscopy assisted by narrow-band imaging detects more patients and tumors of non-muscle-invasive bladder cancer than white-light imaging, and it might be an additional or alternative diagnostic technique for non-muscle-invasive bladder cancer.

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Narrow-band imaging flexible cystoscopy in the detection of primary non-muscle invasive bladder cancer: a “second look” matters?

Abstract: The "second look" did not compromise the superiority of NBI over standard WLI flexible cystoscopy for detecting primary NMIBC including CIS lesions.

Cited by 47 publications

References 19 publications

New Optical Imaging Technologies for Bladder Cancer: Considerations and Perspectives

New Optical Imaging Technologies for Bladder Cancer: Considerations and Perspectives

Narrow band imaging-assisted transurethral resection reduces the recurrence risk of non-muscle invasive bladder cancer: A systematic review and meta-analysis

Diagnosis of narrow‐band imaging in non‐muscle‐invasive bladder cancer: A systematic review and meta‐analysis

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