title: Narrow band imaging cystoscopy improves the detection of non-muscle-invasive bladder cancer.
abstract: OBJECTIVE
  To determine whether narrow band imaging (NBI) improves detection of non-muscle-invasive bladder cancer over white-light imaging (WLI) cystoscopy.
  
  
  METHODS
  We conducted a prospective, within-patient comparison on 103 consecutive procedures on 95 patients scheduled for (re-) transurethral resection of a bladder tumor (84) or bladder biopsies (19) in the Academic Medical Center, Amsterdam (September 2007-July 2009) and in the General Faculty Hospital, Prague (January 2009-July 2009). WLI and NBI cystoscopy were subsequently performed by different surgeons who independently indicated all tumors and suspect areas on a bladder diagram. The lesions identified were resected/biopsied and sent for histopathological examination. Number of patients with additional tumors detected by WLI and NBI were calculated; mean number of urothelial carcinomas (UCs) per patient, detection rates, and false-positive rates of both techniques were compared.
  
  
  RESULTS
  A total of 78 patients had a confirmed UC; there were 226 tumors in total. In 28 (35.9%) of these patients, a total of 39 additional tumors (17.3%) (26pTa, 6pT1, 1pT2, 6pTis) were detected by NBI, whereas 4 additional tumors (1.8%) (1pTa, 1pT1, 2pTis) within 3 patients (2.9%) were detected by WLI. The mean (SD, range) number of UCs per patient identified by NBI was 2.1 (2.6, 0-15), vs 1.7 (2.3, 0-15) by WLI (P <.001). The detection rate of NBI was 94.7% vs 79.2% for WLI (P <.001). The false-positive rate of NBI and WLI was 31.6% and 24.5%, respectively (P <.001).
  
  
  CONCLUSIONS
  NBI cystoscopy improves the detection of primary and recurrent nonmuscle invasive bladder cancer over WLI. However, further validation of the technique with comparative studies is required.
authors.affiliation: Department of Urology, Medical Center, Amsterdam, The Netherlands. e.c.cauberg@amc.uva.nl
authors.forename: Evelyne C C
authors.initials: EC
authors.lastname: Cauberg
authors.forename: Sarah
authors.initials: S
authors.lastname: Kloen
authors.forename: Mike
authors.initials: M
authors.lastname: Visser
authors.forename: Jean J M C H
authors.initials: JJ
authors.lastname: de la Rosette
authors.forename: Marko
authors.initials: M
authors.lastname: Babjuk
authors.forename: Viktor
authors.initials: V
authors.lastname: Soukup
authors.forename: Michael
authors.initials: M
authors.lastname: Pesl
authors.forename: Jaroslava
authors.initials: J
authors.lastname: Duskova
authors.forename: Theo M
authors.initials: TM
authors.lastname: de Reijke
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001706:Biopsy; D003558:Cystoscopy / Q000379:methods*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D009364:Neoplasm Recurrence, Local / Q000473:pathology*; D011446:Prospective Studies; D001749:Urinary Bladder Neoplasms / Q000473:pathology*