title: Diagnosis of narrow-band imaging in non-muscle-invasive bladder cancer: a systematic review and meta-analysis.
abstract: OBJECTIVE
  The objective was to evaluate the diagnostic accuracy of cystoscopy assisted by narrow-band imaging compared with white-light imaging for non-muscle-invasive 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.
authors.affiliation: Department of Urology, Sun Yat-sen Memorial Hospital, Guangzhou, China.
authors.forename: Kaiwen
authors.initials: K
authors.lastname: Li
authors.forename: Tianxin
authors.initials: T
authors.lastname: Lin
authors.forename: Xinxiang
authors.initials: X
authors.lastname: Fan
authors.forename: Yu
authors.initials: Y
authors.lastname: Duan
authors.forename: Jian
authors.initials: J
authors.lastname: Huang
mesh_terms: D003558:Cystoscopy; D006801:Humans; D062048:Narrow Band Imaging / Q000379:methods; D016032:Randomized Controlled Trials as Topic / Q000379:methods; D001749:Urinary Bladder Neoplasms / Q000175:diagnosis*