title: Comparison of White Light, Photodynamic Diagnosis, and Narrow-band Imaging in Detection of Carcinoma In Situ or Flat Dysplasia at Transurethral Resection of the Bladder: the DaBlaCa-8 Study.
abstract: To compare findings in NBI to findings in WL and PDD in a high-risk patient population.
  
  
  
  A total of 171 patients were included in the study from 4 different urology departments in Denmark and Norway. Patients were scheduled for a PDD-guided transurethral tumor resection or cystoscopy-guided biopsy in accordance with Danish guidelines, on the suspicion of primary or concomitant CIS. All patients were examined with WL cystoscopy followed by both NBI and PDD before biopsy.
  
  
  
  A total of 136 patients were biopsied due to findings with suspicion of CIS in at least 1 modality (482 biopsies with a mean of 3.5 biopsies per patient). Analysis at patient level showed that NBI and PDD had a significantly higher sensitivity regarding identification of CIS and dysplasia compared with WL (NBI: 95.7%, PDD: 95.7% vs WL: 65.2%, P < .05). Specificity was not significantly different between the 3 methods (NBI: 52.0%, PDD: 48.0%, and WL: 56.8%). When analyzed per biopsy, NBI and PDD had a significantly higher sensitivity than WL (NBI: 72.7% and PDD: 78.2% vs WL: 52.7%, P < .05), whereas the positive predictive values were not significantly different (NBI: 23.7%, PDD: 22.2%, and WL: 19.0%).
  
  
  
  NBI was found to be a valid alternative to PDD regarding diagnosis of CIS and flat dysplasia.
authors.affiliation: Department of Urology, Aarhus University Hospital, Aarhus, Denmark; Department of Urology, Hospital of West Jutland, Holstebro, Denmark. Electronic address: Dittedrejer@dadlnet.dk.
authors.forename: Ditte
authors.initials: D
authors.lastname: Drejer
authors.affiliation: Department of Urology, Herlev Hospital, Herlev, Denmark.
authors.forename: Sami
authors.initials: S
authors.lastname: Béji
authors.affiliation: Department of Urology, Oslo University Hospital, Oslo, Norway.
authors.forename: Recep
authors.initials: R
authors.lastname: Oezeke
authors.affiliation: Department of Urology, Aarhus University Hospital, Aarhus, Denmark.
authors.forename: Anna Munk
authors.initials: AM
authors.lastname: Nielsen
authors.affiliation: Institute of Pathology, Aarhus University Hospital, Aarhus, Denmark.
authors.forename: Søren
authors.initials: S
authors.lastname: Høyer
authors.affiliation: Department of Urology, Oslo University Hospital, Oslo, Norway.
authors.forename: Truls Erik
authors.initials: TE
authors.lastname: Bjerklund Johansen
authors.affiliation: Department of Urology, Herlev Hospital, Herlev, Denmark.
authors.forename: Gitte W
authors.initials: GW
authors.lastname: Lam
authors.affiliation: Department of Urology, Aarhus University Hospital, Aarhus, Denmark; Department of Urology, Hospital of West Jutland, Holstebro, Denmark.
authors.forename: Jørgen B
authors.initials: JB
authors.lastname: Jensen
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D002278:Carcinoma in Situ / Q000000981:diagnostic imaging* / Q000601:surgery*; D015653:Cystectomy / Q000379:methods; D003558:Cystoscopy; D005260:Female; D006801:Humans; D008027:Light; D008297:Male; D008875:Middle Aged; D062048:Narrow Band Imaging; D011446:Prospective Studies; D014521:Urethra; D001743:Urinary Bladder / Q000473:pathology*; D001749:Urinary Bladder Neoplasms / Q000000981:diagnostic imaging* / Q000601:surgery*; D055815:Young Adult