A comparison of white-light cystoscopy and narrow-band imaging cystoscopy to detect bladder tumour recurrences.

Overview

OBJECTIVE: To determine whether narrow-band imaging (NBI) cystoscopy enhances the detection of non-muscle-invasive bladder tumours over standard white-light imaging (WLI) cystoscopy, as surveillance WLI is the standard method used to diagnose patients with recurrent bladder tumours, but they can be missed by WLI cystoscopy, possibly accounting for early recurrences. PATIENTS AND METHODS: We evaluated 427 patients for recurrent bladder tumours by WLI cystoscopy, followed by NBI cystoscopy as a further procedure, using the same video-cystoscope. Recurrent tumours visualized by WLI or NBI cystoscopy were mapped, imaged, biopsied and subsequently treated by transurethral resection (TUR) or fulguration. Biopsies or TUR specimens obtained by WLI and NBI were examined separately for presence of tumour. RESULTS: In all, 103 patients (24%) had tumour recurrences; 90 (87%) were detected by both WLI and NBI and another 13 (100%) only by NBI cystoscopy. NBI detected extra papillary tumours or more extensive carcinoma in situ in 58 (56%) patients found to have recurrences. The mean number of recurrent tumours visualized on WLI cystoscopy was 2.3, vs to 3.4 seen on NBI cystoscopy (P = 0.01). CONCLUSION: NBI cystoscopy improved the detection of recurrent non-muscle-invasive bladder tumours over standard WLI cystoscopy.