Performance of narrow band imaging (Nbi) and photodynamic diagnosis (pdd) fluorescence imaging compared to white light cystoscopy (wlc) in detecting non-muscle invasive bladder cancer: A systematic review and lesion-level diagnostic meta-analysis

Giorgio I. Russo, Tamir N. Sholklapper, Andrea Cocci, Giuseppe Broggi, Rosario Caltabiano, Angela B. Smith, Yair Lotan, Giuseppe Morgia, Ashish M. Kamat, J. Alfred Witjes, Siamak Daneshmand, Mihir M. Desai, Indebir S. Gill, Giovanni E. Cacciamani

Research output: Contribution to journalReview articlepeer-review

2 Scopus citations

Abstract

Despite early detection and regular surveillance of non-muscle invasive bladder cancer (NMIBC), recurrence and progression rates remain exceedingly high for this highly prevalent malignancy. Limited visualization of malignant lesions with standard cystoscopy and associated false-negative biopsy rates have been the driving force for investigating alternative and adjunctive technologies for improved cystoscopy. The aim of our systematic review and meta-analysis was to compare the sensitivity, specificity, and oncologic outcomes of photodynamic diagnosis (PDD) fluorescence, narrow band imaging (NBI), and conventional white light cystoscopy (WLC) in detecting NMIBC. Out of 1,087 studies reviewed, 17 prospective non-randomized and randomized controlled trials met inclusion criteria for the study. We demonstrated that tumor resection with either PDD and NBI exhibited lower recurrence rates and greater diagnostic sensitivity compared to WLC alone. NBI demonstrated superior disease sensitivity and specificity as compared to WLC and an overall greater hierarchical summary receiver operative characteristic. Our findings are consistent with emerging guidelines and underscore the value of integrating these enhanced technologies as a part of the standard care for patients with suspected or confirmed NMIBC.

Original languageEnglish (US)
Article number4378
JournalCancers
Volume13
Issue number17
DOIs
StatePublished - Sep 1 2021

Keywords

  • 5-ALA
  • 5-aminolaevulinic acid
  • Accuracy meta-analysis
  • Bladder cancer
  • Blue light cystoscopy
  • Cystoscopy
  • HAL
  • Hexaminolevulinate
  • Narrow band imaging
  • PDD
  • Photodynamic diagnosis fluorescence

ASJC Scopus subject areas

  • Oncology
  • Cancer Research

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