Cystoscopy and transurethral resection (TUR) using white light (WL) has been used as a standard procedure for diagnosis and treatment of non-muscle invasive bladder cancer (NMIBC). However, WL cystoscopy cannot always effectively identify small tumor or high grade flat lesions, carcinoma in situ (CIS). Small tumors can be frequently missed resulting in a high rate of residual tumors after WL-assisted TUR, and deficient visualization of tumor borders or associated CIS may lead to incomplete resection. Such oversights of small tumors or incomplete resections are considered to be a cause of the high incidence of intravesical recurrence after WL-assisted TUR.
Recently, Narrow-band imaging (NBI) has been developed as a new technology to overcome such shortcomings of WL cystoscopy or WL-assisted TUR. NBI devices filter out the red spectrum from WL, leaving the resultant blue (415 nm) and green (540 nm) spectra. These specific wavelengths penetrate only the surface of the bladder tissue, and are strongly absorbed by hemoglobin. Consequently, high vessel contrast and delicate tissue surface structure can be obtained without any medication. NBI can be used easily and safely in an outpatient clinic for cystoscopy, and in an operating room for TUR. NBI increases the detection of bladder tumors including CIS without any significant increase in false-positive rates that would lead to unnecessary negative biopsies. NBI also may improve the quality of TUR and consequently reduce the subsequent tumor recurrence particularly in low-risk patients.
Thus, NBI is a promising technology that facilitates the diagnosis and treatment of NMIBC.
Narrow-band imaging Non-muscle invasive bladder cancer Transurethral resection
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