Editing Bladder Cancer: Diagnosis and Evaluation (section)

===== Narrow band imaging (NBI) =====

*Filters white light into blue and green wavelengths.
*'''The light penetrates the superficial bladder tissues and is <span style="color:#ff0000">strongly absorbed by hemoglobin</span>, enhancing the contrast between normal urothelium and the blood vessels in the highly vascular malignant tumours.'''
*Does not require bladder instillation, unlike blue-light cystoscopy
*'''Improves tumour detection, but the prognostic impact remains unknown'''
**Herr and Donat (2008) performed white light and NBI cystoscopy in 427 consecutive patients with a history of NMIBC. Of the 103 patients with a tumor recurrence, 56% had additional tumors identified with NBI compared with use of WLC, and in 12% of patients, the recurrent tumor was found only with NBI. For WLC and NBI cystoscopy, the overall sensitivities were 87% and 100% and the overall specificities were 85% and 82%, respectively
*'''<span style="color:#ff0000">Guideline perspective on role of NBI cystoscopy:</span>'''
**'''<span style="color:#ff0000">CUA: NBI improves tumour detection, but the prognostic impact remains unknown</span>'''
**'''<span style="color:#ff0000">AUA:</span> in a patient with NMIBC, <span style="color:#ff0000">consider the use of NBI to increase detection and decrease recurrence</span>'''