Research Article
Emerging Endoscopic and Photodynamic Techniques for Bladder Cancer Detection and Surveillance
Table 1
Overview of NBI and PDD techniques.
| | NBI | PDD |
| Optical principle | Absorption | Fluorescence | Costs stack | Equivalent | Equivalent | Costs scopes | Can be used on compatible “scopes” | New rigid “scopes” with blue light filter are required | Costs staff | Nil | Extra | Costs consumables | Nil | Extra | Convenience | Very convenient | Inconvenient | Extra invasiveness for patient | None | Extra catheterisation for preoperative instillation of photosensitising agent | Sensitivity (%) for visualisation of bladder tumours | 93–100 | 82–97 | Specificity (%) for visualisation of bladder tumours | 68–82 | 41.4–98.5 | On Initial suspicion of bladder cancer diagnosis | Good in an outpatient setting at initial cystoscopy | Good in an inpatient setting at time of TURBT | On CIS diagnosis | Accuracy of 83% [38] | Good | In patients with positive urine cytology but negative WLC | Not known | Recommended | For assessment at time of tumour recurrences in patients not previously staged with NBI/PDD | Not known | Recommended | Tumour treatment | Good in outpatient setting for ablation of tumours by diathermy or laser, especially for recurrences during surveillance | Good in an inpatient setting in conjunction with TURBT | Haematuria clinic | Considerable potential | Impractical due to patient numbers and not all patients presenting to haematuria clinic have UC | For surveillance | Good. Effect of previous BCG, inflammation or scarring is yet unknown | No data available. Specificity is reduced in patients who have had previous BCG, inflammation, or scars and hence limits the use | Extra applications | Upper urinary tract, upper and lower GI, and so forth | Nil | As a teaching tool | Good | Good |
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