Comparative Prospective Analysis of the Diagnostic Accuracy of Three Transurethral Resection Bladder Cancer Detection Techniques: White Light, Narrow Band Imaging (NBI) And Photodynamic Diagnosis (PDD-HEXYL AMINOLEVULINATE) Bladder's Cancer Detection Comparaison

Thomas Loubersac, Stephane De Vergie, Julien Branchereau, Guillaume Muller, François Buge, Olivier Bouchot and Jerome Rigaud

Department of Urology Unit, CHU de Nantes, France

^*Correspondance to: Jerome Rigaud 

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Abstract:

Introduction: Narrow Band Imaging (NBI) technology has been recently used in the context of transurethral resection of Bladder Tumours (TURBT) and its contribution has yet to be demonstrated with respect to the other two available techniques: White Light (WL) and Photodynamic Diagnosis (PDD-HEXYL AMINOLEVULINATE*). The objective of this study was to compare these 3 techniques in the same series of patients.Materials and
Methods: Ten endoscopic resections were prospectively performed for suspected bladder tumour with an indication for Hexyl aminolevulinate photodynamic diagnosis-assisted Transurethral Resection of Bladder Tumours (TURBT) between May 2015 and November 2015. All patients underwent cystoscopy with each of the three techniques in the following order: WL, NBI, then Hexyl aminolevulinate*. Each lesion detected was then resected separately. Interpretation of these 3 diagnostic techniques was compared to the histological diagnosis of each of the lesions resected.Results: Twenty lesions (9 flat lesions and 11 papillary lesions) were examined. The histological diagnosis was non-neoplastic lesion in 6 cases (30%), pTa-pT1 bladder cancer in 7 cases (35%), carcinoma in situ in 6 cases (30%) and pT2 bladder cancer in 1 case (5%).The sensitivity and specificity of the various tests in the overall population were: 100% and 33% for WL, 100% and 20% for Hexyl aminolevulinate*, and 71% and 33% for NBI, respectively.The sensitivity and specificity for flat lesions were 100% and 50% for WL, 100% and 25% for Hexyl aminolevulinate*, and 71% and 0% for NBI, respectively.The sensitivity and specificity for papillary lesions were 100% and 0% for WL, 100% and 0% for Hexyl aminolevulinate*, and 71% and 100% for NBI, respectively.Conclusion: The diagnostic accuracy of NBI technology during TURBT in this study was poorer than that of WL or Hexyl aminolevulinate*, except for papillary tumours, for which NBI was more specific.

Keywords:

Non-muscle-invasive bladder cancer; Photodynamic diagnosis; Narrow band imaging Hexyl aminolevulinate; Carcinoma in situ

Cite the Article:

Loubersac T, De Vergie S, Branchereau J, Muller G, Buge F, Bouchot O, et al. Comparative Prospective Analysis of the Diagnostic Accuracy of Three Transurethral Resection Bladder Cancer Detection Techniques: White Light, Narrow Band Imaging (NBI) And Photodynamic Diagnosis (PDD-HEXYL AMINOLEVULINATE) Bladder's Cancer Detection Comparaison. Clin Oncol. 2019; 4: 1590.