NBI - Why it Might Be Needed in NMIBC Management

Reviewing the literature, 50–70% of NMIBC patients suffer from recurrences after the initial treatment in form of superficial tumors. Missing small papillary tumours or CIS is an acknowledged risk, at an estimated rate of 10–20%. Superficial tumours of the mucosa are typically indicated by specific capillary and vessel structures.

Identifying these structures – especially small tumours under white light conditions – is possible, but could be improved. This is where the patented HD-NBI technology helps as shown by the clinical evidence described below.

NBI Visualizes 28% More Carcinomas in Situ Compared to WLI.
NBI Detects Bladder Cancer in 17% Additional Patients Compared to WLI.

Diagnosis of narrow-band imaging in non-muscle-invasive bladder cancer: a systematic review and meta-analysis.


Kaiwen Li, Tianxin Lin, Xinxiang Fan, Yu Duan, and Jian Huang

Key Outcomes

  • Cystoscopy assisted by NBI detects more NMIBC patients and tumors than WLI.
  • NBI is an alternative diagnostic technique for NMIBC.
  • In the patient- and tumor-level analyses, an additional 17% of patients and an additional 24% of tumors were detected by NBI compared to WLI.
  • On the tumor level, an additional 28% of carcinomas in situ were detected by NBI compared to WLI, and a significantly higher detection rate was found.


Source: http://www.ncbi.nlm.nih.gov/pubmed/23113702

© 2012 The Japanese Urological Association, International Journal of Urology (2013) 20, 602–609


NBI Reduces the Risk of Recurrence to 17% at One Year.

Narrow Band Imaging-Assisted Transurethral Resection Reduces the Recurrence Risk of Non-Muscle Invasive Bladder Cancer: A Systematic Review and Meta-Analysis


Weiting Kang, Zilian Cui, Qianqian Chen, Dong Zhang, Haiyang Zhang, and Xunbo Jin

Key Outcomes

  • Compared with WLI cystoscopy, NBI cystoscopy increases the visualization and detection of bladder cancer.
  • TUR-BT using NBI reduces the risk of NMIBC recurrence at three months, one year, and two years significantly when compared with TUR-BT using WLI.
  • At three months, NBI reduces the recurrence risk by 59.5% (NBI 6% vs WLI 14.8%).
  • At one year, NBI reduces the recurrence risk by 48% (NBI 16.5% vs WLI 31.7%).
  • At two years, NBI reduces the recurrence risk by 40% (NBI 17.7% vs WLI 29.5%).


Source: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5410352/

© Oncotarget, Advance Publications 2016


Using NBI or PDD during TUR-BT Reduces Recurrence Rate Compared to WLI.

A network meta-analysis of therapeutic outcomes after new image technology-assisted transurethral resection for non-muscle invasive bladder cancer: 5-aminolaevulinic acid fluorescence vs hexylaminolevulinate fluorescence vs narrow band imaging.


Joo Yong Lee, Kang Su Cho, Dong Hyuk Kang, Hae Do Jung, Jong Kyou Kwon, Cheol Kyu Oh, Won Sik Ham and Young Deuk Choi

Key Outcomes

  • Previous RCT and meta-analyses including this network meta-analysis have proven PDD and NBI can enhance the diagnosis of bladder lesions, guide an adequate resection, and reduce tumor recurrence.
  • Both NBI and PDD are superior to WLI for reducing cancer recurrence rates after TUR-BT.
  • When TUR-BT is performed using PDD or NBI, the recurrence rate of NMIBC is reduced compared to WLI by at least 35%.


Source: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4521364/

BMC Cancer (2015) 15:566 ; DOI 10.1186/s12885-015-1571-8


NBI Increases Detection Rate of UUT-TCC by 23% Compared to WLI.

Narrow Band Imaging Digital Flexible Ureteroscopy in Detection of Upper Urinary Tract Transitional-Cell Carcinoma: initial experience.


Olivier Traxer, Bogdan Geavlete, S. Gil diez de Medina, Matilde Sibony, and Saeed M. Al-Qahtani

Key Outcomes

  • NBI has a higher diagnostic power for identifying upper urinary tract transitional-cell carcinoma (UUT-TCC) than WLI alone, objectively confirmed via histological analysis.
  • NBI enables the urologist to determine the exact limits of tumors, thereby facilitating complete laser vaporization.
  • From 35 detected, pathology-confirmed transitional-cell tumors NBI exclusively diagnosed five additional tumors (14.2%), and identified extended limits for another 8.5% of tumors.
  • NBI improves the tumor detection rate by 23% compared with WLI.
  • NBI seems to represent a valuable diagnostic technology for UUT-TCC, showing considerable improvement in tumor visual accuracy as well as in the tumor detection rate.


Source: http://www.ncbi.nlm.nih.gov/pubmed/21247287

JOURNAL OF ENDOUROLOGY, issue 25, number 1,January 2011, p. 19–23, DOI: 10.1089=end.2009.0593