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Int J Urol. 2013 Jun;20(6):602-9. doi: 10.1111/j.1442-2042.2012.03211.x. Epub 2012 Nov 1.

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

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Department of Urology, Sun Yat-sen Memorial Hospital, Guangzhou, China.



The objective was to evaluate the diagnostic accuracy of cystoscopy assisted by narrow-band imaging compared with white-light imaging for non-muscle-invasive bladder cancer.


An electronic database search of PubMed, Embase, the Cochrane Library, Ovid and Web of Science was carried out for all articles comparing narrow-band imaging with white-light imaging cystoscopy in the detection of non-muscle-invasive bladder cancer. The review process followed the guidelines of the Cochrane Collaboration.


Seven studies with prospectively collected data including a total of 1040 patients were identified, and 611 patients with 1476 tumors were detected by biopsy. In the patient- and tumor-level analysis, an additional 17% of patients (95% confidence interval, 10-25%) and an additional 24% of tumors (95% confidence interval, 17-31%) were detected by narrow-band imaging, respectively. In the patient- and tumor-level analysis, significantly higher detection rates using narrow-band imaging (rate difference 11%; 95% confidence interval 5-17%; P < 0.001; and rate difference 19%; 95% confidence interval 12-26%; P < 0.001, respectively) rather than white-light imaging were found. On the tumor level, an additional 28% of carcinoma in situ was detected (95% confidence interval 14-45%) by narrow-band imaging, and a significantly higher detection rate (rate difference 11%; 95% confidence interval 1-21%; P = 0.03) was found. The false-positive detection rate of tumor level did not differ significantly between the two techniques.


Cystoscopy assisted by narrow-band imaging detects more patients and tumors of non-muscle-invasive bladder cancer than white-light imaging, and it might be an additional or alternative diagnostic technique for non-muscle-invasive bladder cancer.

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