Ditte Drejer1, Sami Béji2, Recep Oezeke3, Anna Munk Nielsen4, Søren Høyer5, Truls Erik Bjerklund Johansen3, Gitte W Lam2, Jørgen B Jensen6. 1. Department of Urology, Aarhus University Hospital, Aarhus, Denmark; Department of Urology, Hospital of West Jutland, Holstebro, Denmark. Electronic address: Dittedrejer@dadlnet.dk. 2. Department of Urology, Herlev Hospital, Herlev, Denmark. 3. Department of Urology, Oslo University Hospital, Oslo, Norway. 4. Department of Urology, Aarhus University Hospital, Aarhus, Denmark. 5. Institute of Pathology, Aarhus University Hospital, Aarhus, Denmark. 6. Department of Urology, Aarhus University Hospital, Aarhus, Denmark; Department of Urology, Hospital of West Jutland, Holstebro, Denmark.
Abstract
OBJECTIVE: To compare findings in NBI to findings in WL and PDD in a high-risk patient population. MATERIALS AND METHODS: A total of 171 patients were included in the study from 4 different urology departments in Denmark and Norway. Patients were scheduled for a PDD-guided transurethral tumor resection or cystoscopy-guided biopsy in accordance with Danish guidelines, on the suspicion of primary or concomitant CIS. All patients were examined with WL cystoscopy followed by both NBI and PDD before biopsy. RESULTS: A total of 136 patients were biopsied due to findings with suspicion of CIS in at least 1 modality (482 biopsies with a mean of 3.5 biopsies per patient). Analysis at patient level showed that NBI and PDD had a significantly higher sensitivity regarding identification of CIS and dysplasia compared with WL (NBI: 95.7%, PDD: 95.7% vs WL: 65.2%, P < .05). Specificity was not significantly different between the 3 methods (NBI: 52.0%, PDD: 48.0%, and WL: 56.8%). When analyzed per biopsy, NBI and PDD had a significantly higher sensitivity than WL (NBI: 72.7% and PDD: 78.2% vs WL: 52.7%, P < .05), whereas the positive predictive values were not significantly different (NBI: 23.7%, PDD: 22.2%, and WL: 19.0%). CONCLUSION: NBI was found to be a valid alternative to PDD regarding diagnosis of CIS and flat dysplasia.
OBJECTIVE: To compare findings in NBI to findings in WL and PDD in a high-risk patient population. MATERIALS AND METHODS: A total of 171 patients were included in the study from 4 different urology departments in Denmark and Norway. Patients were scheduled for a PDD-guided transurethral tumor resection or cystoscopy-guided biopsy in accordance with Danish guidelines, on the suspicion of primary or concomitant CIS. All patients were examined with WL cystoscopy followed by both NBI and PDD before biopsy. RESULTS: A total of 136 patients were biopsied due to findings with suspicion of CIS in at least 1 modality (482 biopsies with a mean of 3.5 biopsies per patient). Analysis at patient level showed that NBI and PDD had a significantly higher sensitivity regarding identification of CIS and dysplasia compared with WL (NBI: 95.7%, PDD: 95.7% vs WL: 65.2%, P < .05). Specificity was not significantly different between the 3 methods (NBI: 52.0%, PDD: 48.0%, and WL: 56.8%). When analyzed per biopsy, NBI and PDD had a significantly higher sensitivity than WL (NBI: 72.7% and PDD: 78.2% vs WL: 52.7%, P < .05), whereas the positive predictive values were not significantly different (NBI: 23.7%, PDD: 22.2%, and WL: 19.0%). CONCLUSION: NBI was found to be a valid alternative to PDD regarding diagnosis of CIS and flat dysplasia.
Authors: M C Kriegmair; S Hein; D S Schoeb; H Zappe; R Suárez-Ibarrola; F Waldbillig; B Gruene; P-F Pohlmann; F Praus; K Wilhelm; C Gratzke; A Miernik; C Bolenz Journal: Urologe A Date: 2020-12-10 Impact factor: 0.639