Jeffrey M Howard1, Solomon L Woldu1, Siamak Daneshmand2, Yair Lotan1. 1. Department of Urology, University of Texas Southwestern Medical Center, Dallas, Texas, USA. 2. Department of Urology, University of Southern California, Los Angeles, California, USA.
Abstract
Purpose: We assessed the ability of enhanced cystoscopy with CHROMA image enhancement (Karl Storz SE & Co. KG, Tuttlingen, Germany) to improve cancer detection during transurethral resection of bladder tumors (TURBT) in patients with known or suspected nonmuscle invasive bladder cancer (NMIBC). Patients and Methods: A total of 49 patients (82% men) with a median age of 71 years underwent TURBT for known or suspected NMIBC. Bladders were assessed first with conventional white light imaging and then with CHROMA enhancement. We quantified the number of tumors seen with white light and any additional tumors seen with CHROMA and correlated with pathologic results. Results: A total of 165 tumors were viewed in 47 patients; of these, 25 were only seen using CHROMA. Use of CHROMA yielded additional tumors not appreciated on white light in 14 of 39 patients with underlying malignancy, for an additional detection rate (ADR) of 36% (95% confidence interval, 21%-53%). CHROMA improved detection of tumors in the setting of both low-grade (LG) and high-grade (HG) disease with equal efficacy (ADR 43% in LG and 44% in HG, p = 0.98, Barnard exact test). Conclusions: Cystoscopy with CHROMA contrast enhancement facilitates detection of bladder tumors that are not readily appreciated using conventional white light cystoscopy. The technology integrates seamlessly with current practice and can serve as an adjunct to other novel technologies.
Purpose: We assessed the ability of enhanced cystoscopy with CHROMA image enhancement (Karl Storz SE & Co. KG, Tuttlingen, Germany) to improve cancer detection during transurethral resection of bladder tumors (TURBT) in patients with known or suspected nonmuscle invasive bladder cancer (NMIBC). Patients and Methods: A total of 49 patients (82% men) with a median age of 71 years underwent TURBT for known or suspected NMIBC. Bladders were assessed first with conventional white light imaging and then with CHROMA enhancement. We quantified the number of tumors seen with white light and any additional tumors seen with CHROMA and correlated with pathologic results. Results: A total of 165 tumors were viewed in 47 patients; of these, 25 were only seen using CHROMA. Use of CHROMA yielded additional tumors not appreciated on white light in 14 of 39 patients with underlying malignancy, for an additional detection rate (ADR) of 36% (95% confidence interval, 21%-53%). CHROMA improved detection of tumors in the setting of both low-grade (LG) and high-grade (HG) disease with equal efficacy (ADR 43% in LG and 44% in HG, p = 0.98, Barnard exact test). Conclusions: Cystoscopy with CHROMA contrast enhancement facilitates detection of bladder tumors that are not readily appreciated using conventional white light cystoscopy. The technology integrates seamlessly with current practice and can serve as an adjunct to other novel technologies.
Authors: Jean de la Rosette; Alexey Martov; Rodolfo Hurle; Gabriel Favre; Charalampos Mamoulakis; Manuel Castanheira de Oliveira; Arnulf Stenzl; Estefania Linares-Espinós; Carlos R Trelles Guzmán; Stavros Gravas; Thomas Knoll; Mustafa Yucel Boz; Thomas Herrmann; Pilar Laguna Journal: World J Urol Date: 2021-11-06 Impact factor: 4.226
Authors: Jeremy Yuen-Chun Teoh; Ashish M Kamat; Peter C Black; Petros Grivas; Shahrokh F Shariat; Marek Babjuk Journal: Nat Rev Urol Date: 2022-03-31 Impact factor: 16.430