A meta-analysis of narrow band imaging for the diagnosis and therapeutic outcome of non-muscle invasive bladder cancer

<div><p>Objectives</p><p>To assess the additional detection rate (ADR) of within-patient comparisons of Narrow band imaging (NBI) and white light cystoscopy (WLC) for non-muscle invasive bladder cancer (NMIBC) detection and compare the impact of NBI and WLC on bladder cancer recurrence risk.</p><p>Methods</p><p>We searched relevant studies from PubMed, Embase, Medline, Web of Science and the Cochrane Library database for all articles in English published beforeJuly26^th, 2016. Pooled ADR, diagnostic accuracy, relative risk (RR) and their 95% confidence intervals (CIs) were calculated.</p><p>Results</p><p>Twenty-five studies including 17 full texts and eight meeting abstracts were included for analysis. Compared to WLC, pooled ADR of NBI for NMIBC diagnosis was 9.9% (95% CI: 0.05–0.14) and 18.6% (95% CI: 0.15–0.25) in per-patient and per-lesion analysis, respectively. Pooled ADR of NBI for carcinoma in situ (CIS) diagnosis was 25.1% (95% CI: 0.09–0.42) and 31.1% (95% CI: 0.24–0.39) for per-patient and per-lesion analyses, respectively. The pooled sensitivity of NBI was significantly higher than WLC both at the per-patient (95.8% vs. 81.6%) and per-lesion levels (94.8% vs. 72.4%). In addition, NBI significantly reduced the recurrence rate of bladder cancer with a pooled RR value of 0.43 (95% CI: 0.23–0.79) and0.81 (95% CI: 0.69–0.95) at month three and twelve, respectively.</p><p>Conclusions</p><p>NBI is a valid technique that improves the diagnosis of NMIBC and CIS compared to standard WLC either at per-patient or per-lesion level. It can reduce the recurrence rate of bladder cancer accordingly.</p></div

Basic characteristic of the eligible studies for recurrencerate analysis.

<p>Basic characteristic of the eligible studies for recurrencerate analysis.</p

The PRISMA checklist for this meta-analysis.

<p>The PRISMA checklist for this meta-analysis.</p

Diagnostic accuracy of NBI and WLC in detection of NMIBC.

<p>Diagnostic accuracy of NBI and WLC in detection of NMIBC.</p

Basic characteristic of the eligible studies for additional detection rate analysis.

<p>Basic characteristic of the eligible studies for additional detection rate analysis.</p

A meta-analysis of narrow band imaging for the diagnosis and therapeutic outcome of non-muscle invasive bladder cancer - Fig 5

<p>Forest plot of the pooled relative risk (RR) for Narrow-band imaging (NBI) compared to White light cystoscopy (WLC) at month three (a) and twelve (b).</p

Forest plot of the pooled additional detection rate (ADR) of Narrow-band imaging (NBI)when compared toWhite light cystoscopy (WLC)for non-muscle invasive bladder cancer (NMIBC) detection in per-lesion analysis.

<p>Forest plot of the pooled additional detection rate (ADR) of Narrow-band imaging (NBI)when compared toWhite light cystoscopy (WLC)for non-muscle invasive bladder cancer (NMIBC) detection in per-lesion analysis.</p

Forest plot of the pooled additional detection rate (ADR) of Narrow-band imaging (NBI) when compared to White light cystoscopy (WLC) for non-muscle invasive bladder cancer (NMIBC) detection in per-patient analysis.

<p>Forest plot of the pooled additional detection rate (ADR) of Narrow-band imaging (NBI) when compared to White light cystoscopy (WLC) for non-muscle invasive bladder cancer (NMIBC) detection in per-patient analysis.</p