Clinical application of photodynamic diagnostics, narrow band imaging, and the Storz professional image enhancement system in the diagnosis of bladder tumours
DOI: 10.22591/magyurol.2024.1.pytela.17
Authors:
Pytel Ákos dr.
Pécsi Tudományegyetem KK, Urológiai Klinika, Pécs (igazgató: Szántó Árpád dr.)
Summary
Introduction: In the diagnostics of non-muscle invasive bladder tumours, cystoscopy is referred as gold standard. Main criticism of the procedure is the misdiagnosis of lesion potentially responsible for recurrence and progression.
Objective: The goal of recent paper is to present the innovative endoscopic technics in the diagnosis of bladder tumours and to demonstrate their clinical impact. Hungarian data are also demonstrated.
Method and results: Literature review about photodynamic diagnosis (PDD), narrow band imaging (NBI) and Storz Professional Image Enhancing System (IMAGE1 S®/SPIES). Own data of 89 patients operated by PDD guided TURB demonstrate using 5-amino-levulinic acid, hexyl amino-laevulinic acid, and hypericin 98% ,97% and 100% sensitivity, 82%, 72% and 81% specificity respectively. Previous Hungarian data demonstrated in two patient diagnostic benefit among the 26 patient treated with NBI guided TURB. As a Hungarian pilot study using IMAGE1 S®/SPIES guidance demonstrated diagnostic improvement in 3 patients from a cohort of 10.
Conclusion: The innovative technics described in the article have superior diagnostic accuracy compared with standard cystoscopy and may prolong not only recurrence over time but also risk of progression, so we have to strive the utilise the enhanced visualisation technics in wider range.