Detection Rate of Carcinoma In Situ During TURBT Following Shift from Photodynamic Diagnosis to Narrow Band Imaging in a Single University Hospital

Abstract

ObjectiveTo examine whether or not the detection rate of Carcinoma In Situ (CIS) was significantly higher after switching from Photodynamic Diagnosis (PDD) guided TURBT to Narrow Band Imaging (NBI) guided TURBT. Materials and MethodsPathological outcome regarding CIS detection was reviewed in all TURBT procedures in a 2 year period. A total number of 1132 TURBT procedures were reviewed. In period 1, starting from January 2018 to December 2018, 487 TURBTs were performed and in period 2, from January 2019 to December 2019, 645 TURBTs were performed. PDD was used as assistance to detect CIS in period 1 and NBI was introduced as assistance instead of PDD in all TURBT in period 2. ResultsA significantly higher detection rate of CIS was found in period 2 compared to period 1 (8.7% vs 4.9%, P = .02). In primary tumors, CIS was detected in 8.4% in period 2 vs 5.4% in period 1 (not significant) whereas in TURBs for recurrent tumor, CIS was detected in 8.6% in period 2 vs 4.6% in period 1 (P = .04). There was no difference in CIS detection in patients investigated following BCG treatment for CIS (18.1% vs 21.4%). ConclusionThe overall detecting of CIS is significantly higher in period 2 but not in the recurrent tumor group, neither in the control after BCG group. These data suggest that PDD is not superior to NBI. The reduced cost and the convenient logistics of NBI can most likely improve the overall CIS detection rate.