New technology improves early detection of bladder tumors

The Department of Urology at the Klinik am Ring is one of the first centers in Germany to use Olympus' new state-of-the-art narrowband imaging system for the visualization of the bladder mucosa. The new narrowband technology allows physicians to detect bladder tumors at a very early, curable stage and reduce the recurrence rate.

If urination pains or blood is in the urine, this could indicate bladder cancer. Clarity is only provided by a special examination, the so-called cystoscopy. Through the urethra, the doctor inserts a thin, flexible endoscope (cystoscope) with a camera attached to it into the patient's bladder and examines the tissue for changes. Dr. Stephan Neubauer, urologist at the KLINIK am RING in Cologne, explains:"The quality of the visual representation of the bladder wall plays an important role in early diagnosis.

As one of a total of ten German centers, the Urological Department of the Clinic at RING has had a completely new technique at its disposal since the beginning of the year to scan the patient's bladder for tumor-suspicious changes - the so-called narrowband (NBI) technology. A special filter removes certain color components from the normal white light. Contrasts become sharper and blood and tumour vessels of the bladder mucosa become more visible,"explains Dr. Neubauer. Even very shallow, superficial tumours that are easily overlooked with conventional standard white light endoscopes can be detected with this device. The highlight: the surgeon can switch between NBI and white light imaging at the push of a button, depending on his requirements. This gives us a much more detailed picture of the bladder mucosa than has been the case up to now,"said Neubauer happily.

Images in HD quality

The state-of-the-art cystoscope also makes it possible to capture images in HD, ensuring excellent image quality. While conventional endoscopes produce images via a bundle of optical fibres onto a camera located at the tip, the HD video endoscope uses a so-called "chip-on-the-tip" technology. This means that a camera chip attached to the end of the endoscope produces high-resolution images of the bubble in HD quality similar to a digital camera.

Early detection of bladder cancer is curable

The new HD video endoscope with NBI technology enables us to diagnose a bladder tumor at a very early stage. This applies not only to the initial diagnosis, but also to a possible recurrence of the tumor (recurrence) after cancer treatment,"emphasizes Dr. Neubauer. For example, a recent meta-analysis of 1040 patients showed that a quarter more tumors were found with narrow-band cystoscopy than with conventional white-light cystoscopy. A further study shows that the reduction in the rate of recurrence by 10 percent compared to the standard procedure has been proven. This new technology is therefore also of great use for regular check-ups after tumour therapy.

According to estimates by the Robert Koch Institute, about 28,000 people in Germany contract bladder cancer each year. Whether bladder cancer can be cured depends primarily on the tumor stage: it is crucial whether the cancerous tissue has already attacked deeper layers of the bladder wall or whether it remains confined to the surface. For the patient, the early detection of a bladder tumour means that therapy can be initiated in good time and thus offers a greater chance of successful treatment,"said Neubauer.

Literature:

Li K et al.: Diagnosis of narrow-band imaging in non-muscle-invasive bladder cancer: a systematic review and meta-analysis. Int J Urol. 2013 Jun; 20 (6): 602-9. doi: 10.1111/y. 1442-2042.2012.03211. x. Epub 2012 Nov 1st Review.

Naselli A et al.: A randomized prospective trial to assess the impact of transurethral resection in narrow band imaging modality on non-muscle-invasive bladder cancer re-currence. Eur Urol. 2012 May; 61 (5): 908-13. doi: 10.1016/y. eururo. 2012.01.018. Epub 2012 Jan 20.

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