Narrow Band Imaging (NBI): Cost-Effective Bladder Visualization

On December 14th, the FDA cleared Olympus’ Narrow Band Imaging (NBI), for use in visualizing Non-Muscle Invasive Bladder Cancer (NMIBC). NBI promises urologists and surgeons the ability to visualize the boundaries of lesions more efficiently. Long believed to be able to improve the visualization of bladder lesions, a 2012 meta-analysis found an additional 17% of patients and additional 24% of tumors were detected by NBI when compared to white-light imaging, based on a weighted average. In another study, NBI had significantly higher sensitivity for the visualization of bladder tumor recurrence (100% vs. 87%) as compared to white-light imaging.

How It Works

This improved visualization occurs without the need for dyes or drugs through the use of optical filters. NBI technology utilizes only blue and green wavelengths that are absorbed more strongly by hemoglobin in the blood. When exposed to these wavelengths tumors and polyps appear darker than the sounding tissue since cancerous tissue is often more highly vascularized than healthy tissue. This allows the physician to better visualize the lesion boundaries and remove potentially cancerous tissue as compared to traditional methods like white-light cystoscopy.

Role in Reducing Costs

Bladder cancer currently has the highest lifetime treatment costs per patient of all cancers and treatment costs for NMIBC were estimated to be $157.5 million for 2009-2014 alone. These substantial costs are due to the high rate of recurrence and disease progression that requires continuous long-term monitoring for these patients. Some of this cost could potentially be mitigated by NBI due to improved visualization and potential cancer detection which could lead to earlier intervention and a reduction in both the cost and invasiveness of treatment.

Olympus also claims that the enhanced visibility of lesion margins could lead to more complete resection which would reduce the chances of recurrence. Additionally, NBI can be used throughout patient management and follow-up and requires no additional capital or consumable investment for existing Olympus users. Company representatives have stated that the technology is already built into existing CV-170 (office based systems) CV-190, OTVS -190, CV-180 and OTV-7s Pro, provided they were purchased in the last 6 to 7 years.

James Laskaris, Senior Clinical Strategist

James Laskaris joined MD Buyline in 1994 with more than 30 years’ experience in the healthcare field.