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

Clinical Data

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.

NBI compared to 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, EE, BME
James Laskaris, EE, BME, Clinical Analyst — Mr. James Laskaris is a senior emerging technology analyst at MD Buyline and has been with the company since 1994. With over 30 years of experience in the healthcare field, Mr. Laskaris is the primary analyst of high-end OR technology. He also covers issues related to the legislative and reimbursement effect on healthcare and authors a bimonthly “Issues that Matter” publication. Mr. Laskaris received his biomedical engineering degree from Southern Illinois University. His work has been published in hfm Magazine, Radiology Manager and Healthcare Purchasing News.