Beyond the photodynamic diagnosis: Searching for excellence in the diagnosis of non-muscle-invasive bladder cancer

Cystoscopy is gold-standard method in non muscule invasive bladder cancer diagnosis. In the cistoscopic exploration 30% of tumors could be overlookeed: it is due to a flat forms, litle size tumours or difficult visualization. Photodynamic diagnosis reduces overlooked tumours rate, and has improved diagnosis on flat forms, with the consequence of increasing lap time to recurrence and decrasing the number of iterative cistoscopy; nevertheless the false positive rate is high. In the last years developed new optical devices who try to improve alone or asociated diagnostic sensibility in cistoscopy whithout reduction of specificity. Among new devices we must emphasize some like Narow Band Imaging, Optical Coherence Tomography or Laser Confocal Endomicroscopy. (C) 2010 AEU. Published by Elsevier Espana, S.L. All rights reserved.