Indian Journal of Urology · Published 2026-02-03 · DOI 10.4103/iju.iju_221_25
Introduction: White light cystoscopy (WLC) often fails to detect flat or subtle bladder lesions. Enhanced imaging techniques offer improved detection. The Storz Professional Image Enhancement System (SPIESTM) overcomes these limitations and enables concurrent display of WLC and enhanced images, potentially improving tumor detection. In this study, the SPIESTM system was integrated into the diagnostic cystoscopy protocol to compare SpectraTM modes with conventional WLC in the diagnosis of bladder lesions. Methods: This 1-year prospective observational pilot study included 150 patients with suspected or known bladder tumors. Each patient initially underwent WLC, followed by Spectra BTM and Spectra ATM modes. Lesions were mapped according to EAU guidelines; suspicious areas were biopsied or resected for histopathological analysis. Results: WLC showed a sensitivity of 96% and specificity of 45%, with a false positive rate (FPR) of 54.5%. After WLC, Spectra B did not detect any additional lesions, whereas Spectra A identified three additional lesions, including a T2 recurrence. Spectra ATM had 100% sensitivity, but lower specificity (35%) and higher FPR (65%). Spectra ATM detected more lesions than WLC, although the difference was not statistically significant (P = 0.131). The increase in FPR of the Spectra ATM was significant (P = 0.04). Conclusions: Spectra ATM showed higher sensitivity and identified additional cancerous lesions, including one muscle-invasive tumor missed by WLC. However, it also had a significantly higher FPR. While promising, it has its limitations. Spectra ATM shows potential and warrants further research in larger, multicenter trials.
Abstract from DOAJ. Public domain (CC0 1.0).
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