Comparison between spectra modes of STORZ professional image enhancement system™ and white light cystoscopy in diagnosis of bladder lesions

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 (SPIES ™ ) overcomes these limitations and enables concurrent display of WLC and enhanced images, potentially improving tumor detection. In this study, the SPIES ™ system was integrated into the diagnostic cystoscopy protocol to compare Spectra ™ 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 B ™ and Spectra A ™ 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 A ™ had 100% sensitivity, but lower specificity (35%) and higher FPR (65%). Spectra A ™ detected more lesions than WLC, although the difference was not statistically significant ( P = 0.131). The increase in FPR of the Spectra A ™ was significant ( P = 0.04). Conclusions: Spectra A ™ 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 A ™ shows potential and warrants further research in larger, multicenter trials.