About NBI Technology

Get to know the principle behind this unique optical filter technology.

Video Library

Explore how NBI can help in your clinical practice by watching real cases for Cystoscopy, Ureteroscopy and Resection.

Clinical Evidence and Guidelines

Check out latest clinical studies and guidelines demonstrating increased detection and reduced recurrence risk thanks to NBI.

Educational Programm

Become a member of our comprehensive platform for educational programs and gain practical knowledge through our training courses.

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About NBI Technology

How Does NBI Work?

NBI is a patented optical filter technology for diagnosing and treating NMIBC that creates significantly higher contrast between blood vessels and the surrounding tissue than WLI. NBI clearly sets a new standard in endoscopy and bladder cancer management.

The Technical Principle: Tissue Absorption

Olympus NBI light passes through a special narrow-band filter before it hits the tissue. The filter eliminates all wavelengths except the shorter 415 nm blue and the longer 540 nm green ones. Both blue and green wavelengths match exactly the absorption spectrum of hemoglobin. So when the blue and the green wavelengths hit the tissue, they are selectively absorbed by the hemoglobin and reflected by other structures.

White light vs. Olympus NBI light

Normal white light consists of light of different wavelengths. But only a small part of the spectrum is visible – the part the human eye perceives as colors. When an object is illuminated by white light, some of the colors are absorbed while others are reflected. The reflected colors are the ones we see. NBI light from Olympus works differently, revealing considerably more details about the tissue being examined. The blue wavelength only penetrates the superficial layers of the mucosa and is absorbed by the vessels on the surface. The green wavelength is reflected, hence the green color of NBI images. That makes the tissue’s superficial structure much clearer and more visible to specialists, thus facilitating the detection of highly vascularized tumors.

Practical Benefits of this Technology

  • No additional costs, no extra equipment, disposables or drugs needed
  • High versatility - proven and trusted across multiple medical disciplines
  • Easy handling - switching modes at the push of a button

NBI Procedure Video Database

On the following blog, you will be able to access a large database of real-life clinical clips. As NBI is an advanced imaging technique, it is evident that short procedural videos will best explain how the technology can contribute to a more precise cancer diagnosis.

NBI in Flexible Ureteroscopy

The following clips are grouped according to the upper tract cancer classification and allow you to understand how different tumors and suspicious areas look in NBI light compared to conventional white light. Discover completely new perspectives and details in conservative upper tract tumor management with NBI technology and explore a superior visualization of lesions so small they could barely be seen before.

Malignant Lesions

Solid Tumor of the Renal Pelvis

UTUC Bridge

Tumor of the Renal Pelvis

UTUC Follow-up

Microscopic UTUC Recurrence

UTUC Covering the Whole Surface of the Calyx

Small Neoplasm Close to the Renal Papilla

Small Lesion of the Upper Urinary Tract

UTUC Carpet in the Whole Ureter

Small UTUC of the Lower Calyx

Precise Demarcation of Upper Urinary Tract Tumor Margins

UTUC of the Minor Calyx and Papilla

Several Small UTUCs Covering the Renal Papilla
Show all

Benign Findings

Ureteral Fibro-Epithelial Polyp

Hemangioma of the Upper Urinary Tract

Pyeloureteritis Cystica

Massive Ureteral Inflammation after Ureteral Stenting
Show all

NBI Tips & Tricks

Small Petechiae of the Urothelium

Ureteral Edema in Patient with DJ Stent

Inflammation around Impacted Stone

NBI in Resection

On the following clips, transurethral resection of bladder tumor (TURBT) and en-bloc resection (ERBT) with NBI and PLASMA are presented for diagnosis and treatment of NMIBC. With NBI, lesion limits can be visualized better. This allows in the first step precise marking, as well as even the complete resection of the bladder tumor using the PLASMA technology.

Transurethral Resection of the Bladder Tumor

En bloc NMIBC Resection Dr Malavaud

Clinical Evidence

Increase Your Detection Rate

Numerous studies, including a growing number of randomized clinical trials (RCTs) and meta-analyses, highlight the clinical value of NBI, especially with regard to the detection of bladder cancer and the recurrence risk. The results of these studies show that the use of NBI has several clinical benefits for patient outcomes compared to WLI, and there are no contraindications for the use of NBI.

NBI Visualizes 28% More Carcinomas in Situ Compared to WLI

  • NBI is an alternative diagnostic technique for NMIBC
  • On the tumor level, an additional 28% of carcinomas in situ were detected by NBI compared to WLI
  • A significantly higher detection rate was found

NBI Detects Bladder Cancer in 17% Additional Patients Compared to WLI

  • Cystoscopy assisted by NBI detects more NMIBC patients and tumors than WLI.
  • In the patient- and tumor-level analyses, an additional 17% of patients and an additional 24% of tumors were detected by NBI compared to WLI.

NBI Reduces the Risk of Recurrence to 17% at One Year

  • Compared with WLI cystoscopy, NBI cystoscopy increases the visualization and detection of bladder cancer
  • TUR-BT using NBI reduces the risk of NMIBC recurrence at three months, one year, and two years significantly when compared with TUR-BT using WLI.
  • At three months, NBI reduces the recurrence risk by 59.5% (NBI 6% vs WLI 14.8%).
  • At one year, NBI reduces the recurrence risk by 48% (NBI 16.5% vs WLI 31.7%).
  • At two years, NBI reduces the recurrence risk by 40% (NBI 17.7% vs WLI 29.5%).

NBI in International Guidelines

Numerous international specialist associations and institutes have commented on the use of NBI for the diagnosis and therapy of NMIBC in their guidelines. These include:

  • European Association of Urology (EAU) 4
  • National Institute for Health and Care Excellence (NICE) 5
  • American Urological Association (AUA) 6
  • French ccAFU 7
  • Dansk Urologisk Cancer Gruppe (DUCG) 8

Learn More about the Clinical Evidence of NBI

It has been clinically proven that by using NBI during procedures more superficial tumors of the bladder mucosa are diagnosed than when using WLI. That ultimately leads to reduced recurrence rates. Explore the evidence in our NBI brochure.

Download the NBI brochure

Explore the Benefits of NBI

Increase your detection rate with the patented Olympus NBI technology. Send us a request and an Olympus representative will contact you.

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Clinical Evidences

  1. 1.Narrow band imaging cystoscopy improves the detection of non-muscle-invasive bladder cancer Urology 2010; 76:658–663 Cauberg et al.
  2. 2.Narrow-band imaging cystoscopy in non-muscle-invasive bladder cancer: a prospective comparison to the standard approach Therapeutic Advances in Urology 2012; 4(5):211–217 Geavlete et al.
  3. 3.A Randomized Prospective Trial to Assess the Impact of Transurethral Resection in Narrow Band Imaging Modality on Non–Muscle-Invasive Bladder Cancer Recurrence European Urology 2012; 61:908–913 Puppo et al.
  4. 4.Narrow band imaging-assisted transurethral resection reduces the recurrence risk of non-muscle invasive bladder cancer: A systematic review and meta-analysis Oncotarget. 2016 Nov 03 Kang et al.
  5. 5.Diagnosis of narrow-band imaging in non-muscle-invasive bladder cancer: A systematic review and meta-analysis International Journal of Urology 2013; 20:602–609 Li et al.
  6. 6.A comparison of NBI and WLI cystoscopy in detecting nonmuscleinvasive bladder cancer: A prospective, randomized and multi-center study Sci Rep. 2015; 5; 10905 Ye et al.
  7. 7.Recommandations françaises du Comité de cancérologie de l’AFU – actualisation 2020–2022 tumeurs de la vessie Progrès en urologie (2020) 30, S78-S135 Rouprêt et al.
  8. 8.Nationale kliniske retningslinier for behandling af blæretumorer i Danmark Dansk BlæreCancer Gruppe - DaBlaCa. 2020 Bjerggaard Jensen at al.

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