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Advances in Label-Free Detection of Non-Muscle Invasive Bladder Cancer: A Critical Review
Gabriela Vera1, Javier Cerda-Infante2, Mario I Fernández3
1Servicio de Urología, Complejo Asistencial Dr. Sotero del Rio, Santiago 8150215, Chile.
Bioengineering (Basel, Switzerland)
|August 28, 2025
Summary
Label-free diagnostic tools offer improved early detection for non-muscle invasive bladder cancer (NMIBC). These advanced technologies show high accuracy and speed, paving the way for better point-of-care surveillance.
Area of Science:
- Biomedical Engineering
- Analytical Chemistry
- Oncology
Background:
- Non-muscle invasive bladder cancer (NMIBC) constitutes 75% of bladder cancer diagnoses.
- Current white-light cystoscopy is invasive, expensive, and has limitations in detecting small or flat lesions, missing up to 45% of cases.
- Need for advanced, label-free diagnostic tools to improve NMIBC detection rates and patient outcomes.
Purpose of the Study:
- To review recent engineering advances in label-free diagnostic platforms for NMIBC detection.
- To evaluate the analytical performance and clinical translation readiness of these novel tools.
- To compare emerging technologies with conventional cytology for NMIBC surveillance.
Main Methods:
- Review of label-free diagnostic technologies utilizing intrinsic optical, electrical, or mechanical signatures of urinary biomarkers.
- Comparative analysis of technologies based on limit of detection, diagnostic accuracy, analysis time, cohort size, and clinical development stage.
- Focus on surface-enhanced Raman spectroscopy, interferometric flow cytometry, and electrochemical sensors.
Main Results:
- Surface-enhanced Raman spectroscopy and interferometric flow cytometry achieve femtomolar sensitivity and >98% accuracy within minutes.
- Compact electrochemical sensors detect NMP22, Galectin-1, and microRNAs at sub-picogram levels on disposable chips.
- Emerging technologies demonstrate significant improvements over conventional cytology in speed and sensitivity.
Conclusions:
- Label-free diagnostic platforms show promise for accurate and rapid NMIBC detection.
- Standardized sample handling, multicenter validation, and cost-effectiveness data are crucial for clinical adoption.
- These advancements are essential for improving point-of-care NMIBC surveillance and patient management.
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