MP08-17 BLUE LIGHT CYSTOSCOPY IMPROVES DETECTION RATES FOR UROTHELIAL BLADDER CANCER COMPARED TO WHITE LIGHT CYSTOSCOPY: UPDATED RESULTS FROM A PROSPECTIVE MULTICENTER REGISTRY

378 Background: Fluorescence cystoscopy (also known as blue-light cystoscopy (BL)) is an adjunct to white light cystoscopy (WL) and aids in visualization of tumors that may be missed with WL as well as allow more complete resection of tumors. Herein we present the impact of BL on subsequent patient management in a real world setting. Methods: A total of 116 consecutive patients who underwent simultaneous BL and WL from January 2013 through December 2014 were included in the study. Pathology and operative reports were reviewed to determine the grade and stage of the tumors and whether they were viewed under BL or WL. Results: Of the 116 patients, a total of 161 biopsies and/or transurethral resected specimens were analyzed. Of these, 46 (28.6%) lesions were seen only with BL, none were seen only with white light, 109 (67.7%) were seen with both, and 7 (4.4%) were identified via random biopsies. Of the 46 lesions seen only on BL, 17 (37%) were positive for cancer, while, of the 109 lesions seen with WL and BL, 84 (77%) were positive. Of the 17 (37%) true positive tumors seen only on BL, the stage and grades were; 5 (29.4%) low-grade Ta, 2 (11.8%) high-grade Ta, 1 (5.9%) high-grade T1, and 9 (52.9%) CIS. There were no instances of a tumor being found on WL that was not also visualized with BL. In this patient cohort, the false positive rates were 23% and 63% for WL and BL, respectively. The false negative rates were 0.9% and 2.1% for WL and BL, respectively. For the 46 (28.6%) lesions that were visible by BL, WL cystoscopy was not able to visualize 10 (21.7%) tumors visualized by BL. In addition, there was one patient who had multiple lesions sent for pathology by BL and WL, and the lesions identified by BL were of higher stage than the lesions visualized by WL. Conclusions: BL identified additional tumors that would have been missed with WL. Moreover, in patients who had tumors visualized only with BL, 11 (26.8%) were high-grade, including one (2.4%) patient with T1 tumor and 8 (19.5%) with CIS. Thus, BL identified a number of high-risk tumors, which had a significant impact on the subsequent management of patients with bladder cancer.

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Cost-Utility of Hexaminolevulinate Blue Light Cystoscopy (Hal) Assisted Transurethral Resection of The Bladder Tumour (Turb) Compared to Turb With White Light Cystoscopy (Wlc) Alone In Patients With Non-Muscle Invasive Bladder Cancer (Nimbc) In Poland

Value in Health ◽

10.1016/j.jval.2015.09.694 ◽

2015 ◽

Vol 18 (7) ◽

pp. A360 ◽

Cited By ~ 1

Author(s):

Z Jablonowski ◽

T Konecki ◽

M Ziobro ◽

M Haldas ◽

Z Wolski ◽

...

Keyword(s):

Bladder Cancer ◽

Blue Light ◽

White Light ◽

Transurethral Resection ◽

Bladder Tumour ◽

Cost Utility ◽

Invasive Bladder Cancer ◽

Muscle Invasive Bladder Cancer ◽

White Light Cystoscopy ◽

Muscle Invasive

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955 A prospective, randomized comparison between the hexaminolevulinate blue light and the standard white light cystoscopy concerning the long term recurrence rates in non-muscle invasive bladder cancer cases

European Urology Supplements ◽

10.1016/s1569-9056(12)60952-x ◽

2012 ◽

Vol 11 (1) ◽

pp. e955-e955a

Author(s):

B. Geavlete ◽

R. Multescu ◽

F. Stanescu ◽

D. Georgescu ◽

M. Jecu ◽

...

Keyword(s):

Bladder Cancer ◽

Blue Light ◽

White Light ◽

Invasive Bladder Cancer ◽

Recurrence Rates ◽

Muscle Invasive Bladder Cancer ◽

White Light Cystoscopy ◽

Muscle Invasive

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Identification of Carbonic Anhydrase IX as a Novel Target for Endoscopic Molecular Imaging of Human Bladder Cancer

Cellular Physiology and Biochemistry ◽

10.1159/000490875 ◽

2018 ◽

Vol 47 (4) ◽

pp. 1565-1577 ◽

Cited By ~ 2

Author(s):

Jiaqi Wang ◽

Ruizhe Fang ◽

Lu Wang ◽

Guang Chen ◽

Hongzhi Wang ◽

...

Keyword(s):

Bladder Cancer ◽

Molecular Imaging ◽

Carbonic Anhydrase ◽

Blue Light ◽

Sensitivity And Specificity ◽

White Light ◽

Real Time Pcr ◽

Normal Tissue ◽

White Light Cystoscopy ◽

Caix Expression

Background/Aims: Emerging novel optical imaging techniques with cancer-specific molecular imaging agents offer a powerful and promising platform for cancer detection and resection. White-light cystoscopy and random bladder biopsies remain the most appropriate but nonetheless suboptimal diagnostic technique for bladder cancer, which is associated with high morbidity and recurrence. However, white-light cystoscopy has intrinsic shortcomings. Although current optical imaging technologies hold great potential for improved diagnostic accuracy, there are few imaging agents for specific molecular targeting. Carbonic anhydrase IX (CAIX) plays a pivotal role in tumorigenesis and tumor progression with potential value as an imaging target. Here, we investigated the feasibility of CAIX as a target and validated the diagnostic performance and significance of CAIX as an imaging agent. Methods: We first analyzed the data from The Cancer Genome Atlas (TCGA). Pairs of samples comprising bladder cancer and adjacent normal tissue were collected. All tissue samples were used for real-time PCR and immunohistochemistry to compare CAIX expression in normal and cancer tissue. Using blue-light cystoscopy, we observed the optical distribution of fluorescently labeled CAIX antibody in freshly excised human bladders and obtained random bladder biopsies to assess sensitivity and specificity. Results: The TCGA data revealed that CAIX expression was significantly higher in bladder cancer specimens than in normal tissue. The outcome was similar in quantitative real-time PCR analysis. In immunohistochemical analysis, bladder cancer specimens classified in four pathological subtypes presented a variety of positive staining intensities, whereas no benign specimens showed CAIX staining. Using blue-light cystoscopy, we distinguished bladder cancers that were mainly papillary, some variants of urothelial carcinoma, and less carcinoma in situ, from benign tissue, despite the presence of suspicious-appearing mucosa. The sensitivity and specificity for CAIX-targeted imaging were 88.00% and 93.75%, respectively. Conclusions: CAIX-targeted molecular imaging could be a feasible and adaptive alternative approach for the accurate diagnosis and complete resection of bladder cancer.

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