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Fluorescent cystoscopy

Maximilian C Kriegmair, P Honeck, M Theuring, C Bolenz, M Ritter
PURPOSE: The aim of this pilot study was to assess the feasibility and value of wide-field autofluorescence imaging (AFI) for the detection of bladder cancer during transurethral resection of the bladder (TUR-B). METHODS: For imaging, the D-Light/AF System (Karl Storz GmbH, Tuttlingen, Germany) and a customized band pass filter (≈ 480-780 nm) at the eyepiece of the endoscope were used. The excitation light wavelength was 440 nm. Representative spectral measurements of tissue autofluorescence (AF) were performed using a spectrometer attached behind the AF band pass filter in selected patients...
December 6, 2017: World Journal of Urology
Susanne Deininger, Tilman Todenhöfer, Jörg Hennenlotter, Valentina Gerber, Jennifer Schwarz, Jens Bedke, Christian Schwentner, Arnulf Stenzl, Steffen Rausch
BACKGROUND: Urinary marker tests for bladder cancer (BC) detection and surveillance represent a desirable approach to diagnosis and follow-up. The SCIMEDX uCyt+ assay detects antigens expressed by BC cells (mucin glycoprotein and carcinoembryonic antigen) using green and red fluorescence and is interpreted according to specific manufacturer's recommendations. In the present study, we evaluated divergent approaches of numeric and morphological analysis of uCyt+ to generate a rationale for alternative test interpretation strategies...
November 8, 2017: Diagnostic Cytopathology
Bo Jiang, Yang Dong, Houguang He, Conghui Han
The aim of this study was to investigate the value of pirarubicin (THP) photosensitizer fluorescence cystoscopy for the early diagnosis of bladder cancer. From January 2012 to June 2015, 25 patients with painless gross hematuria, were injected with THP 15 min prior to surgery and subsequently underwent fluorescence cystoscopy examination. Locations of tumors were recorded and biopsies were performed (total of 109 biopsies) under white and fluorescence light guidance. Biopsies were conducted at the THP-positive and -negative areas under white light and THP-positive areas under fluorescence light...
September 2017: Oncology Letters
J Y Liu, X Peng, X H Ning, T Li, S H Peng, J Y Wang, S J Liu, Y Ding, L Cai, K Gong
OBJECTIVE: To analyze the clinical pathologic characteristics of cases with fluorescence in situ hybridization (FISH) positive of exfoliated urothelial cells, so as to evaluate the clinical utility of FISH in the diagnosis of urothelial carcinoma (UC). METHODS: A total of 271 cases of FISH positive in Department of Urology of Peking University First Hospital from Apr. 2012 to Sep. 2015 were recruited in this study. Retrospective analysis was made on their clinical data...
August 18, 2017: Beijing da Xue Xue Bao. Yi Xue Ban, Journal of Peking University. Health Sciences
M C Kriegmair, M Ritter, M S Michel, C Bolenz
Cystoscopy is the gold standard for the initial diagnosis of urothelial carcinoma in the urinary bladder (UCB). White light exhibits significant limitations in its ability to detect flat lesions or carcinoma in situ. Photodynamic Diagnosis (PDD) and Narrow Band Imaging (NBI) are established techniques which may improve the detection rates of UCB and reduce the risk of recurrence. Multiple novel tools have been developed in order to improve the diagnostic accuracy of endoscopic procedures, including Digital Contrast Enhancement Technology, Confocal Laser Endomicroscopy (CLE) and Optical Coherence Tomography (OCT)...
August 2017: Aktuelle Urologie
Heather Katz, Rahoma E Saad, Krista Denning, Toni O Pacioles
Metastatic esophageal adenocarcinoma to the urinary bladder is extremely rare. We describe a previously healthy 49-year-old female with recent diagnosis of adenocarcinoma of the gastroesophageal junction with metastatic disease to the liver. Biopsy was positive for human epidermal growth factor receptor 2 (HER2) by Fluorescence In Situ Hybridization (FISH). She received six cycles of Cisplatin, 5-Fluorouracil, and Herceptin and subsequently developed symptomatic anemia and hematuria. Cystoscopy with retroflexion was performed and she received a transurethral resection of bladder tumor with fulguration...
2017: Case Reports in Gastrointestinal Medicine
Tianhai Lin, Zhenhua Liu, Liangren Liu, Lu Yang, Ping Han, Peng Zhang, Qiang Wei
Urothelial carcinoma (UC) is the most common type of cancer of the bladder and upper urinary tract, and is characterized by a high risk of recurrence and progression. Urine fluorescence in situ hybridization (FISH) is a technique that detects genetic aberrations in exfoliated cells in the urine, with specific probes for chromosomes 3, 7 and 17 and the p16 gene. To evaluate the diagnostic value of FISH in UC, 119 patients from November 2010 to June 2012 with suspected UC were recruited into a prospective, cross-sectional study and were followed up for 12-30 months...
May 2017: Oncology Letters
Yair Lotan, Paul OʼSullivan, Jay D Raman, Sharokh F Shariat, Laimonis Kavalieris, Chris Frampton, Parry Guilford, Carthika Luxmanan, James Suttie, Henry Crist, Douglas Scherr, Scott Asroff, Evan Goldfischer, Jeffrey Thill, David Darling
OBJECTIVE: Patients with urothelial carcinoma (UC) undergo rigorous surveillance for recurrence. Noninvasive urine tests are not currently recommended by guideline panels owing to insufficient clinical benefit. The objective of this study was to prospectively compare the performance of the Cxbladder Monitor test to other commonly available urine markers and cytology for surveillance of patients with UC. METHODS AND MATERIALS: A total of 1,036 urine samples were collected from 803 patients undergoing surveillance for UC...
March 30, 2017: Urologic Oncology
Eugene J Pietzak
Photodynamic diagnostic technique with blue light cystoscopy (BLC) takes advantage of the preferential uptake and accumulation of protoporphyrins in neoplastic tissue which emit a red fluorescence when illuminated with blue light (360-450 nm wavelengths). This allows enhanced visualization of small papillary tumors and flat carcinoma in situ lesions that might have been missed on white light cystoscopy (WLC). There is compelling evidence that the ability of BLC to detect these additional tumors translates into improved recurrence rates compared to WLC...
May 2017: Current Urology Reports
Lars R Lindvold, Gregers G Hermann
Photodynamic diagnosis (PDD) of bladder tumour tissue significantly improves endoscopic diagnosis and treatment of bladder cancer in rigid cystoscopes in the operating theatre and thus reduces tumour recurrence. PDD comprises the use of blue light, which unfortunately excites green fluorescence from urine. As this green fluorescence confounds the desired red fluorescence of the PDD, methods for avoiding this situation particularly in cystoscopy using flexible cystoscopes are desirable. In this paper we demonstrate how a tailor made high power LED light source at 525 nm can be used for fluorescence assisted tumour detection using both a flexible and rigid cystoscope used in the outpatient department (OPD) and operating room (OR) respectively...
November 14, 2016: Methods and Applications in Fluorescence
Carla L Ellis, Lara R Harik, Cynthia Cohen, Adeboye O Osunkoya
Urologic pathology is evolving rapidly. Emerging trends include the expanded diagnostic utility of biomarkers and molecular testing, as well as adapting to the plethora of technical advances occurring in genitourinary oncology, surgical practice, and imaging. We illustrate those trends by highlighting our approach to the diagnostic workup of a few selected disease entities that pathologists may encounter, including newly recognized subtypes of renal cell carcinoma, pheochromocytoma, and prostate cancer, some of which harbor a distinctive chromosomal translocation, gene loss, or mutation...
April 2017: Archives of Pathology & Laboratory Medicine
Ajay Gopalakrishna, Joseph J Fantony, Thomas A Longo, Richmond Owusu, Wen-Chi Foo, Rajesh Dash, Brian T Denton, Brant A Inman
PURPOSE: The aim of this study was to establish the criteria defining an anticipatory positive test for bladder cancer. METHODS: We reviewed all patients at our institution who underwent urine cytology or UroVysion fluorescence in situ hybridization (FISH) and cystoscopy from 2003 to 2012. Test performance and cancer anticipation was assessed using generalized linear mixed models, mixed-effects proportional hazards models, and cumulative incidence curves using tests performed within 30 days of each other as well as within a lag time of 1 year...
January 10, 2017: Annals of Surgical Oncology
Johannes Mischinger, Lutz Philipp Guttenberg, Jörg Hennenlotter, Georgios Gakis, Stefan Aufderklamm, Steffen Rausch, Eva Neumann, Jens Bedke, Stefan Kruck, Christian Schwentner, Arnulf Stenzl, Tilman Todenhöfer
PURPOSE: Urine fluorescence in situ hybridization (FISH) has become a broadly used marker for noninvasive detection of bladder cancer (BC). However, it has been discussed whether the interpretation algorithm proposed by the manufacturer could be improved. Aim of the present study was to compare alternative evaluation strategies of FISH for detection of BC. METHODS: We included 1048 patients suspicious for BC, who underwent urine FISH examination before cystoscopy (diagnostic cohort)...
April 2017: Journal of Cancer Research and Clinical Oncology
Roger Chou, Shelley Selph, David I Buckley, Rongwei Fu, Jessica C Griffin, Sara Grusing, John L Gore
PURPOSE: We systematically reviewed the comparative effectiveness of fluorescent vs white light cystoscopy on bladder cancer clinical outcomes. MATERIALS AND METHODS: Systematic literature searches of Ovid MEDLINE® (January 1990 through September 2015), Cochrane databases and reference lists were performed. A total of 14 randomized trials of fluorescent cystoscopy using 5-aminolevulinic acid or hexaminolevulinic acid vs white light cystoscopy for the diagnosis of initial or recurrent bladder cancer that reported bladder cancer recurrence, progression, mortality and harms were selected for review...
March 2017: Journal of Urology
Alexander I Rolevich, Alexander G Zhegalik, Andrey A Mokhort, Alexander A Minich, Vladimir Yu Vasilevich, Sergey L Polyakov, Sergey A Krasny, Oleg G Sukonko
OBJECTIVES: To assess the efficacy of two treatment options for non-muscle-invasive bladder cancer (NMIBC): (1) transurethral resection (TUR) guided by fluorescence cystoscopy (FC) with the use of 5-aminolevulinic acid (5-ALA) and (2) single early instillation of doxorubicin in a single-center open-label prospective randomized study with a 2 × 2 factorial design. PATIENTS AND METHODS: Patients with clinical suspicion of primary or recurrent NMIBC were randomized into four study arms: FC-assisted TUR with 5-ALA and single instillation of doxorubicin, FC-assisted TUR without instillation, TUR in white light (WL) with single instillation of doxorubicin, and WL-TUR only...
May 2017: World Journal of Urology
Anna Kołodziej, Wojciech Krajewski, Michał Matuszewski, Krzysztof Tupikowski
INTRODUCTION: Urinary bladder urothelial cell carcinoma is one of the most commonly diagnosed cancers in Europe. After prostate, lung and colon cancers, bladder cancer rates as the fourth most common cancer in men in the world. Urinary bladder cancer detection, treatment, and staging have traditionally been based on an endoscopic examination - cystoscopy. MATERIAL AND METHODS: A Medline, and Web of Science database search was performed on September 2015 without setting time limits, using the terms 'bladder cancer' in conjunction with 'cystoscopy', 'diagnosis', 'detection', 'fluorescence', 'blue-light', 'PDD', 'narrow band imaging', 'molecular imaging', 'optical coherence tomography' or 'confocal laser endomicroscopy'...
2016: Central European Journal of Urology
Ajay Gopalakrishna, Thomas A Longo, Joseph J Fantony, Richmond Owusu, Wen-Chi Foo, Rajesh Dash, Brant A Inman
BACKGROUND: Spectrum effects refer to the phenomenon that test performance varies across subgroups of a population. When spectrum effects occur during diagnostic testing for cancer, difficult patient misdiagnoses can occur. Our objective was to evaluate the effect of test indication, age, gender, race, and smoking status on the performance characteristics of two commonly used diagnostic tests for bladder cancer, urine cytology and fluorescence in situ hybridization (FISH). METHODS: We assessed all subjects who underwent cystoscopy, cytology, and FISH at our institution from 2003 to 2012...
June 13, 2016: BMC Urology
Xiaofeng Yang, Fan Zhang, Junqian Luo, Jianzhi Pang, Sanhua Yan, Fang Luo, Jiehao Liu, Wei Wang, Yongping Cui, Xixi Su
Bladder cancer is common and widespread, and its incidence is increasing. Many new diagnostic methods combined with state-of-the-art technology have been introduced in cystoscopy to collect real-time images of the bladder mucosa for diagnosis, but often miss inconspicuous early-stage tumors. Fluorophore-labeled peptides with high sensitivity and specificity for cancer would be a desirable tool for the detection and treatment of tiny or residual bladder tumors. Phage display and the human non-muscle-invasive bladder cancer cell line BIU-87 were used to identify a peptide...
July 2016: Oncology Reports
Cheng Pang, Youyan Guan, Hongbo Li, Wanqing Chen, Gang Zhu
Cancer remains to be the second most common cause of death, and its incidence and mortality rates are increasing in China. According to the 2015 National Central Cancer Registry (NCCR) of China, the incidence of bladder cancer and prostate cancer ranked sixth and seventh, respectively, in male cancers. The majority of prostate cancer patients were diagnosed at an advanced stage. Early diagnosis of prostate cancer is the key to improve prostate cancer survival in China. Radical prostatectomy or radical radiotherapy is the main treatment for localized prostate cancer, and a comprehensive therapy based on androgen deprivation therapy is the treatment for advanced disease...
June 2016: Japanese Journal of Clinical Oncology
Savino M Di Stasi, Francesco De Carlo, Vincenzo Pagliarulo, Francesco Masedu, Cristian Verri, Francesco Celestino, Claus Riedl
Clinical trials have shown that hexaminolevulinate (HAL) fluorescence cystoscopy improves the detection of bladder tumors compared with standard white-light cystoscopy, resulting in more efficacious treatment. However, some recent meta-analyses report controversially on recurrence-free rates with this procedure. A systematic review of literature was performed from December 2014 to January 2015 using the PubMed, Embase and Cochrane databases for controlled trials on photodynamic diagnosis (PDD) with HAL. A total of 154 publications were found up to January 2015...
December 2015: Therapeutic Advances in Urology
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