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Controlled Clinical Trial
. 2008 Jul-Sep;1(3):355-62.

Hexvix blue light fluorescence cystoscopy--a promising approach in diagnosis of superficial bladder tumors

B Geavlete  1 , R Mulţescu, D Georgescu, P Geavlete
Affiliations
Controlled Clinical Trial

Hexvix blue light fluorescence cystoscopy--a promising approach in diagnosis of superficial bladder tumors

B Geavlete et al. J Med Life. 2008 Jul-Sep.

Abstract

Introduction: Nowadays, Hexvix blue light cystoscopy (BLC) represents an increasingly acknowledged diagnostic method for patients with bladder cancer. The aim of our study was to establish the place of this procedure in superficial bladder tumors diagnosis and to compare it with standard white light cystoscopy (WLC).

Material and methods: Between December 2007 and January 2008, WLC and BLC were performed in 20 cases. Transurethral bladder resection (TURB) was performed for all apparent detected lesions. The patients diagnosed with superficial bladder tumors have been followed-up after 3 months by WLC and BLC. The control group included the same number of consecutive patients with superficial bladder tumors, diagnosed only by WLC, which underwent the same treatment and follow-up protocol as the study group.

Results: WLC identified 30 suspicious lesions (28 pathologically confirmed), while BLC identified 41 apparent tumors (39 pathologically confirmed). So, from the total number of 40 tumors with positive histology, WLC correctly diagnosed 70% of them, with a rate of 6.7% false-positive results, while BLC diagnosed 97.5%, however presenting a 4.9% rate of false-positive results. 17 cases of the study group diagnosed with superficial bladder tumors were followed. The tumor recurrence rate after 3 months was 5.9% for the study group and 23.5% for the control group.

Conclusions: Hexvix fluorescence cystoscopy is a valuable diagnostic method, with considerably better results by comparison to WLC. The improved diagnostic may have a significant impact upon the recurrence rate.

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Figures

Figure 1
Figure 1
Hexvix induced fluorescence of bladder urothelial tumors in blue light
Figure 2
Figure 2
Comparative aspect in WLC (left) and BLC (right) of two pTa urothelial bladder tumors
Figure 3
Figure 3
pTa urothelial tumor not visible in white light but with specific fluorescence in blue light
Figure 4
Figure 4
CIS not visible in white light but with specific fluorescence in blue light
Figure 5
Figure 5
Another case with CIS with not specific aspect in WLC but fluorescent in BLC
Figure 6
Figure 6
Suspicious flat lesion in WLC, with no fluorescence in BLC and no pathological confirmation
Figure 7
Figure 7
Normal fluorescence of the prostatic urethra (left) and bladder neck (right)
Figure 8
Figure 8
False positive fluorescence of the normal urothelium in tangential view
Figure 9
Figure 9
Sharp margins of a malignant lesion (left) by comparison to diffuse aspect of a false-positive fluorescence secondary to inflammation (right)
See this image and copyright information in PMC

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