New publication: blue light cystoscopy shows potential to facilitate the diagnosis of CIS in the upper urinary tract
This week, a new case report was published: “Intravesical hexyl-aminolevulinate used to detect upper tract carcinoma in situ during surveillance ureteroscopy: A case report and review” in the journal European Urology Open Science. The article describes the first upper tract blue light cystoscopy during which the physicians were able to diagnose upper tract carcinoma in situ (CIS).
Abstract from the article: Blue-light cystoscopy with intravesical hexyl-aminolevulinate (HAL; marketed as Hexvix®/Cysview®) has been shown to improve identification of bladder carcinoma. The application of photodynamic techniques in the upper urinary tract has not been well studied. In this report, we present a unique case in which blue light cystoscopy was effective at visualizing and diagnosing upper tract urothelial CIS. This case was significant for blue light fluorescent, biopsy proven upper tract carcinoma in situ that otherwise would have been a benign examination using traditional white light technique.
The authors state further: “While the efficacy of blue-light cystoscopy for diagnosing tumors arising from the bladder is well established within the current literature, few studies have examined the utility of it in diagnosing tumors of the upper tract. […] Future work should be done to study the use of photodynamic techniques in the evaluation of upper tract malignancies.” They conclude “Photodynamic surgery using blue light with Cysview was uniquely added to the diagnostic and therapeutic treatment of insidious upper tract urothelial carcinoma in a patient with a wide, patulous ureteral orifice. To our knowledge, this is the first instance of using blue light to evaluate the upper tract for UTUC. The patient's pathology was confirmed by biopsy to be CIS, and evaluation with white light alone likely would have under-staged the patient without the assistance of alternate wavelength diagnostics utilizing HAL.”
Read the full publication here: https://www.sciencedirect.com/science/article/pii/S2214442024001955