V8-06: BLUE LIGHT CYSTOSCOPY: THE USC EXPERIENCE

Video

Introductions and Objectives
Intravesical administration of hexaminolevulinic acid has been shown to improve the detection of non-muscle invasive bladder (NMIBC) during cystoscopy when viewed under blue light. The product has been available in Europe for several years (Hexvix) and has recently been approved in the US (Cysview) and is being used by select centers. In the video we demonstrate use of Cysview for detection of NMIBC.

Methods
Since August 2012, 220 patients scheduled for TURBT at our institution have undergone instillation of Cysview and cystoscopy under blue light. Several cases are highlighted in the video demonstrating cystosocpic view under normal and blue light with pathology results.

Results
Use of Cysview to detect bladder cancer is demonstrated in 5 select cases. Each case highlights the use of blue light cystoscopy as an adjunct in improved identification of bladder tumors ranging from carcinoma in-situ to muscle invasive disease. The pitfalls of false positive areas are also demonstrated. Use of blue light cystoscopy following use of BCG is also shown in one of the cases. These cases are selected according to the consensus statement on the use of blue light cystoscopy in the United States._x000D_ Two select cases as seen in figure 1. The top images are under normal cystoscopy and the bottom images demonstrate the same view under blue light cystoscopy following administration of Cysview. The fluorescent areas were biopsied and revealed high-grade pT1 in the patient on the left and high grade pT1 and CIS in the patient on the right.

Conclusions
Use of Cysview can help with the detection of NMIBC as well as CIS in patients undergoing TURBT for bladder cancer.

Funding: None