Kan ikke huske å ha sett denne fra april er blitt delt her før.

http://www.urologytimes.com/genitourinary-cancers/point-stand-alone-white-light-cystoscopy-thing-past



While white light cystoscopy (WLC) has been the standard for initial diagnosis and surveillance of nonmuscle-invasive bladder cancer, its use alone can now be considered suboptimal based on recent developments with blue light cystoscopy (BLC), according to Badrinath Konety, MD, MBA.

“White light cystoscopy misses many tumors, both papillary lesions and carcinoma in situ (CIS), and that can lead to higher rates of recurrence and progression,” said Dr. Konety, professor and chair of the department of urology, University of Minnesota, Minneapolis.

“Those issues are now remediable to some extent with BLC using hexaminolevulinate HCl (HAL [Cysview]) because this technique detects more tumors and allows for more complete resection.”


Her forklarer han også noe som kan være en av grunnene til at bruken ikke har tatt av tidligere i usa, og at vi nå etter fda-godkjenningen i februar bør forvente økt veksthastighet fremover:

"With its initial approval, BLC had limitations because it was approved as a one-time only procedure done with one particular type of rigid cystoscope and for finding papillary tumors. In addition, a history of BCG immunotherapy or intravesical chemotherapy within the past 90 days was a contraindication to the procedure due to concern about a potential increased risk of false positives from misidentifying inflamed tissue as cancer.

Labeling for BLC with HAL was revised and expanded based on the results of a randomized controlled trial comparing blue light flexible cystoscopy with WLC for detection of bladder cancer during surveillance.3 In February 2018, the FDA approved use of HAL for the cystoscopic detection of carcinoma of the bladder, including CIS, with flexible cystoscopy (Karl Storz PDD Flexible Blue Light Videoscope System) and for repeated examination in patients undergoing surveillance cystoscopy. In addition, the new labeling removed the contraindication relating to recent BCG or immunotherapy.

The safety of repeat use of BLC with HAL was also demonstrated in a retrospective study that included 62 patients who underwent WLC with BLC two or more times"



Han sier også noen ord om NBI("konkurrenten" til Cysview):
Narrow-band imaging (NBI) also aims to improve detection of bladder cancer and is both easy to perform and widely used. However, results from comparative studies do not show a consistent benefit for achieving improved tumor detection using narrow-band imaging versus white light cystoscopy, Dr, Konety noted.

“Results of a very large randomized trial comparing 12-month recurrence rates following transurethral resection of bladder tumor using NBI or white light indicate that NBI did not lead to a more complete transurethral resection,” he said, referring to a European Urology study published in 2016.5

“Hence, it is unclear if NBI truly improves upon WLC,” Dr. Konety added.