NEW ORLEANS, LA USA (UroToday.com) - In recent years, many novel technologies have been developed to improve diagnostic cystoscopy for detection of CIS and flat TCC lesions. While white light cystoscopy is commonly used in diagnostic cystoscopy and has high specificity for TCC, the sensitivity for white light cystoscopy is low (~40%). Therefore, the authors presented a comprehensive summary of currently available alternative diagnostic technologies and discussed the body of evidence surrounding the advantages, disadvantages, and patient outcomes associated with these technologies.
Several emerging technologies, including florescence cystoscopy, narrow-band imaging, and optical coherence tomography (OCT) were discussed in their presentation. The authors referenced studies showing that fluorescence cystoscopy improves detection rates of bladder tumors, especially CIS, compared to white light. Fluorescence cystoscopy also has been shown to reduce recurrence rates of cancer, but this technology remains very expensive. Narrow-band imaging has been shown to display superficial blood vessels better than white light leading to high sensitivities for flat lesions. However, the technology is very new and little literature is currently available. Similarly, optical coherence tomography has been shown to improve sensitivity and specificity for TCC; however, early studies have suggested that scanning of flat lesions can be expensive and time consuming. To round out their presentation, the authors discussed investigational diagnostic devices, including virtual endoscopy and endoscopic magnification technologies. However, these tools are only in experimental phases and further studies are needed to determine the practical applications of these technologies.
In conclusion, the authors stated that novel technologies are enabling urologists to gain access to more of the urinary tract, improve detection of tumor with higher sensitivity and specificity, and thus provide easier diagnoses of TCC. They proposed that these technologies will lead to better long-term outcomes for patients, better quality of life, and ultimately increased use of organ-sparing treatments. However, futures studies are needed to determine the clinical impact of these technologies.
Presented by Evangelos N. Liasikos at the American Urological Association (AUA) Annual Meeting - May 15 - 19, 2015 - New Orleans, LA USA
Reported by Kyle Spradling (University of California-Irvine), medical writer for UroToday.com