Hospital, University of Florence, Florence, Italy. Abstract BACKGROUND: To date, no study has presented results of photodynamic diagnosis (PDD) cystoscopy compared with white-light cystoscopy (WLC) in daily practice. The aim of the present study is to evaluate the diagnostic accuracy of hexylaminolevulinate hydrochloride (Hexvix(®)) PDD cystoscopy compared with standard WLC used in daily practice. METHODS: An observational, open-label, comparative, controlled (within patient), multicenter study was carried out on 96 consecutive patients with suspected or confirmed bladder cancer. All patients had standard WLC followed by blue-light cystoscopy (BLC). Positive lesions detected using WLC and BLC were recorded. Biopsies/resection of each positive lesion were taken after the bladder was inspected. Sensitivity, specificity, positive predictive value, and negative predictive value with each method were calculated. RESULTS: Overall, 234 suspicious lesions were detected; 108 (46.2 %) were histologically confirmed to be bladder tumors/carcinoma in situ (CIS). The sensitivity of BLC biopsies was significantly higher than for WLC technique (99.1 vs 76.8 %; p < 0.00001). The relative sensitivity of BLC versus WLC was 1.289, showing superiority of BLC of 28.9 %. The specificity of BLC biopsies was not significantly different compared with WLC (36.5 vs 30.2 %). Positive predictive value for BLC- and WLC-guided biopsies was 54.9 and 50.9 %, respectively. Negative predictive value per biopsy for BLC- and WLC-guided biopsies was 97.4 and 64.8 %, respectively. BLC and WLC reached the correct diagnosis in 97.9 and 88.5 % of patients, respectively. This difference was statistically significant (p = 0.0265). The lack of a random biopsy protocol was the major limitation of the study. CONCLUSIONS: Hexvix(®) PDD cystoscopy used in daily practice enhances the diagnostic accuracy of standard cystoscopy with higher negative predictive value, potentially permitting an improvement in patient prognosis.

A comparison of hexaminolevulinate (Hexvix(®)) fluorescence cystoscopy and white-light cystoscopy for detection of bladder cancer: results of the HeRo observational study / Lapini A; Minervini A; Masala A; Schips L; Pycha A; Cindolo L; Giannella R; Martini T; Vittori G; Zani D; Bellomo F; Cosciani Cunico S. - In: SURGICAL ENDOSCOPY. - ISSN 1432-2218. - ELETTRONICO. - 26:(2012), pp. 3634-3641. [10.1007/s00464-012-2387-0]

A comparison of hexaminolevulinate (Hexvix(®)) fluorescence cystoscopy and white-light cystoscopy for detection of bladder cancer: results of the HeRo observational study.

MINERVINI, ANDREA;
2012

Abstract

Hospital, University of Florence, Florence, Italy. Abstract BACKGROUND: To date, no study has presented results of photodynamic diagnosis (PDD) cystoscopy compared with white-light cystoscopy (WLC) in daily practice. The aim of the present study is to evaluate the diagnostic accuracy of hexylaminolevulinate hydrochloride (Hexvix(®)) PDD cystoscopy compared with standard WLC used in daily practice. METHODS: An observational, open-label, comparative, controlled (within patient), multicenter study was carried out on 96 consecutive patients with suspected or confirmed bladder cancer. All patients had standard WLC followed by blue-light cystoscopy (BLC). Positive lesions detected using WLC and BLC were recorded. Biopsies/resection of each positive lesion were taken after the bladder was inspected. Sensitivity, specificity, positive predictive value, and negative predictive value with each method were calculated. RESULTS: Overall, 234 suspicious lesions were detected; 108 (46.2 %) were histologically confirmed to be bladder tumors/carcinoma in situ (CIS). The sensitivity of BLC biopsies was significantly higher than for WLC technique (99.1 vs 76.8 %; p < 0.00001). The relative sensitivity of BLC versus WLC was 1.289, showing superiority of BLC of 28.9 %. The specificity of BLC biopsies was not significantly different compared with WLC (36.5 vs 30.2 %). Positive predictive value for BLC- and WLC-guided biopsies was 54.9 and 50.9 %, respectively. Negative predictive value per biopsy for BLC- and WLC-guided biopsies was 97.4 and 64.8 %, respectively. BLC and WLC reached the correct diagnosis in 97.9 and 88.5 % of patients, respectively. This difference was statistically significant (p = 0.0265). The lack of a random biopsy protocol was the major limitation of the study. CONCLUSIONS: Hexvix(®) PDD cystoscopy used in daily practice enhances the diagnostic accuracy of standard cystoscopy with higher negative predictive value, potentially permitting an improvement in patient prognosis.
2012
26
3634
3641
Lapini A; Minervini A; Masala A; Schips L; Pycha A; Cindolo L; Giannella R; Martini T; Vittori G; Zani D; Bellomo F; Cosciani Cunico S
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Utilizza questo identificatore per citare o creare un link a questa risorsa: https://hdl.handle.net/2158/675805
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