Photodynamic diagnostics of bladder tumors

Investigation of optical properties of dissected and homogenized biological tissue

Knowledge of tissue optical properties, in particular the absorption μa and the reduced scattering coefficient μs', is required for diagnostic and therapeutic applications in which the light distribution during treatment has to be known. As it is generally very difficult to obtain this information with sufficient accuracy in vivo, optical properties are often approximately determined on ex vivo tissue samples. In this case, the obtained optical properties may strongly depend on the sample preparation. The extent of the expectable preparation-dependent differences was systematically investigated in comparative measurements on dissected and homogenized porcine tissue samples (liver, lung, brain, and muscle). These measurements were performed at wavelengths 520, 635, 660, and 785 nm, using a dual-step reflectance device and at a spectral range of 515 to 800 nm with an integrating sphere setup. In a third experiment, the density of tissue samples (dissected and homogenized) was investigated, as the characteristic of the packaging of internal tissue structures strongly influences the absorption and scattering. The standard errors of the obtained absorption and reduced scattering coefficients were found to be reduced in case of homogenized tissue. Homogenizing the tissues also allows a much easier and faster sample preparation, as macroscopic internal tissue structures are destroyed in the homogenized tissue so that a planar tissue sample with well-defined thickness can easily and accurately be prepared by filling the tissue paste into a cuvette. Consequently, a better reproducibility result was obtained when using homogenized samples. According to the density measurements accomplished for dissected and homogenized tissue samples, all types of tissues, except lung, showed a decrease in the density due to the homogenization process. The presented results are in good agreement for μs' regardless of the preparation procedure, whereas μa differs, probably influenced by blood content and dehydration. Because of faster and easier preparation and easier sample positioning, homogenization prior to measurement seems to be suitable for investigating the optical properties ex vivo. Additionally, by means of using the homogenization process, the sample size and thickness do not need to be particularly large, as is the case for most biopsies from the OR.

[Photodynamic diagnostics of bladder carcinoma]

The question whether conventional cystoscopy should always be performed together with fluorescent diagnostic procedures remains to be answered. The current article presents the current literature dealing with this topic. Particularly for relevant carcinoma in situ lesions of the bladder there is no obvious advantage for photodynamic diagnostics compared to conventional cystoscopy with consistent use of urine cytology.