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Neubrand LB, van Leeuwen TG, Faber DJ. Towards non-invasive tissue hydration measurements with optical coherence tomography. JOURNAL OF BIOPHOTONICS 2024; 17:e202300532. [PMID: 38735734 DOI: 10.1002/jbio.202300532] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/11/2023] [Revised: 04/11/2024] [Accepted: 04/16/2024] [Indexed: 05/14/2024]
Abstract
The attenuation coefficient ( μ OCT ) measured by optical coherence tomography (OCT) has been used to determine tissue hydration. Previous dual-wavelength OCT systems could not attain the needed precision, which we attribute to the absence of wavelength-dependent scattering of tissue in the underlying model. Assuming that scattering can be described using two parameters, we propose a triple/quadrupole-OCT system to achieve clinically relevant precision in water volume fraction. In this study, we conduct a quantitative analysis to determine the necessary precision of μ OCT measurements and compare it with numerical simulation. Our findings emphasize that achieving a clinically relevant assessment of a 2% water fraction requires determining the attenuation coefficient with a remarkable precision of 0.01 m m - 1 . This precision threshold is influenced by the chosen wavelength for attenuation measurement and can be enhanced through the inclusion of a fourth wavelength range.
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Affiliation(s)
- Linda B Neubrand
- Department of Biomedical Engineering and Physics, Amsterdam UMC, University of Amsterdam, Amsterdam, The Netherlands
- Amsterdam Cardiovascular Sciences, Atherosclerosis and Ischemic Syndromes, Amsterdam, The Netherlands
- Cancer Center Amsterdam, Imaging and Biomarkers, Amsterdam, The Netherlands
| | - Ton G van Leeuwen
- Department of Biomedical Engineering and Physics, Amsterdam UMC, University of Amsterdam, Amsterdam, The Netherlands
- Amsterdam Cardiovascular Sciences, Atherosclerosis and Ischemic Syndromes, Amsterdam, The Netherlands
- Cancer Center Amsterdam, Imaging and Biomarkers, Amsterdam, The Netherlands
| | - Dirk J Faber
- Department of Biomedical Engineering and Physics, Amsterdam UMC, University of Amsterdam, Amsterdam, The Netherlands
- Amsterdam Cardiovascular Sciences, Atherosclerosis and Ischemic Syndromes, Amsterdam, The Netherlands
- Cancer Center Amsterdam, Imaging and Biomarkers, Amsterdam, The Netherlands
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2
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Sii S, Bolton J, Tempo J, Bolton D. Contemporary status of diagnostic endoluminal ultrasound and optical coherence tomography in the ureter. BJUI COMPASS 2024; 5:514-523. [PMID: 38873352 PMCID: PMC11168776 DOI: 10.1002/bco2.352] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/02/2023] [Revised: 01/11/2024] [Accepted: 02/15/2024] [Indexed: 06/15/2024] Open
Abstract
Objective To evaluate via a review of published literature, the efficacy of endoluminal ultrasound (ELUS) and optical coherence tomography (OCT) in the following ureteric diseases: urolithiasis, upper tract urothelial carcinoma, stricture disease and pelvic-ureteric junction obstruction (PUJO). Patients and methods Ureteric high-frequency ELUS provides 360° imaging, to a depth of 20 mm, and has been demonstrated to assess ureteric stricture length, degree of fibrosis and aetiology. OCT produces high-quality images with a penetration depth of 2 mm. ELUS has proven to be useful at the time of endopyelotomy for PUJO as it can identify crossing vessels, some not detectable on CT angiography, allowing the urologist to avoid these when making their incision. Ureteric ELUS may be utilised for submucosal ureteric stones as they are highly visible. Endoluminal ultrasound may be deployed in the case of known sub-mucosal urolithiasis when the ureter appears stone-free. It may help identify sub-mucosal stones or stones within diverticulum. Results Endoluminal ultrasound has been analysed for its use in determining muscle-invasive urothelial carcinoma of the ureter. The PPV for ≥pT2 was only 16.7% in one study of six patients with MIBC and 76.2% in 21 patients with Conclusions Ureteric ELUS has been reported to be a useful tool in endopyelotomy, urolithiasis and stricture disease. The staging of ureteric urothelial carcinoma remains unsatisfactory with current imaging techniques and biopsy methods, and, based on the current literature, ELUS does not appear to have a strong enough PPV to determine muscle invasion. Ureteric OCT may be a useful tool in the future staging of upper tract urothelial carcinoma, particularly in differentiating the stage of small tumours. Further studies are needed in this area.
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Affiliation(s)
- Samuel Sii
- Department of SurgeryUniversity of Melbourne, Austin HealthMelbourneVictoriaAustralia
| | | | - Jake Tempo
- Department of SurgeryUniversity of Melbourne, Austin HealthMelbourneVictoriaAustralia
| | - Damien Bolton
- Department of SurgeryUniversity of Melbourne, Austin HealthMelbourneVictoriaAustralia
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3
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Gravestock P, Cullum D, Somani B, Veeratterapillay R. Diagnosing upper tract urothelial carcinoma: A review of the role of diagnostic ureteroscopy and novel developments over last two decades. Asian J Urol 2024; 11:242-252. [PMID: 38680592 PMCID: PMC11053284 DOI: 10.1016/j.ajur.2022.08.003] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/07/2022] [Accepted: 08/13/2022] [Indexed: 11/29/2022] Open
Abstract
Objective The role of ureteroscopy in the diagnosis of upper tract urothelial carcinoma is yet to be fully determined. We aimed to provide an up to date evaluation of its role and the emerging technologies in the field. Methods A literature search of the last two decades (from 24th May, 2001 to 24th May, 2021) was carried out identifying 147 papers for potential inclusion within this narrative review. Results Diagnostic ureteroscopy is undeniably useful in its ability to visualise and biopsy indeterminate lesions, and to risk stratify malignant lesions that may be suitable for kidney sparing surgery. However, an increased risk of intravesical recurrence following nephroureterectomy when a prior diagnostic ureteroscopy has been performed, inadequate sampling at biopsy, complications from the procedure, and difficult ureteric access are all potential drawbacks. Furthermore, whilst generally an accurate diagnostic procedure, it risks missing carcinoma in-situ lesions. Despite this, evidence shows that routine use of ureteroscopy changes the management of patients in a large proportion of cases, preventing unnecessary surgery or facilitating kidney sparing surgery. The overall rate of complications is low, and improved biopsy techniques and the use of tissue biomarkers for improved staging and grading are encouraging. The risks of delays to definitive management and post-ureteroscopy intravesical recurrence do not seem to affect survival, and trials are in progress to determine whether intravesical therapy can mitigate the latter. Further promising techniques are being investigated to improve shortcomings, particularly in relation to improved diagnosis of carcinoma in situ and preoperative staging. Conclusion Ureteroscopy has a role in the diagnosis of upper tract malignancy, though whether it should be used routinely is yet to be determined.
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Affiliation(s)
- Paul Gravestock
- Urology Department, Freeman Hospital, Newcastle Upon Tyne, UK
| | - Daniel Cullum
- Urology Department, Freeman Hospital, Newcastle Upon Tyne, UK
| | - Bhaskar Somani
- Department of Urology, University Hospital Southampton, Southampton, UK
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Bitaraf M, Ghafoori Yazdi M, Amini E. Upper Tract Urothelial Carcinoma (UTUC) Diagnosis and Risk Stratification: A Comprehensive Review. Cancers (Basel) 2023; 15:4987. [PMID: 37894354 PMCID: PMC10605461 DOI: 10.3390/cancers15204987] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/18/2023] [Revised: 09/22/2023] [Accepted: 10/11/2023] [Indexed: 10/29/2023] Open
Abstract
Diagnosis and risk stratification are cornerstones of therapeutic decisions in the management of patients with upper tract urothelial carcinoma (UTUC). Diagnostic modalities provide data that can be integrated, to provide nomograms and stratification tools to predict survival and adverse outcomes. This study reviews cytology, ureterorenoscopy and the novel tools and techniques used with it (including photodynamic diagnosis, narrow-band imaging, optical coherence tomography, and confocal laser endomicroscopy), and biopsy. Imaging modalities and novel biomarkers are discussed in another article. Patient- and tumor-related prognostic factors, their association with survival indices, and their roles in different scores and predictive tools are discussed. Patient-related factors include age, sex, ethnicity, tobacco consumption, surgical delay, sarcopenia, nutritional status, and several blood-based markers. Tumor-related prognosticators comprise stage, grade, presentation, location, multifocality, size, lymphovascular invasion, surgical margins, lymph node status, mutational landscape, architecture, histologic variants, and tumor-stroma ratio. The accuracy and validation of pre-operative predictive tools, which incorporate various prognosticators to predict the risk of muscle-invasive or non-organ confined disease, and help to decide on the surgery type (radical nephroureterectomy, or kidney-sparing procedures) are also investigated. Post-operative nomograms, which help decide on adjuvant chemotherapy and plan follow-up are explored. Finally, a revision of the current stratification of UTUC patients is endorsed.
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Affiliation(s)
| | | | - Erfan Amini
- Uro-Oncology Research Center, Tehran University of Medical Sciences, Tehran 1419733141, Iran; (M.B.); (M.G.Y.)
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5
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Yoshida T, Ohe C, Nakamoto T, Kinoshita H. Learning from the past and present to change the future: Endoscopic management of upper urinary tract urothelial carcinoma. Int J Urol 2023; 30:634-647. [PMID: 37294007 DOI: 10.1111/iju.15208] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/25/2023] [Accepted: 05/09/2023] [Indexed: 06/10/2023]
Abstract
Current guidelines recommend endoscopic management (EM) for patients with low-risk upper urinary tract urothelial carcinoma, as well as those with an imperative indication. However, regardless of the tumor risk, radical nephroureterectomy is still mainly performed worldwide despite the benefits of EM, such as renal function maintenance, no hemodialysis requirement, and treatment cost reduction. This might be explained by the association of EM with a high risk of local recurrence and progression. Furthermore, the need for rigorous patient selection and close surveillance following EM may be relevant. Nevertheless, recent developments in diagnostic modalities, pathological evaluation, surgical devices and techniques, and intracavitary regimens have been reported, which may contribute to improved risk stratification and treatments with superior oncological outcomes. In this review, considering recent advances in endourology and oncology, we propose novel treatment strategies for optimal EM.
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Affiliation(s)
- Takashi Yoshida
- Department of Urology and Andrology, Kansai Medical University, Osaka, Japan
- Corporate Sponsored Research Programs for Multicellular Interactions in Cancer, Kansai Medical University, Osaka, Japan
| | - Chisato Ohe
- Corporate Sponsored Research Programs for Multicellular Interactions in Cancer, Kansai Medical University, Osaka, Japan
- Department of Pathology, Kansai Medical University, Osaka, Japan
| | - Takahiro Nakamoto
- Department of Urology and Andrology, Kansai Medical University, Osaka, Japan
- Department of Pathology, Kansai Medical University, Osaka, Japan
| | - Hidefumi Kinoshita
- Department of Urology and Andrology, Kansai Medical University, Osaka, Japan
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Neubrand LB, van Leeuwen TG, Faber DJ. Precision of attenuation coefficient measurements by optical coherence tomography. JOURNAL OF BIOMEDICAL OPTICS 2022; 27:085001. [PMID: 35945668 PMCID: PMC9360497 DOI: 10.1117/1.jbo.27.8.085001] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 04/11/2022] [Accepted: 07/01/2022] [Indexed: 06/15/2023]
Abstract
SIGNIFICANCE Optical coherence tomography (OCT) is an interferometric imaging modality, which provides tomographic information on the microscopic scale. Furthermore, OCT signal analysis facilitates quantification of tissue optical properties (e.g., the attenuation coefficient), which provides information regarding the structure and organization of tissue. However, a rigorous and standardized measure of the precision of the OCT-derived optical properties, to date, is missing. AIM We present a robust theoretical framework, which provides the Cramér -Rao lower bound σμOCT for the precision of OCT-derived optical attenuation coefficients. APPROACH Using a maximum likelihood approach and Fisher information, we derive an analytical solution for σμOCT when the position and depth of focus are known. We validate this solution, using simulated OCT signals, for which attenuation coefficients are extracted using a least-squares fitting procedure. RESULTS Our analytical solution is in perfect agreement with simulated data without shot noise. When shot noise is present, we show that the analytical solution still holds for signal-to-noise ratios (SNRs) in the fitting window being above 20 dB. For other cases (SNR<20 dB, focus position not precisely known), we show that the numerical calculation of the precision agrees with the σμOCT derived from simulated signals. CONCLUSIONS Our analytical solution provides a fast, rigorous, and easy-to-use measure for OCT-derived attenuation coefficients for signals above 20 dB. The effect of uncertainties in the focal point position on the precision in the attenuation coefficient, the second assumption underlying our analytical solution, is also investigated by numerical calculation of the lower bounds. This method can be straightforwardly extended to uncertainty in other system parameters.
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Affiliation(s)
- Linda B. Neubrand
- Amsterdam UMC, Location AMC, University of Amsterdam, Department of Biomedical Engineering and Physics, Amsterdam, The Netherlands
- Amsterdam Cardiovascular Sciences, Atherosclerosis and Ischemic Syndromes, Amsterdam, The Netherlands
- Cancer Center Amsterdam, Imaging and Biomarkers, Amsterdam, The Netherlands
| | - Ton G. van Leeuwen
- Amsterdam UMC, Location AMC, University of Amsterdam, Department of Biomedical Engineering and Physics, Amsterdam, The Netherlands
- Amsterdam Cardiovascular Sciences, Atherosclerosis and Ischemic Syndromes, Amsterdam, The Netherlands
- Cancer Center Amsterdam, Imaging and Biomarkers, Amsterdam, The Netherlands
| | - Dirk J. Faber
- Amsterdam UMC, Location AMC, University of Amsterdam, Department of Biomedical Engineering and Physics, Amsterdam, The Netherlands
- Amsterdam Cardiovascular Sciences, Atherosclerosis and Ischemic Syndromes, Amsterdam, The Netherlands
- Cancer Center Amsterdam, Imaging and Biomarkers, Amsterdam, The Netherlands
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Chen M, Wang J, Tan W, Feng Y, Zheng G. Miniaturized all fiber probe for optical coherence tomography and pH detection of biological tissue. JOURNAL OF BIOPHOTONICS 2021; 14:e202000239. [PMID: 33048463 DOI: 10.1002/jbio.202000239] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/15/2020] [Revised: 08/16/2020] [Accepted: 09/28/2020] [Indexed: 06/11/2023]
Abstract
We present a novel all-fiber probe with 710-μm outside diameter for combined optical coherence tomography and pH detection. In cancer surgery, a significant challenge is how to completely remove the malignant tumor without cutting too much normal tissue. The difference between cancer tissue and normal tissue not only lies in morphology and structure but also in tissue pH, where malignant tissue has a lower pH. This dual-modality probe combined optical coherence tomography and pH detection of biological tissue, is expected to determine whether the tissue is cancerous quickly and accurately. The probe utilizes a typical three-segment structure (double-clad fiber - no-core fiber - graded-index fiber). We obtained a lateral resolution of ~10.6 μm, a working distance of ~506 μm and a pH measurement accuracy of 0.01 pH unit for the probe. The performance of the all-fiber probe was verified through an ex vivo experiment using the porcine brain specimen.
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Affiliation(s)
- Minghui Chen
- Shanghai Institute for Interventional Medical Devices, University of Shanghai for Science and Technology, Shanghai, China
| | - Jianping Wang
- Shanghai Institute for Interventional Medical Devices, University of Shanghai for Science and Technology, Shanghai, China
| | - Weijie Tan
- Shanghai Institute for Interventional Medical Devices, University of Shanghai for Science and Technology, Shanghai, China
| | - Yuanyuan Feng
- Shanghai Institute for Interventional Medical Devices, University of Shanghai for Science and Technology, Shanghai, China
| | - Gang Zheng
- Shanghai Institute for Interventional Medical Devices, University of Shanghai for Science and Technology, Shanghai, China
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Zaffino P, Moccia S, De Momi E, Spadea MF. A Review on Advances in Intra-operative Imaging for Surgery and Therapy: Imagining the Operating Room of the Future. Ann Biomed Eng 2020; 48:2171-2191. [PMID: 32601951 DOI: 10.1007/s10439-020-02553-6] [Citation(s) in RCA: 18] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/16/2020] [Accepted: 06/17/2020] [Indexed: 12/19/2022]
Abstract
With the advent of Minimally Invasive Surgery (MIS), intra-operative imaging has become crucial for surgery and therapy guidance, allowing to partially compensate for the lack of information typical of MIS. This paper reviews the advancements in both classical (i.e. ultrasounds, X-ray, optical coherence tomography and magnetic resonance imaging) and more recent (i.e. multispectral, photoacoustic and Raman imaging) intra-operative imaging modalities. Each imaging modality was analyzed, focusing on benefits and disadvantages in terms of compatibility with the operating room, costs, acquisition time and image characteristics. Tables are included to summarize this information. New generation of hybrid surgical room and algorithms for real time/in room image processing were also investigated. Each imaging modality has its own (site- and procedure-specific) peculiarities in terms of spatial and temporal resolution, field of view and contrasted tissues. Besides the benefits that each technique offers for guidance, considerations about operators and patient risk, costs, and extra time required for surgical procedures have to be considered. The current trend is to equip surgical rooms with multimodal imaging systems, so as to integrate multiple information for real-time data extraction and computer-assisted processing. The future of surgery is to enhance surgeons eye to minimize intra- and after-surgery adverse events and provide surgeons with all possible support to objectify and optimize the care-delivery process.
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Affiliation(s)
- Paolo Zaffino
- Department of Experimental and Clinical Medicine, Universitá della Magna Graecia, Catanzaro, Italy
| | - Sara Moccia
- Department of Information Engineering (DII), Universitá Politecnica delle Marche, via Brecce Bianche, 12, 60131, Ancona, AN, Italy.
| | - Elena De Momi
- Department of Electronics, Information and Bioengineering (DEIB), Politecnico di Milano, Piazza Leonardo da Vinci, 32, 20133, Milano, MI, Italy
| | - Maria Francesca Spadea
- Department of Experimental and Clinical Medicine, Universitá della Magna Graecia, Catanzaro, Italy
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9
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Swaan A, Muller BG, Wilk LS, Almasian M, Zwartkruis ECH, Rozendaal LR, de Bruin DM, Faber DJ, van Leeuwen TG, van Herk MB. En-face optical coherence tomography for the detection of cancer in prostatectomy specimens: Quantitative analysis in 20 patients. JOURNAL OF BIOPHOTONICS 2020; 13:e201960105. [PMID: 32049426 DOI: 10.1002/jbio.201960105] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/06/2019] [Revised: 01/10/2020] [Accepted: 01/27/2020] [Indexed: 06/10/2023]
Abstract
The increase histopathological evaluation of prostatectomy specimens rises the workload on pathologists. Automated histopathology systems, preferably directly on unstained specimens, would accelerate the pathology workflow. In this study, we investigate the potential of quantitative analysis of optical coherence tomography (OCT) to separate benign from malignant prostate tissue automatically. Twenty fixated prostates were cut, from which 54 slices were scanned by OCT. Quantitative OCT metrics (attenuation coefficient, residue, goodness-of-fit) were compared for different tissue types, annotated on the histology slides. To avoid misclassification, the poor-quality slides, and edges of annotations were excluded. Accurate registration of OCT data with histology was achieved in 31 slices. After removing outliers, 56% of the OCT data was compared with histopathology. The quantitative data could not separate malignant from benign tissue. Logistic regression resulted in malignant detection with a sensitivity of 0.80 and a specificity of 0.34. Quantitative OCT analysis should be improved before clinical use.
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Affiliation(s)
- Abel Swaan
- Department of Urology, Amsterdam UMC, University of Amsterdam, Amsterdam, The Netherlands
- Department of Biomedical Engineering and Physics, Cancer Center Amsterdam, Amsterdam UMC, University of Amsterdam, Amsterdam, The Netherlands
| | - Berrend G Muller
- Department of Urology, Amsterdam UMC, University of Amsterdam, Amsterdam, The Netherlands
| | - Leah S Wilk
- Department of Biomedical Engineering and Physics, Cancer Center Amsterdam, Amsterdam UMC, University of Amsterdam, Amsterdam, The Netherlands
| | - Mitra Almasian
- Department of Biomedical Engineering and Physics, Cancer Center Amsterdam, Amsterdam UMC, University of Amsterdam, Amsterdam, The Netherlands
| | - Evita C H Zwartkruis
- Department of Pathology, Amsterdam UMC, Vrije Universiteit Amsterdam, Amsterdam, The Netherlands
| | - L Rence Rozendaal
- Department of Pathology, Amsterdam UMC, Vrije Universiteit Amsterdam, Amsterdam, The Netherlands
| | - Daniel M de Bruin
- Department of Urology, Amsterdam UMC, University of Amsterdam, Amsterdam, The Netherlands
- Department of Biomedical Engineering and Physics, Cancer Center Amsterdam, Amsterdam UMC, University of Amsterdam, Amsterdam, The Netherlands
| | - Dirk J Faber
- Department of Biomedical Engineering and Physics, Cancer Center Amsterdam, Amsterdam UMC, University of Amsterdam, Amsterdam, The Netherlands
| | - Ton G van Leeuwen
- Department of Biomedical Engineering and Physics, Cancer Center Amsterdam, Amsterdam UMC, University of Amsterdam, Amsterdam, The Netherlands
| | - Marcel B van Herk
- Department of Biomedical Engineering and Physics, Cancer Center Amsterdam, Amsterdam UMC, University of Amsterdam, Amsterdam, The Netherlands
- Institute of Cancer Sciences, University of Manchester, Manchester, UK
- Department of Radiotherapy Related Research, The Christie NHS Foundation Trust, Manchester, UK
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10
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Gong P, Almasian M, van Soest G, de Bruin DM, van Leeuwen TG, Sampson DD, Faber DJ. Parametric imaging of attenuation by optical coherence tomography: review of models, methods, and clinical translation. JOURNAL OF BIOMEDICAL OPTICS 2020; 25:1-34. [PMID: 32246615 PMCID: PMC7118361 DOI: 10.1117/1.jbo.25.4.040901] [Citation(s) in RCA: 40] [Impact Index Per Article: 10.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/28/2019] [Accepted: 02/28/2020] [Indexed: 05/07/2023]
Abstract
SIGNIFICANCE Optical coherence tomography (OCT) provides cross-sectional and volumetric images of backscattering from biological tissue that reveal the tissue morphology. The strength of the scattering, characterized by an attenuation coefficient, represents an alternative and complementary tissue optical property, which can be characterized by parametric imaging of the OCT attenuation coefficient. Over the last 15 years, a multitude of studies have been reported seeking to advance methods to determine the OCT attenuation coefficient and developing them toward clinical applications. AIM Our review provides an overview of the main models and methods, their assumptions and applicability, together with a survey of preclinical and clinical demonstrations and their translation potential. RESULTS The use of the attenuation coefficient, particularly when presented in the form of parametric en face images, is shown to be applicable in various medical fields. Most studies show the promise of the OCT attenuation coefficient in differentiating between tissues of clinical interest but vary widely in approach. CONCLUSIONS As a future step, a consensus on the model and method used for the determination of the attenuation coefficient is an important precursor to large-scale studies. With our review, we hope to provide a basis for discussion toward establishing this consensus.
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Affiliation(s)
- Peijun Gong
- The University of Western Australia, Department of Electrical, Electronic and Computer Engineering, Optical+Biomedical Engineering Laboratory, Perth, Western Australia, Australia
- Address all correspondence to Peijun Gong, E-mail:
| | - Mitra Almasian
- University of Amsterdam, Amsterdam University Medical Centers, Cancer Center Amsterdam, Amsterdam Cardiovascular Sciences, Department of Biomedical Engineering and Physics, Amsterdam, The Netherlands
| | - Gijs van Soest
- Erasmus MC, University Medical Center Rotterdam, Department of Cardiology, Rotterdam, The Netherlands
| | - Daniel M. de Bruin
- University of Amsterdam, Amsterdam University Medical Centers, Cancer Center Amsterdam, Amsterdam Cardiovascular Sciences, Department of Biomedical Engineering and Physics, Amsterdam, The Netherlands
| | - Ton G. van Leeuwen
- University of Amsterdam, Amsterdam University Medical Centers, Cancer Center Amsterdam, Amsterdam Cardiovascular Sciences, Department of Biomedical Engineering and Physics, Amsterdam, The Netherlands
| | - David D. Sampson
- The University of Western Australia, Department of Electrical, Electronic and Computer Engineering, Optical+Biomedical Engineering Laboratory, Perth, Western Australia, Australia
- University of Surrey, Surrey Biophotonics, Guildford, Surrey, United Kingdom
| | - Dirk J. Faber
- University of Amsterdam, Amsterdam University Medical Centers, Cancer Center Amsterdam, Amsterdam Cardiovascular Sciences, Department of Biomedical Engineering and Physics, Amsterdam, The Netherlands
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11
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Aragon-Ching JB, Choudhury A, Margulis V, Yu EY. Formidable Scenarios in Urothelial and Variant Cancers of the Urinary Tract. Am Soc Clin Oncol Educ Book 2019; 39:262-275. [PMID: 31099661 DOI: 10.1200/edbk_237451] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
Abstract
Diagnostic and therapeutic challenges in the field of bladder and upper tract cancers provide opportunities for multidisciplinary care. Urothelial cancers make up the majority of the histologic subtype of bladder and upper tract cancers. Although the existence of variant histology, nonurothelial cancers, and urethral cancers is rare, these cancers pose a challenging clinical dilemma given the lack of well-defined consensus treatment guidelines. This review focuses on key issues of treatment: cisplatin ineligibility with emphasis on the definition, nuances of chemotherapy and frontline immune checkpoint inhibitor therapy, use of radiation in bladder-preservation strategies, upper tract urothelial cancer management, and highlights of urothelial variants and nonurothelial tumors and management.
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Affiliation(s)
| | - Ananya Choudhury
- 2 The Christie National Health Service Foundation Trust, Manchester, United Kingdom
| | - Vitaly Margulis
- 3 The Univeristy of Texas Southwestern Medical Center, Dallas, TX
| | - Evan Y Yu
- 4 University of Washington, Seattle, WA
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12
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Tradewell MB, Albersheim J, Dahm P. Use of the IDEAL framework in the urological literature: where are we in 2018? BJU Int 2019; 123:1078-1085. [PMID: 30653798 DOI: 10.1111/bju.14676] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/24/2022]
Abstract
OBJECTIVES To assess uptake and application of the IDEAL principles in original surgical procedure- or device-related clinical research studies, as well as its reported relevance as characterized by secondary publications, editorials and reviews. MATERIALS AND METHODS IDEAL (Idea, Development, Exploration, Assessment, Long-term study) is a framework that provides stage-specific guidance for surgical innovation and represented a major advance towards raising evidential standards. We performed a comprehensive literature search of all urology-related publications citing one or more of seven key publications on IDEAL in The Lancet and BMJ using multiple databases up to 31 December 2017. RESULTS We identified a total of 150 urology-related manuscripts citing IDEAL, of which 83 (55.3%) were original research and 67 (44.7%) were secondary publications. Among the original research articles, 40 (48.2%) did not explicitly apply IDEAL principles or were not surgical innovation studies. The IDEAL phases of the 43 (51.8%) remaining original research studies were IDEAL, in nine (20.9%), 27 (62.8%), four (9.3%), 0 (0%), and three publications (7.0%), respectively. Across IDEAL stages, 30 (75.0%) studies were prospective, 29 (85.3%) reported ethical oversight, and 39 (90.7%) captured treatment-related harms. None of the studies collected information on physician experience. CONCLUSIONS The IDEAL framework has found widespread adoption in the urology literature as witnessed by a large number of original manuscripts and secondary publications citing IDEAL; however, its application is largely limited to the early stages of surgical innovation, frequently with inappropriate and incomplete implementation. Further efforts are needed to guide investigators in the optimal use of the IDEAL framework as it relates to surgical innovation in urology.
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Affiliation(s)
| | - Jacob Albersheim
- Department of Urology, University of Minnesota, Minneapolis, MN, USA
| | - Philipp Dahm
- Department of Urology, University of Minnesota, Minneapolis, MN, USA.,Urology Section, Minneapolis Veterans Administration Health Care System, Minneapolis, MN, USA
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13
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Novel real-time optical imaging modalities for the detection of neoplastic lesions in urology: a systematic review. Surg Endosc 2018; 33:1349-1367. [PMID: 30421080 PMCID: PMC6484817 DOI: 10.1007/s00464-018-6578-1] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/28/2018] [Accepted: 11/02/2018] [Indexed: 12/11/2022]
Abstract
BACKGROUND Current optical diagnostic techniques for malignancies are limited in their diagnostic accuracy and lack the ability to further characterise disease, leading to the rapidly increasing development of novel imaging methods within urology. This systematic review critically appraises the literature for novel imagining modalities, in the detection and staging of urological cancer and assesses their effectiveness via their utility and accuracy. METHODS A systematic literature search utilising MEDLINE, EMBASE and Cochrane Library Database was conducted from 1970 to September 2018 by two independent reviewers. Studies were included if they assessed real-time imaging modalities not already approved in guidelines, in vivo and in humans. Outcome measures included diagnostic accuracy and utility parameters, including feasibility and cost. RESULTS Of 5475 articles identified from screening, a final 46 were included. Imaging modalities for bladder cancer included optical coherence tomography (OCT), confocal laser endomicroscopy, autofluorescence and spectroscopic techniques. OCT was the most widely investigated, with 12 studies demonstrating improvements in overall diagnostic accuracy (sensitivity 74.5-100% and specificity 60-98.5%). Upper urinary tract malignancy diagnosis was assessed using photodynamic diagnosis (PDD), narrow band imaging, optical coherence tomography and confocal laser endomicroscopy. Only PDD demonstrated consistent improvements in overall diagnostic accuracy in five trials (sensitivity 94-96% and specificity 96.6-100%). Limited evidence for optical coherence tomography in percutaneous renal biopsy was identified, with anecdotal evidence for any modality in penile cancer. CONCLUSIONS Evidence supporting the efficacy for identified novel imaging modalities remains limited at present. However, OCT for bladder cancer and PDD in upper tract malignancy demonstrate the best potential for improvement in overall diagnostic accuracy. OCT may additionally aid intraoperative decision making via real-time staging of disease. Both modalities require ongoing investigation through larger, well-conducted clinical trials to assess their diagnostic accuracy, use as an intraoperative staging aid and how to best utilise them within clinical practice.
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14
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Knoedler JJ, Raman JD. Advances in the management of upper tract urothelial carcinoma: improved endoscopic management through better diagnostics. Ther Adv Urol 2018; 10:421-429. [PMID: 30574202 DOI: 10.1177/1756287218805334] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/30/2017] [Accepted: 08/09/2018] [Indexed: 12/12/2022] Open
Abstract
As a rare disease, the management of upper tract urothelial carcinoma (UTUC) continues to evolve. While radical nephroureterectomy remains the gold standard, there is a growing desire to pursue nephron-sparing approaches through endoscopic management, particularly for low-risk disease or in the setting of imperative indications. A particular challenge for those undertaking endoscopic management is appropriate grading and staging of tumors, and thereby appropriate patient selection. In this review we will cover the current state of diagnostics for UTUC as well as highlight the challenges in accurate diagnosis. Additionally, we will focus on emerging technologies to aid in optimizing diagnostic accuracy in UTUC. This will include discussion of narrow band imaging, photodynamic diagnosis, optical coherence tomography, and confocal laser endomicroscopy.
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Affiliation(s)
- John J Knoedler
- Milton S. Hershey Medical Center, 500 University Dr., c4830, Hershey, PA 17033, USA
| | - Jay D Raman
- Milton S. Hershey Medical Center, Hershey, PA, USA
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15
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Jelvehgaran P, Alderliesten T, Georgiou G, Meijer SL, Bloemen PR, Kodach LL, van Laarhoven HWM, van Berge Henegouwen MI, Hulshof MCCM, Rasch CRN, van Leeuwen TG, de Boer JF, de Bruin M, van Herk M. Feasibility of using optical coherence tomography to detect radiation-induced fibrosis and residual cancer extent after neoadjuvant chemo-radiation therapy: an ex vivo study. BIOMEDICAL OPTICS EXPRESS 2018; 9:4196-4216. [PMID: 30615728 PMCID: PMC6157785 DOI: 10.1364/boe.9.004196] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/03/2018] [Revised: 07/03/2018] [Accepted: 08/02/2018] [Indexed: 05/11/2023]
Abstract
Treatment of resectable esophageal cancer includes neoadjuvant chemo-radiation therapy (nCRT) followed by esophagectomy in operable patients. High-risk surgery may have been avoided in patients with a pathological complete response (pCR). We investigated the feasibility of optical coherence tomography (OCT) to detect residual cancer and radiation-induced fibrosis in 10 esophageal cancer patients that underwent nCRT followed by esophagectomy. We compared our OCT findings with histopathology. Overall, OCT was able to differentiate between healthy tissue, fibrotic tissue, and residual cancer with a sensitivity and specificity of 79% and 67%, respectively. Hence, OCT has the potential to add to the assessment of a pCR.
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Affiliation(s)
- Pouya Jelvehgaran
- Department of Biomedical Engineering and Physics, Amsterdam UMC, University of Amsterdam, Amsterdam 1105 AZ, The Netherlands
- Department of Radiation Oncology, Amsterdam UMC, University of Amsterdam, Amsterdam 1105 AZ, The Netherlands
- Institute for Laser Life and Biophotonics Amsterdam, Department of Physics and Astronomy, VU University Amsterdam, Amsterdam 1081 HV, The Netherlands
| | - Tanja Alderliesten
- Department of Radiation Oncology, Amsterdam UMC, University of Amsterdam, Amsterdam 1105 AZ, The Netherlands
| | - Giota Georgiou
- Department of Radiation Oncology, Amsterdam UMC, University of Amsterdam, Amsterdam 1105 AZ, The Netherlands
| | - Sybren L. Meijer
- Department of Pathology, Amsterdam UMC, University of Amsterdam, Amsterdam 1105 AZ, The Netherlands
| | - Paul R. Bloemen
- Department of Biomedical Engineering and Physics, Amsterdam UMC, University of Amsterdam, Amsterdam 1105 AZ, The Netherlands
| | - Liudmila L. Kodach
- Department of Pathology, Amsterdam UMC, University of Amsterdam, Amsterdam 1105 AZ, The Netherlands
| | - Hanneke W. M. van Laarhoven
- Department of Medical Oncology, Amsterdam UMC and Cancer Center Amsterdam, University of Amsterdam, Amsterdam 1105 AZ, The Netherlands
| | - Mark I. van Berge Henegouwen
- Department of Surgery, Amsterdam UMC and Cancer Center Amsterdam, University of Amsterdam, Amsterdam 1105 AZ, The Netherlands
| | - Maarten C. C. M. Hulshof
- Department of Radiation Oncology, Amsterdam UMC, University of Amsterdam, Amsterdam 1105 AZ, The Netherlands
| | - Coen R. N. Rasch
- Department of Radiation Oncology, Amsterdam UMC, University of Amsterdam, Amsterdam 1105 AZ, The Netherlands
| | - Ton G. van Leeuwen
- Department of Biomedical Engineering and Physics, Amsterdam UMC, University of Amsterdam, Amsterdam 1105 AZ, The Netherlands
| | - Johannes F. de Boer
- Institute for Laser Life and Biophotonics Amsterdam, Department of Physics and Astronomy, VU University Amsterdam, Amsterdam 1081 HV, The Netherlands
| | - Martijn de Bruin
- Department of Biomedical Engineering and Physics, Amsterdam UMC, University of Amsterdam, Amsterdam 1105 AZ, The Netherlands
- Department of Urology, Amsterdam UMC, University of Amsterdam, Amsterdam 1105 AZ, The Netherlands
| | - Marcel van Herk
- Department of Biomedical Engineering and Physics, Amsterdam UMC, University of Amsterdam, Amsterdam 1105 AZ, The Netherlands
- Manchester Cancer Research Centre, Division of Cancer Science, School of Medical Sciences, Faculty of Biology, Medicine and Health, University of Manchester, Manchester Academic Health Sciences Centre, Manchester M13 9PL, UK
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16
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Khachane A, Philippou Y, Hirst A, McCulloch P. Appraising the uptake and use of the IDEAL Framework and Recommendations: A review of the literature. Int J Surg 2018; 57:84-90. [PMID: 30098412 DOI: 10.1016/j.ijsu.2018.07.008] [Citation(s) in RCA: 24] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/06/2018] [Revised: 07/18/2018] [Accepted: 07/24/2018] [Indexed: 11/28/2022]
Abstract
INTRODUCTION Evaluation of new surgical innovations is complex and variably regulated, and historically the quality of surgical studies has been criticized. The IDEAL (Idea, Development, Exploration, Assessment, Long-term monitoring) Framework was established to provide a pathway for evaluating surgical innovations at each stage of their development in order to produce high quality surgical research. Since the inception of IDEAL in 2009, there has been no assessment of its use. In this review, we look at the uptake and usage of IDEAL by examining the published literature. METHODS We conducted a literature search to identify all of the publications that cited IDEAL and included only those papers that intentionally used IDEAL as part of the study methodology. We then characterized these publications by year of publication, specialty, and geographical location. We performed a critical appraisal of Stage 1, 2a, and 2b studies in order to assess the degree to which authors have correctly followed the Framework and Recommendations. RESULTS We found 790 citations of IDEAL publications, and after abstract and full-text screening, 38 prospective studies for a surgical innovation that used IDEAL remained. We saw an overall increase in the uptake of IDEAL, with a predominance in urology and origin in the United Kingdom. The critical appraisal showed that although authors identified their project as using IDEAL, they often failed to include key IDEAL characteristics; this was especially true for the features unique to IDEAL Stages 2a and 2b. CONCLUSION It is evident from the large number of studies citing IDEAL that the importance and challenges of reporting surgical research is well recognized among researchers. There is growing enthusiasm for using IDEAL but the current level of understanding of the Recommendations is low. Clearer and more comprehensive explanation of the application of the IDEAL Framework and Recommendations is needed to guide surgical researchers undertaking IDEAL based studies of surgical innovations.
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Affiliation(s)
- Asha Khachane
- IDEAL Collaboration, Oxford, UK, Maimonides Medical Center, Brooklyn, NY, USA.
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17
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Muller BG, van Kollenburg RAA, Swaan A, Zwartkruis ECH, Brandt MJ, Wilk LS, Almasian M, Schreurs AW, Faber DJ, Rozendaal LR, Vis AN, Nieuwenhuijzen JA, van Moorselaar JRJA, de la Rosette JJMCH, de Bruin DM, van Leeuwen TG. Needle-based optical coherence tomography for the detection of prostate cancer: a visual and quantitative analysis in 20 patients. JOURNAL OF BIOMEDICAL OPTICS 2018; 23:1-11. [PMID: 30094972 DOI: 10.1117/1.jbo.23.8.086001] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/19/2018] [Accepted: 07/18/2018] [Indexed: 05/08/2023]
Abstract
Diagnostic accuracy of needle-based optical coherence tomography (OCT) for prostate cancer detection by visual and quantitative analysis is defined. 106 three-dimensional (3-D)-OCT data sets were acquired in 20 prostates after radical prostatectomy and precisely matched with pathology. OCT images were grouped per histological category. Two reviewers performed blind assessments of the OCT images. Sensitivity and specificity for malignancy detection were calculated. Quantitative analyses by automated optical attenuation coefficient calculation were performed. OCT can reliably differentiate between fat, cystic, and regular atrophy and benign glands. The overall sensitivity and specificity for malignancy detection was 79% and 88% for reviewer 1 and 88% and 81% for reviewer 2. Quantitative analysis for differentiation between stroma and malignancy showed a significant difference (4.6 mm - 1 versus 5.0 mm - 1 Mann-Whitney U-test p < 0.0001). A Kruskal-Wallis test showed a significant difference in median attenuation coefficient between stroma, inflammation, Gleason 3, and Gleason 4 (4.6, 4.1, 5.9, and 5.0 mm - 1, respectively). However, attenuation coefficient varied per patient and a related-samples Wilcoxon signed-rank test showed no significant difference per patient (p = 0.17). This study confirmed the one to one correlation of histopathology and OCT. Precise matching showed that most histological tissues categories in the prostate could be distinguished by their unique pattern in OCT images. In addition, the optical attenuation coefficient can play a role in the differentiation between stroma and malignancy; however, a per patient analysis of the optical attenuation coefficient did not show a significant difference.
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Affiliation(s)
- Berrend G Muller
- University of Amsterdam, Academic Medical Center, Department of Urology, The Netherlands
| | - Rob A A van Kollenburg
- University of Amsterdam, Academic Medical Center, Department of Urology, The Netherlands
| | - Abel Swaan
- University of Amsterdam, Academic Medical Center, Department of Urology, The Netherlands
- University of Amsterdam, Academic Medical Center, Department of Biomedical Engineering and Physics, The Netherlands
| | - Evita C H Zwartkruis
- VU University Medical Center, Department of Pathology, Amsterdam, The Netherlands
| | - Martin J Brandt
- University of Amsterdam, Academic Medical Center, Department of Biomedical Engineering and Physics, The Netherlands
| | - Leah S Wilk
- University of Amsterdam, Academic Medical Center, Department of Biomedical Engineering and Physics, The Netherlands
| | - Mitra Almasian
- University of Amsterdam, Academic Medical Center, Department of Biomedical Engineering and Physics, The Netherlands
| | - A Wim Schreurs
- University of Amsterdam, Academic Medical Center, Department of Instrumental Services, The Netherlands
| | - Dirk J Faber
- University of Amsterdam, Academic Medical Center, Department of Biomedical Engineering and Physics, The Netherlands
| | - L Rence Rozendaal
- VU University Medical Center, Department of Pathology, Amsterdam, The Netherlands
| | - Andre N Vis
- VU University Medical Center, Department of Urology, Amsterdam, The Netherlands
| | | | | | - Jean J M C H de la Rosette
- University of Amsterdam, Academic Medical Center, Department of Urology, The Netherlands
- Istanbul Medipol University, Department of Urology, Istanbul, Turkey
| | - Daniel Martijn de Bruin
- University of Amsterdam, Academic Medical Center, Department of Urology, The Netherlands
- University of Amsterdam, Academic Medical Center, Department of Biomedical Engineering and Physics, The Netherlands
| | - Ton G van Leeuwen
- University of Amsterdam, Academic Medical Center, Department of Biomedical Engineering and Physics, The Netherlands
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18
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Freifeld Y, Krabbe LM, Clinton TN, Woldu SL, Margulis V. Therapeutic strategies for upper tract urothelial carcinoma. Expert Rev Anticancer Ther 2018; 18:765-774. [PMID: 29848133 DOI: 10.1080/14737140.2018.1481395] [Citation(s) in RCA: 18] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/23/2022]
Abstract
INTRODUCTION Many controversies exist regarding the appropriate management of patients with upper tract urothelial carcinoma (UTUC), including staging, surgical management, use of systemic therapy, and prevention of bladder recurrence. Due to the rarity of this condition, high-level evidence is often lacking and in many cases guidelines are extrapolated from existing evidence on urothelial bladder cancer. Areas covered: This review paper summarizes the evidence on proper diagnosis and staging, surgical techniques, prevention of bladder recurrences, the use of local or systemic treatments in both neoadjuvant and adjuvant settings as well as special consideration for hereditary UTUC. Expert commentary: UTUC is a rare malignancy and slow progress is being made in the acquisition of high-quality evidence in this field. Treatments that facilitate preservation of the kidney are being explored such as advanced endoscopic techniques or partial resection of ureteral disease with seemingly acceptable oncological results. Further prospective evidence is needed.
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Affiliation(s)
- Yuval Freifeld
- a Department of Urology , University of Texas Southwestern Medical Center , Dallas , TX , USA
| | - Laura-Maria Krabbe
- a Department of Urology , University of Texas Southwestern Medical Center , Dallas , TX , USA.,b Department of Urology , University of Muenster Medical Center , Muenster , Germany
| | - Timothy N Clinton
- a Department of Urology , University of Texas Southwestern Medical Center , Dallas , TX , USA
| | - Solomon L Woldu
- a Department of Urology , University of Texas Southwestern Medical Center , Dallas , TX , USA
| | - Vitaly Margulis
- a Department of Urology , University of Texas Southwestern Medical Center , Dallas , TX , USA
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19
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Jelvehgaran P, de Bruin DM, Salguero FJ, Borst GR, Song JY, van Leeuwen TG, de Boer JF, Alderliesten T, van Herk M. Feasibility of using optical coherence tomography to detect acute radiation-induced esophageal damage in small animal models. JOURNAL OF BIOMEDICAL OPTICS 2018; 23:1-12. [PMID: 29651825 DOI: 10.1117/1.jbo.23.4.046004] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/11/2017] [Accepted: 03/26/2018] [Indexed: 05/25/2023]
Abstract
Lung cancer survival is poor, and radiation therapy patients often suffer serious treatment side effects. The esophagus is particularly sensitive leading to acute radiation-induced esophageal damage (ARIED). We investigated the feasibility of optical coherence tomography (OCT) for minimally invasive imaging of the esophagus with high resolution (10 μm) to detect ARIED in mice. Thirty mice underwent cone-beam computed tomography imaging for initial setup assessment and dose planning followed by a single-dose delivery of 4.0, 10.0, 16.0, and 20.0 Gy on 5.0-mm spots, spaced 10.0 mm apart in the esophagus. They were repeatedly imaged using OCT up to three months postirradiation. We compared OCT findings with histopathology obtained three months postirradiation qualitatively and quantitatively using the contrast-to-background-noise ratio (CNR). Histopathology mostly showed inflammatory infiltration and edema at higher doses; OCT findings were in agreement with most of the histopathological reports. We were able to identify the ARIED on OCT as a change in tissue scattering and layer thickness. Our statistical analysis showed significant difference between the CNR values of healthy tissue, edema, and inflammatory infiltration. Overall, the average CNR for inflammatory infiltration and edema damages was 1.6-fold higher and 1.6-fold lower than for the healthy esophageal wall, respectively. Our results showed the potential role of OCT to detect and monitor the ARIED in mice, which may translate to humans.
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Affiliation(s)
- Pouya Jelvehgaran
- Academic Medical Center, Department of Biomedical Engineering and Physics, Amsterdam, The Netherlands
- Academic Medical Center, Department of Radiation Oncology, Amsterdam, The Netherlands
- Institute for Laser Life and Biophotonics Amsterdam, Department of Physics and Astronomy, Amsterdam, The Netherlands
| | - Daniel Martijn de Bruin
- Academic Medical Center, Department of Biomedical Engineering and Physics, Amsterdam, The Netherlands
- Academic Medical Center, Department of Urology, Amsterdam, The Netherlands
| | - F Javier Salguero
- The Netherlands Cancer Institute, Department of Radiation Oncology, Amsterdam, The Netherlands
| | - Gerben Roelof Borst
- The Netherlands Cancer Institute, Department of Radiation Oncology, Amsterdam, The Netherlands
| | - Ji-Ying Song
- The Netherlands Cancer Institute, Department of Experimental Animal Pathology, Amsterdam, The Netherlands
| | - Ton G van Leeuwen
- Academic Medical Center, Department of Biomedical Engineering and Physics, Amsterdam, The Netherlands
| | - Johannes F de Boer
- Institute for Laser Life and Biophotonics Amsterdam, Department of Physics and Astronomy, Amsterdam, The Netherlands
| | - Tanja Alderliesten
- Academic Medical Center, Department of Radiation Oncology, Amsterdam, The Netherlands
| | - Marcel van Herk
- Academic Medical Center, Department of Biomedical Engineering and Physics, Amsterdam, The Netherlands
- University of Manchester, Institute of Cancer Sciences, Manchester, United Kingdom
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20
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Bus MTJ, Cernohorsky P, de Bruin DM, Meijer SL, Streekstra GJ, Faber DJ, Kamphuis GM, Zondervan PJ, van Herk M, Laguna Pes MP, Grundeken MJ, Brandt MJ, de Reijke TM, de la Rosette JJMCH, van Leeuwen TG. Ex-vivo study in nephroureterectomy specimens defining the role of 3-D upper urinary tract visualization using optical coherence tomography and endoluminal ultrasound. J Med Imaging (Bellingham) 2018; 5:017001. [PMID: 29487884 DOI: 10.1117/1.jmi.5.1.017001] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/30/2017] [Accepted: 01/04/2018] [Indexed: 11/14/2022] Open
Abstract
Minimal invasive endoscopic treatment for upper urinary tract urothelial carcinoma (UUT-UC) is advocated in patients with low-risk disease and limited tumor volume. Diagnostic ureterorenoscopy combined with biopsy is the diagnostic standard. This study aims to evaluate two alternative diagnostic techniques for UUT-UC: optical coherence tomography (OCT) and endoluminal ultrasound (ELUS). Following nephroureterectomy, OCT, ELUS, and computed tomography (CT) were performed of the complete nephroureterectomy specimen. Visualization software (AMIRA®) was used for reconstruction and coregistration of CT, OCT, and ELUS. Finally, CT was used to obtain exact probe localization. Coregistered OCT and ELUS datasets were compared with histology. Coregistration with three-dimensional CT makes exact data matching possible in this ex-vivo setting to compare histology with OCT and ELUS. In OCT images of normal-appearing renal pelvis and ureter, urothelium, lamina propria, and muscularis were visible. With ELUS, all anatomical layers of the ureter could be distinguished, besides the urothelial layer. ELUS identified suspect lesions, although exact staging and differentiation between noninvasive and invasive lesions were not possible. OCT provides high-resolution imaging of normal ureter and ureter lesions. ELUS, however, is of limited value as it cannot differentiate between noninvasive and invasive tumors.
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Affiliation(s)
- Mieke T J Bus
- University of Amsterdam, Academic Medical Center, Department of Urology, Amsterdam, The Netherlands
| | - Paul Cernohorsky
- University of Amsterdam, Academic Medical Center, Department of Plastic, Reconstructive and Hand Surgery, Amsterdam, The Netherlands
| | - Daniel M de Bruin
- University of Amsterdam, Academic Medical Center, Department of Urology, Amsterdam, The Netherlands.,University of Amsterdam, Academic Medical Center, Department of Biomedical Engineering and Physics, Amsterdam, The Netherlands
| | - Sybren L Meijer
- University of Amsterdam, Academic Medical Center, Department of Pathology, Amsterdam, The Netherlands
| | - Geert J Streekstra
- University of Amsterdam, Academic Medical Center, Department of Biomedical Engineering and Physics, Amsterdam, The Netherlands.,University of Amsterdam, Academic Medical Center, Department of Radiology, Amsterdam, The Netherlands
| | - Dirk J Faber
- University of Amsterdam, Academic Medical Center, Department of Biomedical Engineering and Physics, Amsterdam, The Netherlands
| | - Guido M Kamphuis
- University of Amsterdam, Academic Medical Center, Department of Urology, Amsterdam, The Netherlands
| | - Patricia J Zondervan
- University of Amsterdam, Academic Medical Center, Department of Urology, Amsterdam, The Netherlands
| | - Marcel van Herk
- University of Amsterdam, Academic Medical Center, Department of Biomedical Engineering and Physics, Amsterdam, The Netherlands
| | - Maria P Laguna Pes
- University of Amsterdam, Academic Medical Center, Department of Urology, Amsterdam, The Netherlands
| | - Maik J Grundeken
- University of Amsterdam, Academic Medical Center, Department of Cardiology, Amsterdam, The Netherlands
| | - Martin J Brandt
- University of Amsterdam, Academic Medical Center, Department of Biomedical Engineering and Physics, Amsterdam, The Netherlands
| | - Theo M de Reijke
- University of Amsterdam, Academic Medical Center, Department of Urology, Amsterdam, The Netherlands
| | | | - Ton G van Leeuwen
- University of Amsterdam, Academic Medical Center, Department of Biomedical Engineering and Physics, Amsterdam, The Netherlands
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21
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Shu X, Beckmann L, Zhang HF. Visible-light optical coherence tomography: a review. JOURNAL OF BIOMEDICAL OPTICS 2017; 22:1-14. [PMID: 29218923 PMCID: PMC5745673 DOI: 10.1117/1.jbo.22.12.121707] [Citation(s) in RCA: 74] [Impact Index Per Article: 10.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/12/2017] [Accepted: 11/13/2017] [Indexed: 05/03/2023]
Abstract
Visible-light optical coherence tomography (vis-OCT) is an emerging imaging modality, providing new capabilities in both anatomical and functional imaging of biological tissue. It relies on visible light illumination, whereas most commercial and investigational OCTs use near-infrared light. As a result, vis-OCT requires different considerations in engineering design and implementation but brings unique potential benefits to both fundamental research and clinical care of several diseases. Here, we intend to provide a summary of the development of vis-OCT and its demonstrated applications. We also provide perspectives on future technology improvement and applications.
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Affiliation(s)
- Xiao Shu
- Northwestern University, Department of Biomedical Engineering, Evanston, Illinois, United States
| | - Lisa Beckmann
- Northwestern University, Department of Biomedical Engineering, Evanston, Illinois, United States
| | - Hao F. Zhang
- Northwestern University, Department of Biomedical Engineering, Evanston, Illinois, United States
- Northwestern University, Department of Ophthalmology, Chicago, Illinois, United States
- Address all correspondence to: Hao F. Zhang, E-mail:
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22
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Swager AF, Faber DJ, de Bruin DM, Weusten BL, Meijer SL, Bergman JJ, Curvers WL, van Leeuwen TG. Quantitative attenuation analysis for identification of early Barrett's neoplasia in volumetric laser endomicroscopy. JOURNAL OF BIOMEDICAL OPTICS 2017; 22:86001. [PMID: 28777838 DOI: 10.1117/1.jbo.22.8.086001] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/13/2017] [Accepted: 07/17/2017] [Indexed: 06/07/2023]
Abstract
Early neoplasia in Barrett’s esophagus (BE) is difficult to detect. Volumetric laser endomicroscopy (VLE) incorporates optical coherence tomography, providing a circumferential scan of the esophageal wall layers. The attenuation coefficient (μVLE) quantifies decay of detected backscattered light versus depth, and could potentially improve BE neoplasia detection. The aim is to investigate feasibility of μVLE for identification of early BE neoplasia. In vivo and ex vivo VLE scans with histological correlation from BE patients ± neoplasia were used. Quantification by μVLE was performed manually on areas of interest (AoIs) to differentiate neoplasia from nondysplastic (ND)BE. From ex vivo VLE scans from 16 patients (13 with neoplasia), 68 AoIs were analyzed. Median μVLE values (mm−1) were 3.7 [2.1 to 4.4 interquartile range (IQR)] for NDBE and 4.0 (2.5 to 4.9 IQR) for neoplasia, not statistically different (p=0.82). Fourteen in vivo scans were used: nine from neoplastic and five from NDBE patients. Median μVLE values were 1.8 (1.5 to 2.6 IQR) for NDBE and 2.1 (1.9 to 2.6 IQR) for neoplasia, with no statistically significant difference (p=0.37). In conclusion, there was no significant difference in μVLE values in VLE scans from early neoplasia versus NDBE. Future studies with a larger sample size should explore other quantitative methods for detection of neoplasia during BE surveillance.
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Affiliation(s)
- Anne-Fre Swager
- , Department of Gastroenterology and Hepatology, Academic Medical Center, Amsterdam
| | - Dirk J Faber
- , Department of Biomedical Engineering and Physics, Academic Medical Center, Amsterdam
| | - Daniel M de Bruin
- , Department of Biomedical Engineering and Physics, Academic Medical Center, Amsterdam
| | - Bas L Weusten
- , Department of Gastroenterology and Hepatology, Academic Medical Center, Amsterdam
| | - Sybren L Meijer
- , Department of Pathology, Academic Medical Center, Amsterdam
| | - Jacques J Bergman
- , Department of Gastroenterology and Hepatology, Academic Medical Center, Amsterdam
| | | | - Ton G van Leeuwen
- , Department of Biomedical Engineering and Physics, Academic Medical Center, Amsterdam
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23
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Gora MJ, Suter MJ, Tearney GJ, Li X. Endoscopic optical coherence tomography: technologies and clinical applications [Invited]. BIOMEDICAL OPTICS EXPRESS 2017; 8:2405-2444. [PMID: 28663882 PMCID: PMC5480489 DOI: 10.1364/boe.8.002405] [Citation(s) in RCA: 142] [Impact Index Per Article: 20.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/10/2017] [Revised: 03/20/2017] [Accepted: 03/27/2017] [Indexed: 05/07/2023]
Abstract
In this paper, we review the current state of technology development and clinical applications of endoscopic optical coherence tomography (OCT). Key design and engineering considerations are discussed for most OCT endoscopes, including side-viewing and forward-viewing probes, along with different scanning mechanisms (proximal-scanning versus distal-scanning). Multi-modal endoscopes that integrate OCT with other imaging modalities are also discussed. The review of clinical applications of endoscopic OCT focuses heavily on diagnosis of diseases and guidance of interventions. Representative applications in several organ systems are presented, such as in the cardiovascular, digestive, respiratory, and reproductive systems. A brief outlook of the field of endoscopic OCT is also discussed.
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Affiliation(s)
- Michalina J Gora
- Wellman Center for Photomedicine, Massachusetts General Hospital and Harvard Medical School, 55 Fruit Street, Boston, MA 02114, USA
- ICube Laboratory, CNRS, Strasbourg University, 1 Place de l'Hopital, Strasbourg 67091, France
| | - Melissa J Suter
- Wellman Center for Photomedicine, Massachusetts General Hospital and Harvard Medical School, 55 Fruit Street, Boston, MA 02114, USA
- Department of Medicine, Division of Pulmonary and Critical Care, Massachusetts General Hospital, 55 Fruit Street, Boston, MA 02114, USA
- Harvard Medical School, 25 Shattuck Street, Boston, MA 02115, USA
| | - Guillermo J Tearney
- Wellman Center for Photomedicine, Massachusetts General Hospital and Harvard Medical School, 55 Fruit Street, Boston, MA 02114, USA
- Harvard Medical School, 25 Shattuck Street, Boston, MA 02115, USA
- Department of Pathology, Massachusetts General Hospital, 55 Fruit Street, Boston, MA 02114, USA
| | - Xingde Li
- Department of Biomedical Engineering, Department of Electrical and Computer Engineering, and Department of Oncology, Johns Hopkins University, 720 Rutland Avenue, Traylor 710, Baltimore, MD 21205, USA
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24
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25
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Soria F, Shariat SF, Lerner SP, Fritsche HM, Rink M, Kassouf W, Spiess PE, Lotan Y, Ye D, Fernández MI, Kikuchi E, Chade DC, Babjuk M, Grollman AP, Thalmann GN. Epidemiology, diagnosis, preoperative evaluation and prognostic assessment of upper-tract urothelial carcinoma (UTUC). World J Urol 2017; 35:379-387. [PMID: 27604375 DOI: 10.1007/s00345-016-1928-x] [Citation(s) in RCA: 233] [Impact Index Per Article: 33.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/25/2016] [Accepted: 08/27/2016] [Indexed: 12/28/2022] Open
Abstract
PURPOSE Upper-tract urothelial carcinoma (UTUC) is a relatively uncommon disease with limited available evidence on specific topics. The purpose of this article was to review the previous literature to summarize the current knowledge about UTUC epidemiology, diagnosis, preoperative evaluation and prognostic assessment. METHODS Using MEDLINE, a non-systematic review was performed including articles between January 2000 and February 2016. English language original articles, reviews and editorials were selected based on their clinical relevance. RESULTS UTUC accounts for 5-10 % of all urothelial cancers, with an increasing incidence. UTUC and bladder cancer share some common risk factors, even if they are two different entities regarding practical, biological and clinical characteristics. Aristolochic acid plays an important role in UTUC pathogenesis in certain regions. It is further estimated that approximately 10 % of UTUC are part of the hereditary non-polyposis colorectal cancer spectrum disease. UTUC diagnosis remains mainly based on imaging and endoscopy, but development of new technologies is rapidly changing the diagnosis algorithm. To help the decision-making process regarding surgical treatment, extent of lymphadenectomy and selection of neoadjuvant systemic therapies, predictive tools based on preoperative patient and tumor characteristics have been developed. CONCLUSIONS Awareness regarding epidemiology, diagnosis, preoperative evaluation and prognostic assessment changes is essential to correctly diagnose and manage UTUC patients, thereby potentially improving their outcomes.
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Affiliation(s)
- Francesco Soria
- Department of Urology, Medical University of Vienna, Vienna, Austria
- Division of Urology, Department of Surgical Sciences, San Giovanni Battista Hospital, University of Studies of Torino, Turin, Italy
| | - Shahrokh F Shariat
- Department of Urology, Medical University of Vienna, Vienna, Austria
- Karl Landsteiner Institute of Urology and Andrology, Vienna, Austria
- Department of Urology, University of Texas Southwestern Medical Center, Dallas, TX, USA
- Department of Urology, Weill Cornell Medical College, New York, NY, USA
| | - Seth P Lerner
- Scott Department of Urology, Baylor College of Medicine, Houston, TX, USA
| | - Hans-Martin Fritsche
- Department of Urology, Caritas St. Josef Medical Centre, University of Regensburg, Regensburg, Germany
| | - Michael Rink
- Department of Urology, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - Wassim Kassouf
- Department of Surgery (Urology), McGill University, Montreal, QC, Canada
| | - Philippe E Spiess
- Department of Genitourinary Oncology, Moffitt Cancer Center, Tampa, FL, USA
| | - Yair Lotan
- Department of Urology, University of Texas Southwestern Medical Center, Dallas, TX, USA
| | - Dingwei Ye
- Department of Urology, Fudan University Shanghai Cancer Center, Shanghai, China
| | | | - Eiji Kikuchi
- Department of Urology, Keio University School of Medicine, Tokyo, Japan
| | - Daher C Chade
- Urology Department, University of Sao Paulo Medical School and Institute of Cancer, São Paulo, Brazil
| | - Marko Babjuk
- Department of Urology, Faculty Hospital Motol, Second Faculty of Medicine, Charles University in Praha, Prague, Czech Republic
| | - Arthur P Grollman
- Department of Pharmacological Sciences and Department of Medicine, Stony Brook University, Stony Brook, NY, USA
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Pan S, Smith AD, Motamedinia P. Minimally Invasive Therapy for Upper Tract Urothelial Cell Cancer. J Endourol 2017; 31:238-245. [PMID: 28117602 DOI: 10.1089/end.2016.0475] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/05/2023] Open
Abstract
Minimally invasive therapy for upper tract urothelial cell cancer has assumed an important role in the management of this relatively uncommon genitourinary malignancy. In this review, current standards for patient selection, surgical approach, as well as overall outcomes will be discussed. Moreover, the use of intraluminal agents in upper tract disease is examined along with its efficacy and associated complications.
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Affiliation(s)
- Shu Pan
- 1 Yale University School of Medicine , New Haven, Connecticut
| | - Arthur D Smith
- 2 Smith Institute for Urology, Northwell-Hofstra University , New Hyde Park, New York
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Redrow GP, Guo CC, Brausi MA, Coleman JA, Fernandez MI, Kassouf W, Keeley FX, Margulis V, Raman JD, Roupret M, Shariat SF, Spiess PE, Thalmann GN, Matin SF. Upper Urinary Tract Carcinoma In Situ: Current Knowledge, Future Direction. J Urol 2017; 197:287-295. [DOI: 10.1016/j.juro.2016.03.194] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 03/10/2016] [Indexed: 10/21/2022]
Affiliation(s)
- Grant P. Redrow
- Department of Urology, University of Texas MD Anderson Cancer Center, Houston, Texas
- Division of Urology, University of Texas at Houston School of Medicine, Houston, Texas
| | - Charles C. Guo
- Department of Pathology, University of Texas MD Anderson Cancer Center, Houston, Texas
| | | | - Jonathan A. Coleman
- Urology Service, Department of Surgery, Memorial Sloan Kettering Cancer Center, New York, New York
| | | | - Wassim Kassouf
- Division of Urology, McGill University Health Center, Montreal, Quebec, Canada
| | - Francis X. Keeley
- Bristol Urological Institute, Southmead Hospital, Bristol, United Kingdom
| | - Vitaly Margulis
- Department of Urology, U.T. Southwestern Medical Center, Dallas, Texas
| | - Jay D. Raman
- Division of Urology, Penn State Milton S. Hershey Medical Center, Hershey, Pennsylvania
| | - Morgan Roupret
- Department of Urology, Groupe Hospitalier Pitié–Salpêtrière, Assistance Publique Hopitaux de Paris, Faculty of Medicine Pierre et Marie Curie, Institut Universitaire de Cancérologie GRC5, University Paris 6, Paris, France
| | - Shahrokh F. Shariat
- Department of Urology and Comprehensive Cancer Center, Medical University of Vienna, Vienna General Hospital, Vienna, Austria
| | - Philippe E. Spiess
- Department of Genitourinary Oncology, Moffitt Cancer Center, Tampa, Florida
| | - George N. Thalmann
- Department of Urology, University of Bern, Inselspital, Bern, Switzerland
| | - Surena F. Matin
- Department of Urology, University of Texas MD Anderson Cancer Center, Houston, Texas
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Abstract
Upper tract urothelial carcinoma (UTUC) is a rare condition and recommendations based on a high level of evidence for diagnosis, treatment and follow-up monitoring are lacking. Current decision-making is often based on evidence from trials investigating urothelial carcinoma of the lower tract. Radical nephroureterectomy has been the standard of care for UTUC but kidney-sparing treatment using endoscopic approaches has been established for a select patient group with low-grade and low-stage disease. Optimal treatment choice requires correct tumour characterization. According to available recommendations, diagnostic work-up of UTUC includes evaluation by CT urography or MRI urography, cystoscopy and urine cytology. Ureterorenoscopy and lesion biopsy are grade C recommendations in patients with suspected UTUC. When kidney-sparing treatment is planned, ureterorenoscopy and biopsy should be considered and are the procedures of choice in most cases. These diagnostics have limitations and their accuracy varies in defining tumour characteristics and predicting grade and stage. Urinary tests have higher sensitivity than cytology for detection of lower tract urothelial carcinoma but evidence of their benefit in UTUCs is lacking. New optical and image enhancement techniques are being developed to facilitate real-time diagnostics with increased accuracy. A new diagnostic algorithm for patients with suspected UTUC that integrates the diagnosis, treatment and clinical risk stratification is required.
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Bus M, de Bruin D, Faber D, Kamphuis G, Zondervan P, Laguna-Pes M, van Leeuwen T, de Reijke TM, de la Rosette J. Optical Coherence Tomography as a Tool for In Vivo Staging and Grading of Upper Urinary Tract Urothelial Carcinoma: A Study of Diagnostic Accuracy. J Urol 2016; 196:1749-1755. [DOI: 10.1016/j.juro.2016.04.117] [Citation(s) in RCA: 23] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 04/21/2016] [Indexed: 10/21/2022]
Affiliation(s)
- M.T.J. Bus
- Department of Urology, Academic Medical Center, The Netherlands
| | - D.M. de Bruin
- Department of Urology, Academic Medical Center, The Netherlands
- Department of Biomedical Engineering & Physics, Academic Medical Center, The Netherlands
| | - D.J. Faber
- Department of Biomedical Engineering & Physics, Academic Medical Center, The Netherlands
| | - G.M. Kamphuis
- Department of Urology, Academic Medical Center, The Netherlands
| | - P.J. Zondervan
- Department of Urology, Academic Medical Center, The Netherlands
| | - M.P. Laguna-Pes
- Department of Urology, Academic Medical Center, The Netherlands
| | - T.G. van Leeuwen
- Department of Biomedical Engineering & Physics, Academic Medical Center, The Netherlands
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de Bruin DM, Broekgaarden M, van Gemert MJC, Heger M, de la Rosette JJ, Van Leeuwen TG, Faber DJ. Assesment of apoptosis induced changes in scattering using optical coherence tomography. JOURNAL OF BIOPHOTONICS 2016; 9:913-923. [PMID: 26564260 DOI: 10.1002/jbio.201500198] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/23/2015] [Revised: 09/28/2015] [Accepted: 10/18/2015] [Indexed: 06/05/2023]
Abstract
The aim of this study is to identify changes in scattering with optical coherence tomography (OCT) and relate these measurements with mitochondrial changes during the initiation of apoptosis. Human retinal pigment epithelial cells were cultured and apoptosis was induced using 10% alcohol. Using the attenuation coefficient and backscattering, changes were measured during cell death in a cell-pellet and monolayer respectively. To confirm apoptosis, fluorescent activated cell sorting was used. Mitochondrial activity during apoptosis was assessed using an oxidative stress assay and fluorescent confocal microscopy. Pelleted apoptotic cells measured with OCT showed a clear rise while untreated cells showed a very small increase in attenuation coefficient. Monolayered apoptotic cells displayed a distinct increase, while untreated cells showed a small increase in the backscattering. Apoptosis was confirmed by FACS experiments. Mitochondrial changes during the onset of apoptosis were also measured. The results demonstrate that apoptotic cell death could be monitored in real-time by OCT. Changes in the scattering after induction of apoptosis are likely to be related to changes in the intracellular morphology. Oxidative stress-induced mitochondrial swelling could be responsible for the initial increase, while cell blebbing and secondary necrosis subsequently for the observed decrease in scattering.
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Affiliation(s)
- Daniel M de Bruin
- Biomedical Engineering and Physics, Academic Medical Center, University of Amsterdam, Meibergdreef 9, 1105AZ, Amsterdam, Netherlands.
- Urology, Academic Medical Center, University of Amsterdam, Meibergdreef 9, 1105AZ, Amsterdam, Netherlands.
| | - Mans Broekgaarden
- Experimental Surgery, Academic Medical Center, University of Amsterdam, Meibergdreef 9, 1105AZ, Amsterdam, Netherlands
| | - Martin J C van Gemert
- Biomedical Engineering and Physics, Academic Medical Center, University of Amsterdam, Meibergdreef 9, 1105AZ, Amsterdam, Netherlands
| | - Michal Heger
- Experimental Surgery, Academic Medical Center, University of Amsterdam, Meibergdreef 9, 1105AZ, Amsterdam, Netherlands
| | - Jean J de la Rosette
- Urology, Academic Medical Center, University of Amsterdam, Meibergdreef 9, 1105AZ, Amsterdam, Netherlands
| | - Ton G Van Leeuwen
- Biomedical Engineering and Physics, Academic Medical Center, University of Amsterdam, Meibergdreef 9, 1105AZ, Amsterdam, Netherlands
| | - Dirk J Faber
- Biomedical Engineering and Physics, Academic Medical Center, University of Amsterdam, Meibergdreef 9, 1105AZ, Amsterdam, Netherlands
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Muller BG, de Bruin DM, Brandt MJ, van den Bos W, van Huystee S, Faber DJ, Savci D, Zondervan PJ, de Reijke TM, Laguna-Pes MP, van Leeuwen TG, de la Rosette JJMCH. Prostate cancer diagnosis by optical coherence tomography: First results from a needle based optical platform for tissue sampling. JOURNAL OF BIOPHOTONICS 2016; 9:490-498. [PMID: 26856796 DOI: 10.1002/jbio.201500252] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/23/2015] [Revised: 01/03/2016] [Accepted: 01/04/2016] [Indexed: 06/05/2023]
Abstract
The diagnostic accuracy of Optical Coherence Tomography (OCT) based optical attenuation coefficient analysis is assessed for the detection of prostate cancer. Needle-based OCT-measurements were performed on the prostate specimens. Attenuation coefficients were determined by an earlier described in-house developed software package. The mean attenuation coefficients (benign OCT data; malignant OCT data; p-value Mann-Whitney U test) were: (3.56 mm(-1) ; 3.85 mm(-1) ; p < 0.0001) for all patients combined. The area under the ROC curve was 0.64. In order to circumvent the effect of histopathology mismatching, we performed a sub-analysis on only OCT data in which tumor was visible in two subsequent histopathological prostate slices. This analysis could be performed in 3 patients. The mean attenuation coefficients (benign OCT data; malignant OCT data; p-value Mann-Whitney U test) were: (3.23 mm(-1) ; 4.11 mm(-1) ; p < 0.0001) for all patients grouped together. The area under the ROC curve was 0.89. Functional OCT of the prostate has shown to differentiate between cancer and healthy prostate tissue. The optical attenuation coefficient in malignant tissue was significantly higher in malignant tissue compared to benign prostate tissue. Further studies are required to validate these initial results in a larger group of patients with a more tailored histopathology matching protocol.
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Affiliation(s)
- Berrend G Muller
- Department of Urology, Academic Medical Center, University of Amsterdam, Meibergdreef 9, 1105, AZ Amsterdam Z.O., The Netherlands.
| | - Daniel M de Bruin
- Department of Urology, Academic Medical Center, University of Amsterdam, Meibergdreef 9, 1105, AZ Amsterdam Z.O., The Netherlands
- Department of Biomedical Engineering and Physics, Academic Medical Center, University of Amsterdam, The Netherlands
| | - Martin J Brandt
- Department of Biomedical Engineering and Physics, Academic Medical Center, University of Amsterdam, The Netherlands
| | - Willemien van den Bos
- Department of Urology, Academic Medical Center, University of Amsterdam, Meibergdreef 9, 1105, AZ Amsterdam Z.O., The Netherlands
| | - Suzanne van Huystee
- Department of Urology, Academic Medical Center, University of Amsterdam, Meibergdreef 9, 1105, AZ Amsterdam Z.O., The Netherlands
| | - D J Faber
- Department of Biomedical Engineering and Physics, Academic Medical Center, University of Amsterdam, The Netherlands
| | - Dilaria Savci
- Department of Pathology, Academic Medical Center, University of Amsterdam, The Netherlands
| | - Patricia J Zondervan
- Department of Urology, Academic Medical Center, University of Amsterdam, Meibergdreef 9, 1105, AZ Amsterdam Z.O., The Netherlands
| | - Theo M de Reijke
- Department of Urology, Academic Medical Center, University of Amsterdam, Meibergdreef 9, 1105, AZ Amsterdam Z.O., The Netherlands
| | - M Pilar Laguna-Pes
- Department of Urology, Academic Medical Center, University of Amsterdam, Meibergdreef 9, 1105, AZ Amsterdam Z.O., The Netherlands
| | - Ton G van Leeuwen
- Department of Biomedical Engineering and Physics, Academic Medical Center, University of Amsterdam, The Netherlands
| | - Jean J M C H de la Rosette
- Department of Biomedical Engineering and Physics, Academic Medical Center, University of Amsterdam, The Netherlands
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Kata SG, Aboumarzouk O. Are we closer to seeing carcinoma in situ in the upper urinary tract? Cent European J Urol 2016; 69:157-61. [PMID: 27551552 PMCID: PMC4986306 DOI: 10.5173/ceju.2016.801] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/22/2016] [Revised: 03/21/2016] [Accepted: 04/09/2016] [Indexed: 11/22/2022] Open
Abstract
INTRODUCTION There is observed increase in detection rate of upper urinary tract urothelial cancer worldwide. This is a result of improved imaging as well as implementation of novel technologies of direct visualization of upper urinary tract. Standard techniques still remain insufficient to diagnose flat urothelial lesions. Carcinoma in situ is characterized by flat disordered proliferation of urothelial cells with marked cytologic abnormality, which occur within one cell layer as well as full thickness urothelium and therefore requires a better technology to pick up early and subtle mucosal changes. MATERIAL AND METHODS The review presents available diagnostic tools in detection of upper urinary tract urothelial cancer and their ability to depict carcinoma in situ. RESULTS Ureterorenoscopy is an investigation of choice as various promising techniques are under pilot investigations to enhance visualization of upper urinary tract carcinoma in situ. So far only photodynamic diagnosis has been reported to be as effective in detection of carcinoma in situ in the upper as within the lower urinary tract. CONCLUSIONS Although we are close to see upper urinary tract carcinoma in situ all new promising diagnostic techniques still require further validation in multicenter clinical trials to indicate any change to current recommendations.
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Affiliation(s)
- Sławomir G Kata
- Department of Urology, Ninewells Hospital and Medical School, Dundee, United Kingdom
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Abstract
Urothelial carcinoma of the bladder and upper tract is primarily diagnosed by white light endoscopy, which has well-known limitations that contribute to the increased risk of tumor recurrence and progression. Narrow band imaging (NBI) is an optical imaging technology that facilitates detection of tumor vasculature and differentiation of benign urothelium from neoplastic tissue. For urothelial carcinoma, NBI may be utilized in a variety of clinical settings, including office cystoscopy for initial identification and surveillance, transurethral resection for pathological diagnosis, and ureteroscopic management of upper tract lesions. Early evidence suggests that NBI increases the detection of urothelial carcinoma in the bladder and upper tract, including flat high-grade lesions such as carcinoma-in-situ that are a diagnostic challenge under white light. NBI also appears to improve the quality of transurethral resection and thereby reduce the frequency of tumor recurrence.
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Affiliation(s)
- Emanuela Altobelli
- Department of Urology, Stanford University School of Medicine, 300 Pasteur Dr., Room S-287, Stanford, CA, 94305-5118, USA,
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34
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Mathieu R, Bensalah K, Lucca I, Mbeutcha A, Rouprêt M, Shariat SF. Upper urinary tract disease: what we know today and unmet needs. Transl Androl Urol 2016; 4:261-72. [PMID: 26816829 PMCID: PMC4708228 DOI: 10.3978/j.issn.2223-4683.2015.05.01] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/23/2022] Open
Abstract
Purpose Upper tract urothelial carcinoma (UTUC) is a rare and poorly investigated disease. Intense collaborative efforts have increased our knowledge and improved the management of the disease. The objective of this review was to discuss recent advances and unmet needs in UTUC. Methods A non-systematic Medline/PubMed literature search was performed on UTUC using the terms “upper tract urothelial carcinoma” with different combinations of keywords. Original articles, reviews and editorials in English language were selected based on their clinical relevance. Results UTUC is a disease with specific epidemiologic and risk factors different to urothelial carcinoma of the bladder (UCB). Similarly to UCB, smoking increases the risk of UTUC and worsens its prognosis, whereas aristolochic acid (AA) exposure and mismatch repair genes abnormality are UTUC specific risk factors. A growing understanding of biological pathways involved in the tumorigenesis of UTUC has led to the identification of promising prognostic/predictive biomarkers. Risk stratification of UTUC is difficult due to limitations in staging and grading. Modern imaging and endoscopy have improved clinical decision-making, and allowed kidney-sparing management and surveillance in favorable-risk tumors. In high-risk tumors, radical nephroureterectomy (RNU) remains the standard. Complete removal of the intramural ureter is necessary with inferiority of endoscopic management. Post-RNU intravesical instillation has been shown to decrease bladder cancer recurrence rates. While the role of neoadjuvant cisplatin based combination chemotherapy and lymphadenectomy are not clearly established, the body of evidence suggests a survival benefit to these. There is currently no evidence for adjuvant chemotherapy (AC) in UTUC. Conclusions Despite growing interest and understanding of UTUC, its management remains challenging, requiring further high quality multicenter collaborations. Accurate risk estimation is necessary to avoid unnecessary RNUs while advances in technology are still required for optimal kidney-sparing approaches.
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Affiliation(s)
- Romain Mathieu
- 1 Department of Urology, Rennes University Hospital, Rennes, France ; 2 Department of Urology, General Hospital, Medical University Vienna, Vienna, Austria ; 3 Department of Urology, Centre Hospitalier Universitaire Vaudois, Lausanne, Switzerland ; 4 Academic Department of Urology, La Pitié-Salpetrière Hospital, Assistance Publique-Hôpitaux de Paris, Faculté de Médecine Pierre et Marie Curie, University Paris 6, Paris, France ; 5 Department of Urology, University of Texas Southwestern Medical Center, Dallas, USA ; 6 Department of Urology, Weill Cornell Medical College, New York, USA
| | - Karim Bensalah
- 1 Department of Urology, Rennes University Hospital, Rennes, France ; 2 Department of Urology, General Hospital, Medical University Vienna, Vienna, Austria ; 3 Department of Urology, Centre Hospitalier Universitaire Vaudois, Lausanne, Switzerland ; 4 Academic Department of Urology, La Pitié-Salpetrière Hospital, Assistance Publique-Hôpitaux de Paris, Faculté de Médecine Pierre et Marie Curie, University Paris 6, Paris, France ; 5 Department of Urology, University of Texas Southwestern Medical Center, Dallas, USA ; 6 Department of Urology, Weill Cornell Medical College, New York, USA
| | - Ilaria Lucca
- 1 Department of Urology, Rennes University Hospital, Rennes, France ; 2 Department of Urology, General Hospital, Medical University Vienna, Vienna, Austria ; 3 Department of Urology, Centre Hospitalier Universitaire Vaudois, Lausanne, Switzerland ; 4 Academic Department of Urology, La Pitié-Salpetrière Hospital, Assistance Publique-Hôpitaux de Paris, Faculté de Médecine Pierre et Marie Curie, University Paris 6, Paris, France ; 5 Department of Urology, University of Texas Southwestern Medical Center, Dallas, USA ; 6 Department of Urology, Weill Cornell Medical College, New York, USA
| | - Aurélie Mbeutcha
- 1 Department of Urology, Rennes University Hospital, Rennes, France ; 2 Department of Urology, General Hospital, Medical University Vienna, Vienna, Austria ; 3 Department of Urology, Centre Hospitalier Universitaire Vaudois, Lausanne, Switzerland ; 4 Academic Department of Urology, La Pitié-Salpetrière Hospital, Assistance Publique-Hôpitaux de Paris, Faculté de Médecine Pierre et Marie Curie, University Paris 6, Paris, France ; 5 Department of Urology, University of Texas Southwestern Medical Center, Dallas, USA ; 6 Department of Urology, Weill Cornell Medical College, New York, USA
| | - Morgan Rouprêt
- 1 Department of Urology, Rennes University Hospital, Rennes, France ; 2 Department of Urology, General Hospital, Medical University Vienna, Vienna, Austria ; 3 Department of Urology, Centre Hospitalier Universitaire Vaudois, Lausanne, Switzerland ; 4 Academic Department of Urology, La Pitié-Salpetrière Hospital, Assistance Publique-Hôpitaux de Paris, Faculté de Médecine Pierre et Marie Curie, University Paris 6, Paris, France ; 5 Department of Urology, University of Texas Southwestern Medical Center, Dallas, USA ; 6 Department of Urology, Weill Cornell Medical College, New York, USA
| | - Shahrokh F Shariat
- 1 Department of Urology, Rennes University Hospital, Rennes, France ; 2 Department of Urology, General Hospital, Medical University Vienna, Vienna, Austria ; 3 Department of Urology, Centre Hospitalier Universitaire Vaudois, Lausanne, Switzerland ; 4 Academic Department of Urology, La Pitié-Salpetrière Hospital, Assistance Publique-Hôpitaux de Paris, Faculté de Médecine Pierre et Marie Curie, University Paris 6, Paris, France ; 5 Department of Urology, University of Texas Southwestern Medical Center, Dallas, USA ; 6 Department of Urology, Weill Cornell Medical College, New York, USA
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Villa L, Cloutier J, Cotè JF, Salonia A, Montorsi F, Traxer O. Confocal Laser Endomicroscopy in the Management of Endoscopically Treated Upper Urinary Tract Transitional Cell Carcinoma: Preliminary Data. J Endourol 2015; 30:237-42. [PMID: 26472615 DOI: 10.1089/end.2015.0644] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/01/2023] Open
Abstract
PURPOSE To describe our initial experience with confocal laser endomicroscopy (CLE) for the evaluation and treatment of patients with upper urinary tract transitional cell carcinoma (UUT-TCC). MATERIALS AND METHODS Preliminary data were analyzed from 11 patients with suspicion of UUT-TCC scheduled for flexible ureteroscopy (f-URS) and consensual holmium-YAG laser tumor ablation. CLE was performed before endoscopic biopsy and laser photoablation of the suspected lesion using a 3F-diameter flexible probe UroFlex™ B (Cellvizio® system; Mauna Kea Technologies, Paris, France), which allows to obtain microscopic resolution imaging (3.5 μm), with a field of view of 325 μm and a depth of tissue imaging of 40 to 70 μm. Video sequences were analyzed offline and thereafter compared with histopathologic findings. RESULTS CLE technique was feasible and showed good quality imaging in all patients. Overall, the Cellvizio system provided reliable images of healthy urothelium when the probe was pointed toward normal tissue, showing umbrella cells on the surface and vessels in the lamina propria. Moreover, CLE displayed the characteristic features of high-density cellular aggregates and fibrovascular stalks in four patients with pathologically confirmed low-grade UUT-TCC. In the patient with pathologically confirmed high-grade UUT-TCC, more distorted microarchitecture and tortuous vessels were clearly recognized with CLE. CONCLUSIONS These preliminary data showed the feasibility of CLE technique when applied to the diagnosis of UUT-TCC. Further clinical studies are required to confirm CLE accuracy in distinguishing healthy urothelial tissue from malignant lesions, thus helping clinicians in targeting ureteroscopic biopsy and improving the conservative management of UUT-TCC patients.
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Affiliation(s)
- Luca Villa
- 1 Department of Urology, Tenon Hospital, Pierre and Marie Curie University , Paris, France .,2 Division of Experimental Oncology, Unit of Urology , URI, IRCCS Ospedale San Raffaele, Milan, Italy
| | - Jonathan Cloutier
- 1 Department of Urology, Tenon Hospital, Pierre and Marie Curie University , Paris, France
| | - Jean-Francois Cotè
- 3 Department of Pathology, Tenon Hospital, Pierre and Marie Curie University , Paris, France
| | - Andrea Salonia
- 2 Division of Experimental Oncology, Unit of Urology , URI, IRCCS Ospedale San Raffaele, Milan, Italy .,4 Università Vita-Salute San Raffaele , Milan, Italy
| | - Francesco Montorsi
- 2 Division of Experimental Oncology, Unit of Urology , URI, IRCCS Ospedale San Raffaele, Milan, Italy .,4 Università Vita-Salute San Raffaele , Milan, Italy
| | - Olivier Traxer
- 1 Department of Urology, Tenon Hospital, Pierre and Marie Curie University , Paris, France
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Wessels R, De Bruin DM, Faber DJ, Horenblas S, van Rhijn BWG, Vincent AD, van Beurden M, van Leeuwen TG, Ruers TJM. Optical coherence tomography accurately identifies patients with penile (pre) malignant lesions: A single center prospective study. Urol Ann 2015; 7:459-65. [PMID: 26692665 PMCID: PMC4660696 DOI: 10.4103/0974-7796.156147] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/04/2023] Open
Abstract
Introduction: Currently, (multiple) biopsies are taken to obtain histopathological diagnosis of suspicious lesions of the penile skin. Optical coherence tomography (OCT) provides noninvasive in vivo images from which epidermal layer thickness and attenuation coefficient (μoct) can be quantified. We hypothesize that qualitative (image assessment) and quantitative (epidermal layer thickness and attenuation coefficient, μoct) analysis of penile skin with OCT is possible and may differentiate benign penile tissue from (pre) malignant penile tissue. Materials and Methods: Optical coherence tomography-imaging was performed prior to punch biopsy in 18 consecutive patients with a suspicious lesion at the outpatient clinic of the NKI-AVL. Qualitative analysis consisted of visual assessment of clear layers and a visible lower border of the lesions, quantitative analysis comprised of determination of the epidermal layer thickness and μoct. Results were grouped according to histopathology reports. Results: Qualitative analysis showed a statistically significant difference (P = 0.047) between benign and (pre) malignant lesions. Quantitative analysis showed that epidermal layer thickness and attenuation coefficient was significantly different between benign and (pre) malignant tissue, respectively, P = 0.001 and P < 0.001. Conclusion: In this preliminary study, qualitative and quantitative analysis of OCT-images of suspicious penile lesions shows differences between benign lesions and (pre) malignant lesions. These results encourage further research in a larger study population.
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Affiliation(s)
- Ronni Wessels
- Department of Surgery, NKI-AVL, Amsterdam, The Netherlands
| | - Daniel M De Bruin
- Department of Biomedical Engineering and Physics, Amsterdam, The Netherlands ; Department of Urology, AMC-UvA, Amsterdam, The Netherlands
| | - Dirk J Faber
- Department of Biomedical Engineering and Physics, Amsterdam, The Netherlands
| | | | | | | | | | - Ton G van Leeuwen
- Department of Biomedical Engineering and Physics, Amsterdam, The Netherlands
| | - Theo J M Ruers
- Department of Surgery, NKI-AVL, Amsterdam, The Netherlands ; Department of MIRA Institute, University of Twente, Enschede, The Netherlands
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Percutaneous Needle Based Optical Coherence Tomography for the Differentiation of Renal Masses: a Pilot Cohort. J Urol 2015; 195:1578-1585. [PMID: 26719027 DOI: 10.1016/j.juro.2015.12.072] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 12/07/2015] [Indexed: 11/23/2022]
Abstract
PURPOSE We determine the ability of percutaneous needle based optical coherence tomography to differentiate renal masses by using the attenuation coefficient (μOCT, mm(-1)) as a quantitative measure. MATERIALS AND METHODS Percutaneous needle based optical coherence tomography of the kidney was performed in patients presenting with a solid renal mass. A pathology specimen was acquired in the form of biopsies and/or a resection specimen. Optical coherence tomography results of 40 patients were correlated to pathology results of the resected specimens in order to derive μOCT values corresponding with oncocytoma and renal cell carcinoma, and with the 3 main subgroups of renal cell carcinoma. The sensitivity and specificity of optical coherence tomography in differentiating between oncocytoma and renal cell carcinoma were assessed through ROC analysis. RESULTS The median μOCT of oncocytoma (3.38 mm(-1)) was significantly lower (p=0.043) than the median μOCT of renal cell carcinoma (4.37 mm(-1)). ROC analysis showed a μOCT cutoff value of greater than 3.8 mm(-1) to yield a sensitivity, specificity, positive predictive value and negative predictive value of 86%, 75%, 97% and 37%, respectively, to differentiate between oncocytoma and renal cell carcinoma. The area under the ROC curve was 0.81. Median μOCT was significantly lower for oncocytoma vs clear cell renal cell carcinoma (3.38 vs 4.36 mm(-1), p=0.049) and for oncocytoma vs papillary renal cell carcinoma (3.38 vs 4.79 mm(-1), p=0.027). CONCLUSIONS We demonstrated that the μOCT is significantly higher in renal cell carcinoma vs oncocytoma, with ROC analysis showing promising results for their differentiation. This demonstrates the potential of percutaneous needle based optical coherence tomography to help in the differentiation of renal masses, thus warranting ongoing research.
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Bui D, Mach KE, Zlatev DV, Rouse RV, Leppert JT, Liao JC. A Pilot Study of In Vivo Confocal Laser Endomicroscopy of Upper Tract Urothelial Carcinoma. J Endourol 2015; 29:1418-23. [PMID: 26413927 DOI: 10.1089/end.2015.0523] [Citation(s) in RCA: 31] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/03/2023] Open
Abstract
PURPOSE Tissue diagnosis of upper tract urothelial carcinoma (UTUC) is limited by variance in tumor sampling by standard ureteroscopic biopsy. Optical imaging technologies can potentially improve UTUC diagnosis, surveillance, and endoscopic treatment. We previously demonstrated in vivo optical biopsy of urothelial carcinoma of the bladder using confocal laser endomicroscopy (CLE). In this study, we evaluated a new 0.85-mm imaging probe in the upper urinary tract and demonstrated feasibility and compatibility with standard ureteroscopes to achieve in vivo optical biopsy of UTUC. MATERIALS AND METHODS Fourteen patients scheduled for ureteroscopy of suspected upper tract lesions or surveillance of UTUC were recruited. After intravenous (IV) administration of fluorescein, CLE was performed using a 0.85-mm-diameter imaging probe inserted through the working channel of standard ureteroscopes. Acquired confocal video sequences were reviewed and analyzed. A mosaicing algorithm was used to compile a series of images into a single larger composite image. Processed CLE images were compared with standard histopathologic analysis. RESULTS Optical biopsy of the UTUC using CLE was effectively achieved during standard ureteroscopy. There were no adverse events related to IV fluorescein administration or image acquisition. Confocal imaging of UTUC showed characteristic features similar to urothelial carcinoma of the bladder, including papillary structure, fibrovascular stalks, and pleomorphism. Lamina propria in normal areas of the renal pelvis and ureter was also identified. CONCLUSIONS We report an initial feasibility of CLE of UTUC. Pending further clinical investigation, CLE may become a useful adjunct to ureteroscopic biopsy, endoscopic ablation, and surveillance of UTUC.
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Affiliation(s)
- Daniel Bui
- 1 Department of Urology, Stanford University School of Medicine , Stanford, California.,2 Veterans Affairs Palo Alto Health Care System , Palo Alto, California
| | - Kathleen E Mach
- 1 Department of Urology, Stanford University School of Medicine , Stanford, California.,2 Veterans Affairs Palo Alto Health Care System , Palo Alto, California
| | - Dimitar V Zlatev
- 1 Department of Urology, Stanford University School of Medicine , Stanford, California.,2 Veterans Affairs Palo Alto Health Care System , Palo Alto, California
| | - Robert V Rouse
- 2 Veterans Affairs Palo Alto Health Care System , Palo Alto, California.,3 Department of Pathology, Stanford University School of Medicine , Stanford, California
| | - John T Leppert
- 1 Department of Urology, Stanford University School of Medicine , Stanford, California.,2 Veterans Affairs Palo Alto Health Care System , Palo Alto, California
| | - Joseph C Liao
- 1 Department of Urology, Stanford University School of Medicine , Stanford, California.,2 Veterans Affairs Palo Alto Health Care System , Palo Alto, California
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39
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The value of optical coherence tomography in determining surgical margins in squamous cell carcinoma of the vulva: a single-center prospective study. Int J Gynecol Cancer 2015; 25:112-8. [PMID: 25365591 DOI: 10.1097/igc.0000000000000310] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/03/2023] Open
Abstract
BACKGROUND Vulvar squamous cell carcinoma (VSCC) is treated with wide local excision. The challenge is to remove as much skin as necessary to prevent recurrence, but meanwhile preserve genital skin to diminish morbidity. Optical coherence tomography (OCT) is a noninvasive imaging tool that produces cross-sectional images. Optical coherence tomography could be helpful in determining appropriate surgical margins during excision of VSCC. OBJECTIVE This study aimed to assess the value of OCT in determining appropriate surgical margins in patients operated for VSCC. We hypothesize that benign tissue will differ qualitatively (presence of clear epidermal layers) and quantitatively (epidermal layer thickness and attenuation coefficient) from (pre)malignant tissue. MATERIALS AND METHODS In 18 patients with a pretreatment biopsy of VSCC, before excision, areas within the center (tumor), at the margin (skin next to the center), and in normal vulvar skin outside the area of resection were imaged by OCT. Optical coherence tomography data were assessed on the presence of a clear epidermal layer, thickness of the epidermal layer, and values of μOCT. Results were grouped according to histopathological report in a benign group and a (pre)malignant group. RESULTS A clear epidermal layer was observed in all OCT images of benign tissue and only in 6 of 23 premalignant lesions (P < 0.001). The epidermal layer thickness as well as the μOCT was significantly smaller for benign vulvar tissue than for (pre)malignant tissue (0.29 vs 1.03 mm, and 2.4 vs 4.1 mm(-1), respectively; P < 0.001). The diagnostic accuracy of OCT, as calculated by receiver operating characteristic curve analysis, showed at defined thresholds a sensitivity of 100% and specificity of 80% when considering layer thickness, and a sensitivity of 100% and specificity of 70% when considering the attenuation coefficient. CONCLUSIONS We show that qualitative and quantitative OCT imaging can distinguish between benign and (pre)malignant vulvar tissue, enabling appropriate surgical margin detection with noninvasive in vivo OCT imaging.
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Muller BG, de Bruin DM, van den Bos W, Brandt MJ, Velu JF, Bus MTJ, Faber DJ, Savci D, Zondervan PJ, de Reijke TM, Pes PL, de la Rosette J, van Leeuwen TG. Prostate cancer diagnosis: the feasibility of needle-based optical coherence tomography. J Med Imaging (Bellingham) 2015; 2:037501. [PMID: 26171414 DOI: 10.1117/1.jmi.2.3.037501] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/01/2014] [Accepted: 06/04/2015] [Indexed: 01/16/2023] Open
Abstract
The objective of this study is to demonstrate the feasibility of needle-based optical coherence tomography (OCT) and functional analysis of OCT data along the full pullback trajectory of the OCT measurement in the prostate, correlated with pathology. OCT images were recorded using a commercially available C7-XR™ OCT Intravascular Imaging System interfaced to a C7 Dragonfly™ intravascular 0.9-mm-diameter imaging probe. A computer program was constructed for automated image attenuation analysis. First, calibration of the OCT system for both the point spread function and the system roll-off was achieved by measurement of the OCT signal attenuation from an extremely weakly scattering medium (Intralipid® 0.0005 volume%). Second, the data were arranged in 31 radial wedges (pie slices) per circular segments consisting of 16 A-scans per wedge and 5 axial B-scans, resulting in an average A-scan per wedge. Third, the decay of the OCT signal is analyzed over 50 pixels ([Formula: see text]) in depth, starting from the first found maximum data point. Fourth, for visualization, the data were grouped with a corresponding color representing a specific [Formula: see text] range according to their attenuation coefficient. Finally, the analyses were compared to histopathology. To ensure that each single use sterile imaging probe is comparable to the measurements of the other imaging probes, the probe-to-probe variations were analyzed by measuring attenuation coefficients of 0.03, 6.5, 11.4, 17, and 22.7 volume% Intralipid®. Experiments were repeated five times per probe for four probes. Inter- and intraprobe variation in the measured attenuation of Intralipid samples with scattering properties similar to that of the prostate was [Formula: see text] of the mean values. Mean attenuation coefficients in the prostate were [Formula: see text] for parts of the tissue that were classified as benign (SD: [Formula: see text], minimum: [Formula: see text], maximum: [Formula: see text]) and [Formula: see text] for parts of tissue that were classified as malignant (SD: [Formula: see text], minimum: [Formula: see text], maximum: [Formula: see text]). In benign areas, the tissue looked homogeneous, whereas in malignant areas, small glandular structures were seen. However, not all areas in which a high attenuation coefficient became apparent corresponded to areas of prostate cancer. This paper describes the first in-tissue needle-based OCT imaging and three-dimensional optical attenuation analysis of prostate tissue that indicates a correlation with pathology. Fully automated attenuation coefficient analysis was performed at 1300 nm over the full pullback. Correlation with pathology was achieved by coregistration of three-dimensional (3-D) OCT attenuation maps with 3-D pathology of the prostate. This may contribute to the current challenge of prostate imaging and the rising interest in focal therapy for reduction of side effects occurring with current therapies.
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Affiliation(s)
- Berrend G Muller
- University of Amsterdam , Academic Medical Center, Department of Urology, Meibergdreef 9, Amsterdam 1105 AZ, The Netherlands
| | - Daniel M de Bruin
- University of Amsterdam , Academic Medical Center, Department of Urology, Meibergdreef 9, Amsterdam 1105 AZ, The Netherlands ; University of Amsterdam , Academic Medical Center, Department of Biomedical Engineering and Physics, Meibergdreef 9, Amsterdam 1105 AZ, The Netherlands
| | - Willemien van den Bos
- University of Amsterdam , Academic Medical Center, Department of Urology, Meibergdreef 9, Amsterdam 1105 AZ, The Netherlands
| | - Martin J Brandt
- University of Amsterdam , Academic Medical Center, Department of Biomedical Engineering and Physics, Meibergdreef 9, Amsterdam 1105 AZ, The Netherlands
| | - Juliette F Velu
- University of Amsterdam , Academic Medical Center, Department of Biomedical Engineering and Physics, Meibergdreef 9, Amsterdam 1105 AZ, The Netherlands
| | - Mieke T J Bus
- University of Amsterdam , Academic Medical Center, Department of Urology, Meibergdreef 9, Amsterdam 1105 AZ, The Netherlands
| | - Dirk J Faber
- University of Amsterdam , Academic Medical Center, Department of Biomedical Engineering and Physics, Meibergdreef 9, Amsterdam 1105 AZ, The Netherlands
| | - Dilara Savci
- University of Amsterdam , Academic Medical Center, Department of Pathology, Meibergdreef 9, Amsterdam 1105 AZ, The Netherlands
| | - Patricia J Zondervan
- University of Amsterdam , Academic Medical Center, Department of Urology, Meibergdreef 9, Amsterdam 1105 AZ, The Netherlands
| | - Theo M de Reijke
- University of Amsterdam , Academic Medical Center, Department of Urology, Meibergdreef 9, Amsterdam 1105 AZ, The Netherlands
| | - Pilar Laguna Pes
- University of Amsterdam , Academic Medical Center, Department of Urology, Meibergdreef 9, Amsterdam 1105 AZ, The Netherlands
| | - Jean de la Rosette
- University of Amsterdam , Academic Medical Center, Department of Urology, Meibergdreef 9, Amsterdam 1105 AZ, The Netherlands
| | - Ton G van Leeuwen
- University of Amsterdam , Academic Medical Center, Department of Biomedical Engineering and Physics, Meibergdreef 9, Amsterdam 1105 AZ, The Netherlands
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Fu X, Patel D, Zhu H, MacLennan G, Wang YT, Jenkins MW, Rollins AM. Miniature forward-viewing common-path OCT probe for imaging the renal pelvis. BIOMEDICAL OPTICS EXPRESS 2015; 6:1164-71. [PMID: 25909002 PMCID: PMC4399657 DOI: 10.1364/boe.6.001164] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/13/2015] [Revised: 02/27/2015] [Accepted: 03/02/2015] [Indexed: 05/08/2023]
Abstract
We demonstrate an ultrathin flexible cone-scanning forward-viewing OCT probe which can fit through the working channel of a flexible ureteroscope for renal pelvis imaging. The probe is fabricated by splicing a 200 µm section of core-less fiber and a 150 µm section of gradient-index (GRIN) fiber to the end of a single mode (SM) fiber. The probe is designed for common-path OCT imaging where the back-reflection of the GRIN fiber/air interface is used as the reference signal. Optimum sensitivity was achieved with a 2 degree polished probe tip. A correlation algorithm was used to correct image distortion caused by non-uniform rotation of the probe. The probe is demonstrated by imaging human skin in vivo and porcine renal pelvis ex vivo and is suitable for imaging the renal pelvis in vivo for cancer staging.
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Affiliation(s)
- Xiaoyong Fu
- Department of Biomedical Engineering, Case Western Reserve University, Cleveland, Ohio 44106
USA
| | - Dhruti Patel
- Department of Urology and Pathology, Case Western Reserve University, Cleveland, Ohio 44106
USA
| | - Hui Zhu
- Department of Urology and Pathology, Case Western Reserve University, Cleveland, Ohio 44106
USA
| | - Gregory MacLennan
- Department of Urology and Pathology, Case Western Reserve University, Cleveland, Ohio 44106
USA
| | - Yves T Wang
- Department of Biomedical Engineering, Case Western Reserve University, Cleveland, Ohio 44106
USA
- Department of Pediatrics, Case Western Reserve University, Cleveland, Ohio, 44106
USA
| | - Michael W Jenkins
- Department of Biomedical Engineering, Case Western Reserve University, Cleveland, Ohio 44106
USA
- Department of Pediatrics, Case Western Reserve University, Cleveland, Ohio, 44106
USA
| | - Andrew M Rollins
- Department of Biomedical Engineering, Case Western Reserve University, Cleveland, Ohio 44106
USA
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42
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Cernohorsky P, Kok AC, de Bruin DM, Brandt MJ, Faber DJ, Tuijthof GJ, Kerkhoffs GM, Strackee SD, van Leeuwen TG. Comparison of optical coherence tomography and histopathology in quantitative assessment of goat talus articular cartilage. Acta Orthop 2015; 86:257-63. [PMID: 25350610 PMCID: PMC4404781 DOI: 10.3109/17453674.2014.979312] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/31/2023] Open
Abstract
BACKGROUND AND PURPOSE Optical coherence tomography (OCT) is a light-based imaging technique suitable for depiction of thin tissue layers such as articular cartilage. Quantification of results and direct comparison with a reference standard is needed to confirm the role of OCT in cartilage evaluation. MATERIALS AND METHODS Goat talus articular cartilage repair was assessed quantitatively with OCT and compared with histopathology using semi-automated analysis software. Osteochondral defects were created centrally in goat tali with subsequent healing over 24 weeks. After sacrifice, the tali were analyzed using OCT and processed into histopathology slides. Cartilage thickness, repair tissue area, and surface roughness were measured. Also, light attenuation coefficient measurements were performed to assess differences in the properties of healthy tissue and repair tissue. RESULTS Intra-class correlation coefficients for resemblance between the 2 techniques were 0.95 (p < 0.001) for thickness, 0.73 (p = 0.002) for repair tissue area, and 0.63 (p = 0.015) for surface roughness. Light attenuation differed significantly between healthy cartilage (8.2 (SD 3.9) mm(-1)) and repair tissue (2.8 (SD 1.5) mm(-1)) (p < 0.001). INTERPRETATION Compared to histopathology as the standard reference method, OCT is a reproducible technique in quantitative analysis of goat talus articular cartilage, especially when assessing cartilage thickness and to a lesser extent when measuring repair tissue area and surface roughness. Moreover, differences in local light attenuation suggest measurable variation in tissue structure, enhancing the clinical applicability of quantitative measurements from cartilage OCT images.
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Affiliation(s)
| | - Aimee C Kok
- Orthopedic Surgery, Orthopedic Research Center Amsterdam
| | - Daniel Martijn de Bruin
- Biomedical Engineering and Physics,Urology, Academic Medical Center, University of Amsterdam, Amsterdam
| | | | | | - Gabrielle J Tuijthof
- Orthopedic Surgery, Orthopedic Research Center Amsterdam,Faculty of 3ME, BioMechanical Engineering, Delft University of Technology, Delft, the Netherlands
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43
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Wagstaff PG, Swaan A, Ingels A, Zondervan PJ, van Delden OM, Faber DJ, van Leeuwen TG, de la Rosette JJ, de Bruin DM, Laguna Pes MP. In vivo, percutaneous, needle based, optical coherence tomography of renal masses. J Vis Exp 2015:52574. [PMID: 25867845 PMCID: PMC4401379 DOI: 10.3791/52574] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/13/2022] Open
Abstract
Optical coherence tomography (OCT) is the optical equivalent of ultrasound imaging, based on the backscattering of near infrared light. OCT provides real time images with a 15 µm axial resolution at an effective tissue penetration of 2-3 mm. Within the OCT images the loss of signal intensity per millimeter of tissue penetration, the attenuation coefficient, is calculated. The attenuation coefficient is a tissue specific property, providing a quantitative parameter for tissue differentiation. Until now, renal mass treatment decisions have been made primarily on the basis of MRI and CT imaging characteristics, age and comorbidity. However these parameters and diagnostic methods lack the finesse to truly detect the malignant potential of a renal mass. A successful core biopsy or fine needle aspiration provides objective tumor differentiation with both sensitivity and specificity in the range of 95-100%. However, a non-diagnostic rate of 10-20% overall, and even up to 30% in SRMs, is to be expected, delaying the diagnostic process due to the frequent necessity for additional biopsy procedures. We aim to develop OCT into an optical biopsy, providing real-time imaging combined with on-the-spot tumor differentiation. This publication provides a detailed step-by-step approach for percutaneous, needle based, OCT of renal masses.
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Affiliation(s)
| | - Abel Swaan
- Department of Biomedical Engineering and Physics, Academic Medical Center
| | | | | | | | - Dirk J Faber
- Department of Biomedical Engineering and Physics, Academic Medical Center
| | - Ton G van Leeuwen
- Department of Biomedical Engineering and Physics, Academic Medical Center
| | | | - Daniel M de Bruin
- Department of Urology, Academic Medical Center; Department of Biomedical Engineering and Physics, Academic Medical Center
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Zlatev DV, Altobelli E, Liao JC. Advances in imaging technologies in the evaluation of high-grade bladder cancer. Urol Clin North Am 2015; 42:147-57, vii. [PMID: 25882557 DOI: 10.1016/j.ucl.2015.01.001] [Citation(s) in RCA: 29] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/02/2023]
Abstract
Bladder cancer ranges from a low-grade variant to high-grade disease. Assessment for treatment depends on white light cystoscopy, however because of its limitations there is a need for improved visualization of flat, multifocal, high-grade, and muscle-invasive lesions. Photodynamic diagnosis and narrow-band imaging provide additional contrast enhancement of bladder tumors and have been shown to improve detection rates. Confocal laser endomicroscopy and optical coherence tomography enable real-time, high-resolution, subsurface tissue characterization with spatial resolutions similar to histology. Molecular imaging offers the potential for the combination of optical imaging technologies with cancer-specific molecular agents to improve the specificity of disease detection.
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Affiliation(s)
- Dimitar V Zlatev
- Department of Urology, Stanford University School of Medicine, 300 Pasteur Drive, Room S-287, Stanford, CA 94305-5118, USA
| | - Emanuela Altobelli
- Department of Urology, Stanford University School of Medicine, 300 Pasteur Drive, Room S-287, Stanford, CA 94305-5118, USA; Department of Urology, Campus Biomedico, Via Alvaro del Portillo 200, Rome 00128, Italy
| | - Joseph C Liao
- Department of Urology, Stanford University School of Medicine, 300 Pasteur Drive, Room S-287, Stanford, CA 94305-5118, USA; Urology Section, Veterans Affairs Palo Alto Health Care System, 3801 Miranda Avenue, Palo Alto, CA 94304, USA.
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45
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Risk-adapted strategy for the kidney-sparing management of upper tract tumours. Nat Rev Urol 2015; 12:155-66. [DOI: 10.1038/nrurol.2015.24] [Citation(s) in RCA: 59] [Impact Index Per Article: 6.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/06/2023]
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46
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Bus MT, de Bruin DM, Faber DJ, Kamphuis GM, Zondervan PJ, Laguna Pes MP, de Reijke TM, Traxer O, van Leeuwen TG, de la Rosette JJ. Optical Diagnostics for Upper Urinary Tract Urothelial Cancer: Technology, Thresholds, and Clinical Applications. J Endourol 2015; 29:113-23. [DOI: 10.1089/end.2014.0551] [Citation(s) in RCA: 43] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Affiliation(s)
- Mieke T.J. Bus
- Department of Urology, Academic Medical Center, Amsterdam, The Netherlands
| | - D. Martijn de Bruin
- Department of Biomedical Engineering and Physics, Academic Medical Center, Amsterdam, The Netherlands
| | - Dirk J. Faber
- Department of Biomedical Engineering and Physics, Academic Medical Center, Amsterdam, The Netherlands
| | - Guido M. Kamphuis
- Department of Urology, Academic Medical Center, Amsterdam, The Netherlands
| | | | | | - Theo M. de Reijke
- Department of Urology, Academic Medical Center, Amsterdam, The Netherlands
| | - Olivier Traxer
- Department of Urology, Tenon Hospital Pierre and Marie Curie University, Paris, France
| | - Ton G. van Leeuwen
- Department of Biomedical Engineering and Physics, Academic Medical Center, Amsterdam, The Netherlands
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47
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Almasian M, Bosschaart N, van Leeuwen TG, Faber DJ. Validation of quantitative attenuation and backscattering coefficient measurements by optical coherence tomography in the concentration-dependent and multiple scattering regime. JOURNAL OF BIOMEDICAL OPTICS 2015; 20:121314. [PMID: 26720868 DOI: 10.1117/1.jbo.20.12.121314] [Citation(s) in RCA: 25] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/30/2015] [Accepted: 11/30/2015] [Indexed: 05/19/2023]
Abstract
Optical coherence tomography (OCT) has the potential to quantitatively measure optical properties of tissue such as the attenuation coefficient and backscattering coefficient. However, to obtain reliable values for strong scattering tissues, accurate consideration of the effects of multiple scattering and the nonlinear relation between the scattering coefficient and scatterer concentration (concentration-dependent scattering) is required. We present a comprehensive model for the OCT signal in which we quantitatively account for both effects, as well as our system parameters (confocal point spread function and sensitivity roll-off). We verify our model with experimental data from controlled phantoms of monodisperse silica beads (scattering coefficients between 1 and 30 mm(−1) and scattering anisotropy between 0.4 and 0.9). The optical properties of the phantoms are calculated using Mie theory combined with the Percus–Yevick structure factor to account for concentration-dependent scattering. We demonstrate excellent agreement between the OCT attenuation and backscattering coefficient predicted by our model and experimentally derived values. We conclude that this model enables us to accurately model OCT-derived parameters (i.e., attenuation and backscattering coefficients) in the concentration-dependent and multiple scattering regime for spherical monodisperse samples.
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Affiliation(s)
- Mitra Almasian
- University of Amsterdam, Academic Medical Center, Department of Biomedical Engineering and Physics, Meibergdreef 9, 1105 AZ, Amsterdam, The Netherlands
| | - Nienke Bosschaart
- University of Twente, MIRA Institute for Biomedical Technology and Technical Medicine, Biomedical Photonic Imaging Group, Zuidhorst ZH263, 7500 AE, Enschede, The Netherlands
| | - Ton G van Leeuwen
- University of Amsterdam, Academic Medical Center, Department of Biomedical Engineering and Physics, Meibergdreef 9, 1105 AZ, Amsterdam, The Netherlands
| | - Dirk J Faber
- University of Amsterdam, Academic Medical Center, Department of Biomedical Engineering and Physics, Meibergdreef 9, 1105 AZ, Amsterdam, The Netherlands
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48
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Wessels R, de Bruin DM, Faber DJ, Sanders J, Vincent AD, van Beurden M, van Leeuwen TG, Ruers TJM. Learning curve and interobserver variance in quantification of the optical coherence tomography attenuation coefficient. JOURNAL OF BIOMEDICAL OPTICS 2015; 20:121313. [PMID: 26662606 DOI: 10.1117/1.jbo.20.12.121313] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/18/2015] [Accepted: 11/04/2015] [Indexed: 06/05/2023]
Abstract
The learning curve and interobserver variance of attenuation coefficient (μOCT ) determination from optical coherence tomography (OCT) images were quantified. The μOCT of normal and diseased vulvar tissues was determined at five time points by three novice students and three OCT experts who reached consensus for reference. Students received feedback between time points. Eventually, variance in μOCT was smaller in images of diseased tissue than in images of normal vulvar tissue. The difference between the consensus and student μOCT values was larger for smaller values of μOCT . We conclude that routine μOCT determination for tissue classification does not require extensive training.
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Affiliation(s)
- Ronni Wessels
- Netherlands Cancer Institute-Antoni van Leeuwenhoek Hospital, Department of Surgery, P.O. Box 90203, 1006 BE Amsterdam, The Netherlands
| | - Daniel M de Bruin
- Academic Medical Center-University of Amsterdam, Department of Biomedical Engineering and Physics, Meibergdreef 9, 1105 AZ Amsterdam, The NetherlandscAcademic Medical Center-University of Amsterdam, Department of Urology, Meibergdreef 9, 1105 AZ Amsterdam
| | - Dirk J Faber
- Academic Medical Center-University of Amsterdam, Department of Biomedical Engineering and Physics, Meibergdreef 9, 1105 AZ Amsterdam, The Netherlands
| | - Joyce Sanders
- Netherlands Cancer Institute-Antoni van Leeuwenhoek Hospital, Department of Pathology, P.O. Box 90203, 1006 BE Amsterdam, The Netherlands
| | - Andrew D Vincent
- Netherlands Cancer Institute-Antoni van Leeuwenhoek Hospital, Department of Biometrics, P.O. Box 90203, 1006 BE Amsterdam, The Netherlands
| | - Marc van Beurden
- Netherlands Cancer Institute-Antoni van Leeuwenhoek Hospital, Department of Gynaecology, P.O. Box 90203, 1006 BE Amsterdam, The Netherlands
| | - Ton G van Leeuwen
- Academic Medical Center-University of Amsterdam, Department of Biomedical Engineering and Physics, Meibergdreef 9, 1105 AZ Amsterdam, The Netherlands
| | - Theo J M Ruers
- Netherlands Cancer Institute-Antoni van Leeuwenhoek Hospital, Department of Surgery, P.O. Box 90203, 1006 BE Amsterdam, The NetherlandsgUniversity of Twente, MIRA Institute, Nanobiophysics Group, Enschede, The Netherlands
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Abstract
Modern urologic endoscopy is the result of continuous innovations since the early nineteenth century. White-light cystoscopy is the primary strategy for identification, resection, and local staging of bladder cancer. While highly effective, white light cystoscopy has several well-recognized shortcomings. Recent advances in optical imaging technologies and device miniaturization hold the potential to improve bladder cancer diagnosis and resection. Photodynamic diagnosis and narrow band imaging are the first to enter the clinical arena. Confocal laser endomicroscopy, optical coherence tomography, Raman spectroscopy, UV autofluorescence, and others have shown promising clinical and pre-clinical feasibility. We review their mechanisms of action, highlight their respective advantages, and propose future directions.
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Affiliation(s)
- Aristeo Lopez
- Department of Urology, Stanford University School of Medicine, 300 Pasteur Dr., Room S-387, Stanford, CA, 94305-5118, USA
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50
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Diagnostics clinique, urétéroscopique et photodynamique des tumeurs de la voie excrétrice urinaire supérieures : état-de-l’art pour le rapport scientifique annuel de l’Association française d’urologie. Prog Urol 2014; 24:977-86. [DOI: 10.1016/j.purol.2014.07.012] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/25/2014] [Revised: 07/16/2014] [Accepted: 07/22/2014] [Indexed: 11/23/2022]
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