Spectroscopic measurement of diffuse reflectance for enhanced detection of bladder carcinoma
Spectroscopic measurement of diffuse reflectance for enhanced detection of bladder carcinoma
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DOI：
10.1016/s0090-4295(97)00612-2
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发表时间：
1998-02-01
期刊：
影响因子：
2.1
通讯作者：
Deutsch, TF
中科院分区：
文献类型：
--
作者：
Koenig, F;Larne, R;Deutsch, TF
目标。目的探讨漫反射光谱在膀胱镜检查中对膀胱癌的诊断价值。我们的假设是肿瘤（发育不良和恶性）区域的新生血管将导致不同于正常组织的血液吸收“特征”。方法。漫反射测量在14例接受粘膜活检或经尿道膀胱肿瘤切除术的患者中进行。石英光纤通过膀胱镜的工作通道，与膀胱表面平缓接触。使用标准的膀胱镜氙灯光源照明，用光学多通道分析仪（OMA）系统记录反射光谱。从光谱中，计算血红蛋白（Hb）、氧合血红蛋白（HbO(2)）、血氧饱和度（HbO(2)%）的相对浓度和血总量（任意单位），以评估其在区分肿瘤和良性膀胱区域中的作用。结果。分析了26个膀胱区域（9个恶性区域，包括4个原位癌，2个发育不良病变，15个良性区域）的光谱。只有血的总量是一个有用的参数，以区分肿瘤和良性膀胱区域。该方法对肿瘤组织的敏感性为91%，特异性为60%，阳性预测值为63%，阴性预测值为90%。结论。漫反射测量是一种快速、简单、无创的方法，可以在体内测定膀胱血液灌注。肿瘤膀胱组织血总浓度升高，使其成为组织诊断的工具。特异性相对较低的原因是炎症区域也表现出总血浓度升高。这项初步研究鼓励进一步的研究来评估反射测量对增强膀胱癌检测的有用性。(C) 1998, Elsevier Science Inc.；版权所有。
Objectives. To assess the diagnostic potential of diffuse reflectance spectroscopy for the detection of bladder carcinoma during cystoscopy. Our hypothesis is that neovasculature in neoplastic (dysplastic and malignant) regions will lead to a blood absorption "signature" that is different from that of normal tissue. Methods. Diffuse reflectance measurements have been performed in 14 patients undergoing mucosal biopsies or transurethral resection of a bladder tumor. A quartz optical fiber was advanced through the working channel of a cystoscope and placed in gentle contact with the bladder surface. A standard cystoscopy xenon light source was used for illumination and the reflectance spectra were recorded using an optical multichannel analyzer (OMA) system. From the spectra, the relative concentrations of hemoglobin (Hb), oxyhemoglobin (HbO(2)), oxygen saturation (HbO(2)%), and the total amount of blood (arbitrary units) were calculated to assess their usefulness in differentiating between neoplastic and benign bladder areas. Results. The spectra of 26 bladder areas (9 malignant areas including 4 carcinomata in situ, 2 dysplastic lesions, and 15 benign areas) have been analyzed. Only the total amount of blood was a useful parameter for the differentiation between neoplastic and benign bladder areas. The sensitivity, specificity, and positive and negative predictive values of this method for neoplastic tissue were found to be 91%, 60%, 63%, and 90%, respectively. Conclusions. The measurement of diffuse reflectance is a fast, simple, and noninvasive method which allows in vivo determination of bladder blood perfusion. The total blood concentration was increased in neoplastic bladder tissue, making it a tool for tissue diagnosis. The relatively low specificity is a result of inflammatory areas also exhibiting an increased total blood concentration. This pilot study encourages further studies to assess the usefulness of reflectance measurements for enhanced detection of bladder cancer. (C) 1998, Elsevier Science Inc. All rights reserved.