Optical coherence tomography as an adjunct to white light cystoscopy for intravesical real-time imaging and staging of bladder cancer
Optical coherence tomography as an adjunct to white light cystoscopy for intravesical real-time imaging and staging of bladder cancer
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DOI：
10.1016/j.urology.2008.02.002
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发表时间：
2008-07-01
期刊：
影响因子：
2.1
通讯作者：
Shen, Steven S.
中科院分区：
文献类型：
--
作者：
Lerner, Seth P.;Goh, Alvin C.;Shen, Steven S.
目的光学相干断层扫描(OCT)是一种新的、实时的内窥镜成像方式，它可以描绘出膀胱病变的微结构特征。它可以提供传统膀胱镜检查的延伸，允许在显微镜分辨率(10到20微米)下对膀胱组织进行非侵入性检查。方法对32例有膀胱癌(24例)、原发肿瘤(6例)、前列腺癌(1例)或血尿(1例)患者的OCT作为传统膀胱镜检查辅助手段的应用进行了机构回顾委员会批准的单机构、单用户回顾。在活检或切除前获取可疑区域的OCT图像，并对其进行实时解析，并与病理结果进行对照。结果32例患者共94幅图像接受了膀胱活检或经尿道膀胱肿瘤电切术。患者年龄从49岁到84岁(平均59岁)，其中男性25人(78%)，女性7人(22%)。我们将38个可疑区域与活检结果进行了关联。OCT对局限于粘膜的肿瘤诊断的敏感性和特异性分别为90%和%。7个病变中有7个检出肌肉浸润性肿瘤，灵敏度为100%，特异度为90%，准确率为92%。结论光学相干断层扫描是一种快速、易用的工具，可帮助鉴别Ta和T1肿瘤，并识别多侵袭性膀胱肿瘤。它提供了实时的微结构信息，可以帮助评估膀胱肿瘤以及邻近和远程的尿路上皮。
OBJECTIVES Optical coherence tomography (OCT) is a novel, real-time endoscopic imaging modality that permits delineation of microarchitectural features of bladder lesions. It may provide an extension of conventional cystoscopy by allowing noninvasive examination of bladder tissue at microscopic resolution (10 to 20 mu m). The purpose of this study was to examine the application of OCT in augmenting the diagnosis and staging of bladder lesions.METHODS We conducted a retrospective institutional review board-approved, single-institution, single-user review on the use of OCT as an adjunct to conventional cystoscopy in 32 patients with a history of bladder cancer (24), primary tumor (6), prostate cancer (1), or hematuria (1). We obtained OCT images Of Suspicious areas before biopsy or resection, interpreted them in real time, and subsequently compared them with pathology results.RESULTS We Obtained 94 images in 32 patients undergoing bladder biopsy or transurethral resection Of bladder tumor. Age of the patients ranged from 49 to 84 years (mean, 59 years), with 25 men (78%) and 7 women (22%). We correlated 38 Suspicious areas with biopsy findings. OCT imaging correctly identified tumors confined to the mucosa with a sensitivity and specificity of 90% and 89%, respectively. Muscle-invasive tumors were detected in 7 of 7 lesions with 100% sensitivity, 90% specificity, and 92% accuracy.CONCLUSIONS Optical coherence tomography is a rapid, easy-to-use tool that can help differentiate Ta and T1 tumors and identify mucle-invasive bladder tumors. It provides real-time microarchitectural information that can aid in the evaluation of bladder tumors and adjacent and remote Urothelium.