Real time diagnosis of bladder cancer with probe-based confocal laser endomicroscopy

Jen-Jane Liu; Katherine Wu; Winifred Adams; Shelly T. Hsiao; Kathleen E. Mach; Andrew H. Beck; Kristin C. Jensen; Joseph C. Liao

doi:10.1117/12.874243

23 February 2011 Real time diagnosis of bladder cancer with probe-based confocal laser endomicroscopy

Jen-Jane Liu, Katherine Wu, Winifred Adams, Shelly T. Hsiao, Kathleen E. Mach, Andrew H. Beck, Kristin C. Jensen, Joseph C. Liao

Author Affiliations +

Proceedings Volume 7902, Imaging, Manipulation, and Analysis of Biomolecules, Cells, and Tissues IX; 79021V (2011) https://doi.org/10.1117/12.874243
Event: SPIE BiOS, 2011, San Francisco, California, United States

Abstract

Probe-based confocal laser endomicroscopy (pCLE) is an emerging technology for in vivo optical imaging of the urinary tract. Particularly for bladder cancer, real time optical biopsy of suspected lesions will likely lead to improved management of bladder cancer. With pCLE, micron scale resolution is achieved with sterilizable imaging probes (1.4 or 2.6 mm diameter), which are compatible with standard cystoscopes and resectoscopes. Based on our initial experience to date (n = 66 patients), we have demonstrated the safety profile of intravesical fluorescein administration and established objective diagnostic criteria to differentiate between normal, benign, and neoplastic urothelium. Confocal images of normal bladder showed organized layers of umbrella cells, intermediate cells, and lamina propria. Low grade bladder cancer is characterized by densely packed monomorphic cells with central fibrovascular cores, whereas high grade cancer consists of highly disorganized microarchitecture and pleomorphic cells with indistinct cell borders. Currently, we are conducting a diagnostic accuracy study of pCLE for bladder cancer diagnosis. Patients scheduled to undergo transurethral resection of bladder tumor are recruited. Patients undergo first white light cystocopy (WLC), followed by pCLE, and finally histologic confirmation of the resected tissues. The diagnostic accuracy is determined both in real time by the operative surgeon and offline after additional image processing. Using histology as the standard, the sensitivity, specificity, positive and negative predictive value of WLC and WLC + pCLE are calculated. With additional validation, pCLE may prove to be a valuable adjunct to WLC for real time diagnosis of bladder cancer.

Citation Download Citation

Jen-Jane Liu, Katherine Wu, Winifred Adams, Shelly T. Hsiao, Kathleen E. Mach, Andrew H. Beck, Kristin C. Jensen, and Joseph C. Liao "Real time diagnosis of bladder cancer with probe-based confocal laser endomicroscopy", Proc. SPIE 7902, Imaging, Manipulation, and Analysis of Biomolecules, Cells, and Tissues IX, 79021V (23 February 2011); https://doi.org/10.1117/12.874243

ACCESS THE FULL ARTICLE

INSTITUTIONAL
Select your institution to access the SPIE Digital Library.

SELECT YOUR INSTITUTION

PERSONAL
Sign in with your SPIE account to access your personal subscriptions or to use specific features such as save to my library, sign up for alerts, save searches, etc.

PERSONAL SIGN IN

No SPIE Account? Create one

PURCHASE THIS CONTENT

SUBSCRIBE TO DIGITAL LIBRARY

50 downloads per 1-year subscription

Members: $195

Non-members: $335 ADD TO CART

25 downloads per 1 - year subscription

Members: $145

Non-members: $250 ADD TO CART

PURCHASE SINGLE ARTICLE

Includes PDF, HTML & Video, when available

Members: $17.00

Non-members: $21.00 ADD TO CART

PROCEEDINGS
7 PAGES

DOWNLOAD PAPER SAVE TO MY LIBRARY

GET CITATION

RIGHTS & PERMISSIONS

Get copyright permission Get copyright permission on Copyright Marketplace

KEYWORDS

Confocal microscopy

Bladder cancer

Diagnostics

Bladder

Tumors

Tissues

Biopsy

Show All Keywords

Keywords/Phrases

Search In:

Publication Years