Bladder cancer was the 10th most prevalent cancer worldwide in 2020. Currently, the gold standard for diagnosing bladder cancer is a cystoscopy followed by a transurethral resection of the bladder tumour. The tumour invasion and grade are needed to determine the treatment plan. However, a transurethral resection is an invasive procedure, needs planning and has complication risks. Therefore, finding an alternative option to determine tumour invasion and grade is necessary. That would also enable other treatment options for bladder cancer such as laser fulguration, chemo-resection and active surveillance. Optical Coherence Tomography (OCT) has the potential to aid in the diagnosis of bladder cancer
Transperineal focal laser ablation (TPLA) has the potential to obtain oncological control, while sparing nearby tissue to preserve continence and erectile function with a low toxicity profile. However, registration and prediction of the ablation zone is essential for TPLA to become a clinal standard of care treatment. In this study we investigated the capability of MRI and CEUS to image the treated volume. We show that the treatment effects of TPLA can reliably be visualized using these techniques and that the results are in good agreement with histopathology. These results are essential first steps towards improved planning and performance of TPLA.
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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