Dynamic real-time microscopy of the urinary tract using confocal laser endomicroscopy

Katherine Wu, Jen Jane Liu, Winifred Adams, Geoffrey A. Sonn, Kathleen E. MacH, Ying Pan, Andrew H. Beck, Kristin C. Jensen, Joseph C. Liao

Research output: Contribution to journalArticle

85 Scopus citations

Abstract

Objectives: To develop the diagnostic criteria for benign and neoplastic conditions of the urinary tract using probe-based confocal laser endomicroscopy (pCLE), a new technology for dynamic, in vivo imaging with micron-scale resolution. The suggested diagnostic criteria will formulate a guide for pCLE image interpretation in urology. Methods: Patients scheduled for transurethral resection of bladder tumor (TURBT) or nephrectomy were recruited. After white-light cystoscopy (WLC), fluorescein was administered as contrast. Different areas of the urinary tract were imaged with pCLE via direct contact between the confocal probe and the area of interest. Confocal images were subsequently compared with standard hematoxylin and eosin analysis. Results: pCLE images were collected from 66 participants, including 2 patients who underwent nephrectomy. We identified key features associated with different anatomic landmarks of the urinary tract, including the kidney, ureter, bladder, prostate, and urethra. In vivo pCLE of the bladder demonstrated distinct differences between normal mucosa and neoplastic tissue. Using mosaicing, a post hoc image-processing algorithm, individual image frames were juxtaposed to form wide-angle views to better evaluate tissue microarchitecture. Conclusions: In contrast to standard pathologic analysis of fixed tissue with hematoxylin and eosin, pCLE provides real time microscopy of the urinary tract to enable dynamic interrogation of benign and neoplastic tissues in vivo. The diagnostic criteria developed in this study will facilitate adaptation of pCLE for use in conjunction with WLC to expedite diagnosis of urinary tract pathology, particularly bladder cancer.

Original languageEnglish (US)
Pages (from-to)225-231
Number of pages7
JournalUrology
Volume78
Issue number1
DOIs
StatePublished - Jul 1 2011

ASJC Scopus subject areas

  • Urology

Fingerprint Dive into the research topics of 'Dynamic real-time microscopy of the urinary tract using confocal laser endomicroscopy'. Together they form a unique fingerprint.

  • Cite this

    Wu, K., Liu, J. J., Adams, W., Sonn, G. A., MacH, K. E., Pan, Y., Beck, A. H., Jensen, K. C., & Liao, J. C. (2011). Dynamic real-time microscopy of the urinary tract using confocal laser endomicroscopy. Urology, 78(1), 225-231. https://doi.org/10.1016/j.urology.2011.02.057