Next generation of optical diagnostics for bladder cancer using probebased confocal laser endomicroscopy

Jen-Jane Liu, Timothy C. Chang, Ying Pan, Shelly T. Hsiao, Kathleen E. Mach, Kristin C. Jensen, Joseph C. Liao

Research output: Chapter in Book/Report/Conference proceedingConference contribution

Abstract

Real-time imaging with confocal laser endomicroscopy (CLE) probes that fit in standard endoscopes has emerged as a clinically feasible technology for optical biopsy of bladder cancer. Confocal images of normal, inflammatory, and neoplastic urothelium obtained with intravesical fluorescein can be differentiated by morphologic characteristics. We compiled a confocal atlas of the urinary tract using these diagnostic criteria to be used in a prospective diagnostic accuracy study. Patients scheduled to undergo transurethral resection of bladder tumor underwent white light cystoscopy (WLC), followed by CLE, and histologic confirmation of resected tissue. Areas that appeared normal by WLC were imaged and biopsied as controls. We imaged and prospectively analyzed 135 areas in 57 patients. We show that CLE improves the diagnostic accuracy of WLC for diagnosing benign tissue, low and high grade cancer. Interobserver studies showed a moderate level of agreement by urologists and nonclinical researchers. Despite morphologic differences between inflammation and cancer, real-time differentiation can still be challenging. Identification of bladder cancer-specific contrast agents could provide molecular specificity to CLE. By using fluorescently-labeled antibodies or peptides that bind to proteins expressed in bladder cancer, we have identified putative molecular contrast agents for targeted imaging with CLE. We describe one candidate agent - anti-CD47 - that was instilled into bladder specimens. The tumor and normal urothelium were imaged with CLE, with increased fluorescent signal demonstrated in areas of tumor compared to normal areas. Thus, cancer-specificity can be achieved using molecular contrast agents ex vivo in conjunction with CLE.

Original languageEnglish (US)
Title of host publicationProgress in Biomedical Optics and Imaging - Proceedings of SPIE
Volume8207
DOIs
StatePublished - 2012
Externally publishedYes
EventPhotonic Therapeutics and Diagnostics VIII - San Francisco, CA, United States
Duration: Jan 21 2012Jan 24 2012

Other

OtherPhotonic Therapeutics and Diagnostics VIII
CountryUnited States
CitySan Francisco, CA
Period1/21/121/24/12

Fingerprint

bladder
Urinary Bladder Neoplasms
Lasers
cancer
Cystoscopy
lasers
Contrast Media
Tumors
Urothelium
tumors
Neoplasms
Light
Tissue
Imaging techniques
endoscopes
Endoscopy
Biopsy
Atlases
Endoscopes
Fluorescein

Keywords

  • Bladder cancer diagnosis
  • Confocal laser endomicroscopy
  • In vivo imaging

ASJC Scopus subject areas

  • Atomic and Molecular Physics, and Optics
  • Electronic, Optical and Magnetic Materials
  • Biomaterials
  • Radiology Nuclear Medicine and imaging

Cite this

Liu, J-J., Chang, T. C., Pan, Y., Hsiao, S. T., Mach, K. E., Jensen, K. C., & Liao, J. C. (2012). Next generation of optical diagnostics for bladder cancer using probebased confocal laser endomicroscopy. In Progress in Biomedical Optics and Imaging - Proceedings of SPIE (Vol. 8207). [820716] https://doi.org/10.1117/12.907623

Next generation of optical diagnostics for bladder cancer using probebased confocal laser endomicroscopy. / Liu, Jen-Jane; Chang, Timothy C.; Pan, Ying; Hsiao, Shelly T.; Mach, Kathleen E.; Jensen, Kristin C.; Liao, Joseph C.

Progress in Biomedical Optics and Imaging - Proceedings of SPIE. Vol. 8207 2012. 820716.

Research output: Chapter in Book/Report/Conference proceedingConference contribution

Liu, J-J, Chang, TC, Pan, Y, Hsiao, ST, Mach, KE, Jensen, KC & Liao, JC 2012, Next generation of optical diagnostics for bladder cancer using probebased confocal laser endomicroscopy. in Progress in Biomedical Optics and Imaging - Proceedings of SPIE. vol. 8207, 820716, Photonic Therapeutics and Diagnostics VIII, San Francisco, CA, United States, 1/21/12. https://doi.org/10.1117/12.907623
Liu J-J, Chang TC, Pan Y, Hsiao ST, Mach KE, Jensen KC et al. Next generation of optical diagnostics for bladder cancer using probebased confocal laser endomicroscopy. In Progress in Biomedical Optics and Imaging - Proceedings of SPIE. Vol. 8207. 2012. 820716 https://doi.org/10.1117/12.907623
Liu, Jen-Jane ; Chang, Timothy C. ; Pan, Ying ; Hsiao, Shelly T. ; Mach, Kathleen E. ; Jensen, Kristin C. ; Liao, Joseph C. / Next generation of optical diagnostics for bladder cancer using probebased confocal laser endomicroscopy. Progress in Biomedical Optics and Imaging - Proceedings of SPIE. Vol. 8207 2012.
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