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

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

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.

Original languageEnglish (US)
Title of host publicationProgress in Biomedical Optics and Imaging - Proceedings of SPIE
Volume7902
DOIs
StatePublished - 2011
Externally publishedYes
EventImaging, Manipulation, and Analysis of Biomolecules, Cells, and Tissues IX - San Francisco, CA, United States
Duration: Jan 22 2011Jan 25 2011

Other

OtherImaging, Manipulation, and Analysis of Biomolecules, Cells, and Tissues IX
CountryUnited States
CitySan Francisco, CA
Period1/22/111/25/11

Fingerprint

bladder
Urinary Bladder Neoplasms
Lasers
cancer
probes
lasers
Light
cells
Cystoscopes
grade
Intravesical Administration
Urothelium
Optical Imaging
Imaging techniques
surgeons
Operative Time
Histology
histology
Fluorescein
Urinary Tract

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., Wu, K., Adams, W., Hsiao, S. T., Mach, K. E., Beck, A. H., ... Liao, J. C. (2011). Real time diagnosis of bladder cancer with probe-based confocal laser endomicroscopy. In Progress in Biomedical Optics and Imaging - Proceedings of SPIE (Vol. 7902). [79021V] https://doi.org/10.1117/12.874243

Real time diagnosis of bladder cancer with probe-based confocal laser endomicroscopy. / Liu, Jen-Jane; Wu, Katherine; Adams, Winifred; Hsiao, Shelly T.; Mach, Kathleen E.; Beck, Andrew H.; Jensen, Kristin C.; Liao, Joseph C.

Progress in Biomedical Optics and Imaging - Proceedings of SPIE. Vol. 7902 2011. 79021V.

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

Liu, J-J, Wu, K, Adams, W, Hsiao, ST, Mach, KE, Beck, AH, Jensen, KC & Liao, JC 2011, Real time diagnosis of bladder cancer with probe-based confocal laser endomicroscopy. in Progress in Biomedical Optics and Imaging - Proceedings of SPIE. vol. 7902, 79021V, Imaging, Manipulation, and Analysis of Biomolecules, Cells, and Tissues IX, San Francisco, CA, United States, 1/22/11. https://doi.org/10.1117/12.874243
Liu J-J, Wu K, Adams W, Hsiao ST, Mach KE, Beck AH et al. Real time diagnosis of bladder cancer with probe-based confocal laser endomicroscopy. In Progress in Biomedical Optics and Imaging - Proceedings of SPIE. Vol. 7902. 2011. 79021V https://doi.org/10.1117/12.874243
Liu, Jen-Jane ; Wu, Katherine ; Adams, Winifred ; Hsiao, Shelly T. ; Mach, Kathleen E. ; Beck, Andrew H. ; Jensen, Kristin C. ; Liao, Joseph C. / Real time diagnosis of bladder cancer with probe-based confocal laser endomicroscopy. Progress in Biomedical Optics and Imaging - Proceedings of SPIE. Vol. 7902 2011.
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