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Optical Coherence Tomography in Bladder Cancer

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Advances in Image-Guided Urologic Surgery

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Abstract

The current diagnostic standard for grading and staging of non-muscle-invasive bladder cancer (NMIBC) is based on the histopathology obtained during transurethral resection of the bladder tumour (TURBT) or biopsies. Although considered reference standard, this technique has some limitations: First, no real-time intraoperative histological information is obtained on stage and grade. Real-time intraoperative histological information could be helpful when NMIBC is treated by electric coagulation or laser ablation. The urologist has to rely on his/her judgement of stage and grade since no tissue is harvested for histological confirmation. In addition, in many centres, patients with a history of low-grade, non-invasive NMIBC with small recurrent NMIBC are being followed up with regular cystoscopy, instead of having directly TURBT. Real-time histological confirmation during cystoscopy could be very helpful in these patients. Finally, carcinoma in situ (CIS) may appear as a red mucosal lesion, mimicking inflammation. Again, real-time histological information could help in discriminating between CIS and inflammation. CIS can easily be missed on cystoscopy due to its flat appearance. If urine cytology is suspicious for high-grade bladder cancer, random biopsies are taken from the bladder to confirm or exclude CIS. This method results in a high rate of unnecessary biopsies. Real-time histopathology can possibly guide the direction of biopsies and thus avoid taking unnecessary biopsies. These examples illustrate the need for a fast, effective minimally invasive tool for assessment of cancerous lesions in the bladder. Optical coherence tomography (OCT) is a technology that has the potential to provide real-time information on grade and stage of a bladder cancer lesion.

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Acknowledgements

The authors like to thank Dr. Jörg Schmidbauer from the Medical University of Vienna and professor Ruth Knüchel from the University Hospital of Aachen for generously providing the OCT figures used in this paper.

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Authors and Affiliations

  1. Department of Urology, Academic Medical Center Amsterdam, Amsterdam, The Netherlands

    M. T. J. Bus MD, MSc, D. M. de Bruin PhD, Th. M. de Reijke MD, PhD & J. J. M. C. H. de la Rosette MD, PhD

  2. Department of Biomedical Engineering & Physics, Academic Medical Center Amsterdam, Amsterdam, The Netherlands

    D. M. de Bruin PhD

Authors
  1. M. T. J. Bus MD, MSc
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  2. D. M. de Bruin PhD
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  3. Th. M. de Reijke MD, PhD
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  4. J. J. M. C. H. de la Rosette MD, PhD
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Correspondence to M. T. J. Bus MD, MSc .

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Editors and Affiliations

  1. Department of Urology, Stanford University School of Medicine, Stanford, California, USA

    Joseph C. Liao

  2. Department of Urology, University of Florida College of Medicine, Gainesville, Florida, USA

    Li-Ming Su

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Bus, M.T.J., de Bruin, D.M., de Reijke, T.M., de la Rosette, J.J.M.C.H. (2015). Optical Coherence Tomography in Bladder Cancer. In: Liao, J., Su, LM. (eds) Advances in Image-Guided Urologic Surgery. Springer, New York, NY. https://doi.org/10.1007/978-1-4939-1450-0_3

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  • DOI: https://doi.org/10.1007/978-1-4939-1450-0_3

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