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Journal of Biomedical Optics

High-magnification vascular imaging to reject false-positive sites in situ during Hexvix® fluorescence cystoscopy
Author(s): Blaise Lovisa; Patrice Jichlinski; Bernd-Claus Weber; Daniela Aymon; Hubert van den Bergh; Georges A. Wagnières
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Paper Abstract

Fluorescence imaging for detection of non-muscle-invasive bladder cancer is based on the selective production and accumulation of fluorescing porphyrins-mainly, protoporphyrin IX-in cancerous tissues after the instillation of Hexvix®. Although the sensitivity of this procedure is very good, its specificity is somewhat limited due to fluorescence false-positive sites. Consequently, magnification cystoscopy has been investigated in order to discriminate false from true fluorescence positive findings. Both white-light and fluorescence modes are possible with the magnification cystoscope, allowing observation of the bladder wall with magnification ranging between 30× for standard observation and 650×. The optical zooming setup allows adjusting the magnification continuously in situ. In the high-magnification (HM) regime, the smallest diameter of the field of view is 600 microns and the resolution is 2.5 microns when in contact with the bladder wall. With this cystoscope, we characterized the superficial vascularization of the fluorescing sites in order to discriminate cancerous from noncancerous tissues. This procedure allowed us to establish a classification based on observed vascular patterns. Seventy-two patients subject to Hexvix® fluorescence cystoscopy were included in the study. Comparison of HM cystoscopy classification with histopathology results confirmed 32/33 (97%) cancerous biopsies and rejected 17/20 (85%) noncancerous lesions.

Paper Details

Date Published: 1 September 2010
PDF: 8 pages
J. Biomed. Opt. 15(5) 051606 doi: 10.1117/1.3484257
Published in: Journal of Biomedical Optics Volume 15, Issue 5
Show Author Affiliations
Blaise Lovisa, Ecole Polytechnique Fédérale de Lausanne (Switzerland)
Patrice Jichlinski, Ctr. Hospitalier Univ. Vaudois (Switzerland)
Bernd-Claus Weber, Richard Wolf GmbH (Germany)
Daniela Aymon, Ctr. Hospitalier Univ. Vaudois (Switzerland)
Hubert van den Bergh, Ecole Polytechnique Fédérale de Lausanne (Switzerland)
Georges A. Wagnières, Ecole Polytechnique Fédérale de Lausanne (Switzerland)


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