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Proceedings Paper

Human bladder cancer diagnosis using multiphoton microscopy
Author(s): Sushmita Mukherjee; James S. Wysock; Casey K. Ng; Mohammed Akhtar; Sven Perner; Ming-Ming Lee; Mark A. Rubin; Frederick R. Maxfield; Watt W. Webb; Douglas S. Scherr
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Paper Abstract

At the time of diagnosis, approximately 75% of bladder cancers are non-muscle invasive. Appropriate diagnosis and surgical resection at this stage improves prognosis dramatically. However, these lesions, being small and/or flat, are often missed by conventional white-light cystoscopes. Furthermore, it is difficult to assess the surgical margin for negativity using conventional cystoscopes. Resultantly, the recurrence rates in patients with early bladder cancer are very high. This is currently addressed by repeat cystoscopies and biopsies, which can last throughout the life of a patient, increasing cost and patient morbidity. Multiphoton endoscopes offer a potential solution, allowing real time, noninvasive biopsies of the human bladder, as well as an up-close assessment of the resection margin. While miniaturization of the Multiphoton microscope into an endoscopic format is currently in progress, we present results here indicating that Multiphoton imaging (using a bench-top Multiphoton microscope) can indeed identify cancers in fresh, unfixed human bladder biopsies. Multiphoton images are acquired in two channels: (1) broadband autofluorescence from cells, and (2) second harmonic generation (SHG), mostly by tissue collagen. These images are then compared with gold standard hematoxylin/eosin (H&E) stained histopathology slides from the same specimen. Based on a "training set" and a very small "blinded set" of samples, we have found excellent correlation between the Multiphoton and histopathological diagnoses. A larger blinded analysis by two independent uropathologists is currently in progress. We expect that the conclusion of this phase will provide us with diagnostic accuracy estimates, as well as the degree of inter-observer heterogeneity.

Paper Details

Date Published: 23 February 2009
PDF: 10 pages
Proc. SPIE 7161, Photonic Therapeutics and Diagnostics V, 716117 (23 February 2009); doi: 10.1117/12.808314
Show Author Affiliations
Sushmita Mukherjee, Weill Cornell Medical College (United States)
James S. Wysock, Weill Cornell Medical College (United States)
Casey K. Ng, Weill Cornell Medical College (United States)
Mohammed Akhtar, Weill Cornell Medical College (United States)
Sven Perner, Weill Cornell Medical College (United States)
Ming-Ming Lee, Weill Cornell Medical College (United States)
Mark A. Rubin, Weill Cornell Medical College (United States)
Frederick R. Maxfield, Weill Cornell Medical College (United States)
Watt W. Webb, Cornell Univ. (United States)
Douglas S. Scherr, Weill Cornell Medical College (United States)

Published in SPIE Proceedings Vol. 7161:
Photonic Therapeutics and Diagnostics V
Henry Hirschberg M.D.; Brian Jet-Fei Wong M.D.; Kenton W. Gregory M.D.; Reza S. Malek; Nikiforos Kollias; Bernard Choi; Guillermo J. Tearney; Justus F. R. Ilgner; Steen J. Madsen; Laura Marcu; Haishan Zeng, Editor(s)

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