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Proceedings Paper

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

Paper Details

Date Published: 23 February 2011
PDF: 7 pages
Proc. SPIE 7902, Imaging, Manipulation, and Analysis of Biomolecules, Cells, and Tissues IX, 79021V (23 February 2011); doi: 10.1117/12.874243
Show Author Affiliations
Jen-Jane Liu, Stanford Univ. School of Medicine (United States)
Veterans Affairs Palo Alto Health Care System (United States)
Katherine Wu, Stanford Univ. School of Medicine (United States)
Veterans Affairs Palo Alto Health Care System (United States)
Winifred Adams, Stanford Univ. School of Medicine (United States)
Veterans Affairs Palo Alto Health Care System (United States)
Shelly T. Hsiao, Stanford Univ. School of Medicine (United States)
Veterans Affairs Palo Alto Health Care System (United States)
Kathleen E. Mach, Stanford Univ. School of Medicine (United States)
Veterans Affairs Palo Alto Health Care System (United States)
Andrew H. Beck, Stanford Univ. School of Medicine (United States)
Veterans Affairs Palo Alto Health Care System (United States)
Kristin C. Jensen, Stanford Univ. School of Medicine (United States)
Veterans Affairs Palo Alto Health Care System (United States)
Joseph C. Liao, Stanford Univ. School of Medicine (United States)
Veterans Affairs Palo Alto Health Care System (United States)


Published in SPIE Proceedings Vol. 7902:
Imaging, Manipulation, and Analysis of Biomolecules, Cells, and Tissues IX
Daniel L. Farkas; Dan V. Nicolau; Robert C. Leif, Editor(s)

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