High-magnification vascular imaging to reject false-positive sites in situ during Hexvix® fluorescence cystoscopy
| Autor: | Bernd-Claus Weber, Hubert van den Bergh, Georges Wagnières, Blaise Lovisa, Daniela Aymon, Patrice Jichlinski |
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| Předmět: |
Male
Fluorescence-lifetime imaging microscopy Pathology Cystoscope 030232 urology & nephrology Protoporphyrins Cystoscopes fluorescence cystoscopy angiogenesis 0302 clinical medicine 5-Aminolevulinic Acid Aged 80 and over Phase-Iii vessel patterns Urinary bladder Superficial Bladder-Cancer medicine.diagnostic_test Cystoscopy Middle Aged Transitional-Cell Carcinoma Atomic and Molecular Physics and Optics 3. Good health Electronic Optical and Magnetic Materials Transitional cell carcinoma medicine.anatomical_structure 030220 oncology & carcinogenesis Intravesical Therapy Female Adult medicine.medical_specialty Adolescent Biomedical Engineering Magnification Fluorescence vasculogenesis Biomaterials Young Adult 03 medical and health sciences Endogenous Protoporphyrin high magnification medicine Humans False Positive Reactions Transurethral Resection Aged Fluorescent Dyes Bladder cancer Urinary-Bladder business.industry nonmuscle invasive bladder cancer medicine.disease Urinary Bladder Neoplasms Photodynamic Diagnosis White-Light Cystoscopy Nuclear medicine business Hexvix |
| Zdroj: | Journal of Biomedical Optics |
| Popis: | 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 (R). 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 X for standard observation and 650 X. 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 (R) 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. c 2010 Society of Photo-Optical Instrumentation Engineers. [DOI: 10.1117/1.3484257] |
| Databáze: | OpenAIRE |
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