Fiber-Optic Confocal Laser Endomicroscopy of Small Renal Masses: Toward Real-Time Optical Diagnostic Biopsy

The Journal of Urology
Li-Ming SuChristopher M Carter

Abstract

The incidental detection of small renal masses is increasing. However, not all require aggressive treatments as up to 20% are benign and the majority of malignant tumors harbor indolent features. Improved preoperative diagnostics are needed to differentiate tumors requiring aggressive treatment from those more suitable for surveillance. We evaluated and compared confocal laser endomicroscopy with standard histopathology in ex vivo human kidney tumors as proof of principle towards diagnostic optical biopsy. Patients with a solitary small renal mass scheduled for partial or radical nephrectomy were enrolled in study. Two kidneys were infused with fluorescein via intraoperative intravenous injection and 18 tumors were bathed ex vivo in dilute fluorescein prior to confocal imaging. A 2.6 mm confocal laser endomicroscopy probe was used to image tumors and surrounding parenchyma from external and en face surfaces after specimen bisection. Confocal laser endomicroscopy images were compared to standard hematoxylin and eosin analysis of corresponding areas. Ex vivo confocal laser endomicroscopy imaging revealed normal renal structures that correlated well with histology findings. Tumor tissue was readily distinguishable from normal pare...Continue Reading

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Citations

Feb 24, 2016·The Journal of Urology·Joseph C Liao
Aug 24, 2017·Journal of Biophotonics·Mei WangJ Quincy Brown
Feb 12, 2017·Current Urology Reports·Ricardo R N LeãoPatrick O Richard
Apr 30, 2019·Science Advances·A OrthB C Gibson
Mar 3, 2017·Current Urology Reports·Miki Haifler, Alexander Kutikov
May 2, 2020·Visceral Medicine·David Benjamin EllebrechtNils Gessert

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