Validation of Confocal Laser Endomicroscopy Features of Bladder Cancer: The Next Step Towards Real-time Histologic Grading.

European Urology Focus
Esmee Iml LiemDaniel Martijn de Bruin

Abstract

Cystoscopy enables the visualisation of suspicious bladder lesions but lacks the ability to provide real-time histopathologic information. Confocal laser endomicroscopy (CLE) is a probe-based optical technique that can provide real-time microscopic images. This high-resolution optical imaging technique may enable real-time tumour grading during cystoscopy. To validate and adapt CLE criteria for bladder cancer diagnosis and grading. Prospectively, 73 patients scheduled for transurethral resection of bladder tumour(s) were included. CLE imaging was performed intraoperatively prior to en bloc resection. Histopathology was the reference standard for comparison. Cystoscopic CLE imaging. Three independent observers evaluated the CLE images to classify tumours as low- or high-grade urothelial carcinoma (UC), or benign lesions. Interobserver agreement was calculated with Fleiss kappa analysis and diagnostic accuracy with 2×2 tables. Histopathology of 66 lesions (53 patients) revealed 25 low-grade UCs, 27 high-grade UCs, and 14 benign lesions. For low-grade UC, most common features were papillary configuration (100%), distinct cell borders (81%), presence of fibrovascular stalks (79%), cohesiveness of cells (77%), organised cell pattern...Continue Reading

Citations

Mar 25, 2020·Current Opinion in Urology·Angelo TerritoAlberto Breda
Apr 3, 2020·Current Opinion in Urology·José D SubielaJoan Palou
Oct 29, 2019·Journal of Endourology·Marit LucasDaniel M de Bruin
Jun 20, 2019·International Urology and Nephrology·Jie WuYi-Ping Zhu
Aug 27, 2021·International Urology and Nephrology·Dániel UrbánGabriella Varga

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