Advances in cystoscopic surveillance of superficial bladder cancer: detection of the invisible tumor

Abstract

Objectives: To review recent advances in imaging modalities available for diagnosis and surveillance of superficial bladder cancer. Methods: Detailed PubMed searches were performed using the terms "fluorescence cystoscopy," "narrow-band imaging," and "optical coherence tomography" with "bladder cancer" and "urothelial carcinoma." Relevant literature was selected for analysis. We explored the clinical evidence to support the use of these technologies for the detection and surveillance of bladder cancer. Results: Fluorescence cystoscopy, narrow-band imaging, and optical coherence tomography are designed to improve the visualization of bladder cancer. These technological advancements have demonstrated an improvement in the detection of bladder cancer, including carcinoma in situ. Fluorescence cystoscopy has also been shown to decrease residual tumor rates and improve recurrence free survival. Both fluorescence cystoscopy and narrow-band imaging have a relatively high false positive rate. Optical coherence tomography can estimate bladder tumor stage without an invasive biopsy, however data is lacking in diagnostic accuracy. Conclusions: Evidence for the utility of fluorescence cystoscopy, narrow-band imaging, and optical coherence tomography has begun to compile. Fluorescence cystoscopy has the most evidence supporting its clinical applications. Low specificity currently limits these novel technologies from widespread use. More prospective studies are needed particularly of narrow band imaging, and optical coherence tomography. In addition, further research is necessary to determine the long-term impact of these technologies on recurrence, progression, and survival of bladder cancer.

Complementary Study of Collagen State in Bladder Diseases Using Cross-Polarization Optical Coherence Tomography, Nonlinear and Atomic Force Microscopy

“…The FNS parameters of the structure were determined for all the images obtained in such windows (typically, there were 5-8 images) [26]. It has previously been demonstrated [6] that, out of the entered 3D parameters of the structure in the specified range of spatial dimensions, the following ones are most sensitive to pathological changes in the tissue: parameter σ, which is a measure of the jump-like irregularities of the chaotic surface profiles against the low frequency -baselineit is determined as a "stepwiseness factor" of the chaotic component of the profile; and parameter S(L 0 -1 ), which is a measure of the spike-like irregularities of the profile being observed -it is determined as the "spikiness factor" of the surface structure. These two parameters were considered as the fundamental ones for the FNS parametrization of the bladder tissue AFM images.…”

“…Quantitative processing of 3D OCT images was demonstrated to significantly increase the diagnostic performance of the method for in situ detection of bladder carcinomas [3][4][5]. Meanwhile, an analysis of a large number of works on the use of OCT for bladder cancer visualization by Hale and Deem [6] indicated that cases of false positive cancer diagnoses are fairly typical for OCT against a background of severe inflammation as well as in cases of the diagnosis of cancer in the region of the postoperative scar.…”

Biopsy-Proven Transitional Cell Carcinoma of a Lung Mass Without an Urothelial Origin - A Rare Case Report

“…Abdominal CT has a sensitivity of 80% for upper urinary tract tumor and a sensitivity of 60% for bladder tumors [3,4]. Cystoscopy has a sensitivity of 62-84% in white light cystoscopy [5]. Retrograde pyelography has a sensitivity of 72% when being read by urologist in the operation room [6].…”