Fluorescence visualization of the borders of bladder tumors after TUR with quantitative determination of diagnostic contrast

Abstract

The study demonstrates the ability of fluorescence diagnosis to perform intraoperative analysis of the bladder wall. The data of 10 patients with superficial bladder cancer who underwent PDD with the use of the fluorescence video system with excitation wavelenght in the “red” wavelength range and TUR is discussed. General condition of the bladder is assessed, the main foci of the tumor are determined. Then a tumor resection is performed. Further examination and identification of the fluorescing boundaries of the tumor remaining after TUR is performed to make a decision of a re‐resection. In addition, small fluorescing tumor foci, not detected with WL cystoscopy, are detected. Moreover the diagnostic fluorescence contrast is measured, allowing quantitative assessment of the 5‐ALA accumulation in tissues. The applied laser wavelength of 635 nm allows the light to penetrate deeper into the bladder tissue, making it possible to detect tumors including in the deeper layers.

Raman Spectroscopic Imaging of Human Bladder Resectates towards Intraoperative Cancer Assessment

“…Further examination and identification of the fluorescing boundaries of the tumor remaining after TUR are performed to make a decision of a re-resection. In addition, small fluorescing tumor foci, not detected with white light cystoscopy, can be detected [ 5 ].…”

Validation of a White Light and Fluorescence Augmented Panoramic Endoscopic Imaging System on a Bimodal Bladder Wall Experimental Model

“…The peak wavelength of the laser (635 nm) was chosen as the best trade-o (i) using only one fluorescence excitation light source; (ii) extending tissue dep (compared to blue light excitation); and (iii) enabling the detection of three d (Ce6, PpIX, and MB). Regarding Ce6, despite its second main absorption pea gion of 660 nm, its molar extinction at 635 nm is still about 5000 cm −1 /M (whic The imaging system has already been tested in clinical settings and has shown that it detects fluorescence in real conditions with sufficient sensitivity [29,30]. In the present work, the experiment was designed to be as close as possible to the picture obtained in real conditions.…”

“…A bimodal video system with a rigid endoscope featuring a 45-degree bevel was used for image acquisition. The main technical features of this device, developed by our team, are provided in [29,30]. Briefly, it consists of two cameras (a highly sensitive black-andwhite digital CCD with an optical filter and a color camera), beam splitter, cystoscope, and illuminating devices (WL source, laser).…”

“…However, it appears that this low level of absorption is sufficient to be detected in clinics by specific sensitive devices or for antibacterial use [31][32][33][34][35][36][37]. PpIX has a pronounced maximum at 635 nm (Figure 3), and examples of its detection in different organs being excited at 630-635 nm can be found in [13,14,29,30].…”

“…(Figure 3), and examples of its detection in different organs being excited at 630-635 nm can be found in [13,14,29,30].…”