Optical Diagnostics for Upper Urinary Tract Urothelial Cancer: Technology, Thresholds, and Clinical Applications

Abstract

NBI, SPIES, and PDD aim at improving visualization of UUT-UC through contrast enhancement. OCT and CLE aim at providing real-time predictions of histopathological diagnosis. For all techniques, more research has to be conducted before these techniques can be implemented in the routine management of UUT-UC. All techniques might be of value in specific clinical scenarios and allow for integration, for example, OCT with NBI, and could therefore improve tumor detection and staging and help in selecting the optimal treatment for the individual patient.

Use of the IDEAL framework in the urological literature: where are we in 2018?

“…Twenty review articles identified were systematic reviews and the remaining 15 were narrative reviews. Ten review articles used the IDEAL framework to categorize studies included within the review .…”

Evaluation of the Spies™ modalities image quality

“…The challenge of adequate diagnosis arises in cases of doubtful small and flat lesions where radiological and cytological evaluations may have low accuracy (3, 9, 10). For these situations, aside from Spies™, the NBI™ system (Olympus®) was developed specifically to increase tumor diagnosis accuracy, contrary to Spies™ in which the company does not recommend its use for any specific situation (4).…”

“…Aside from the standard white light it uses the following modalities: Spectra A and B by color spectral separation using different color filter settings that allow better contrast between tissues, Clara: by manipulating the image brightness to achieve better views of dark spots, Chroma by increasing color contrast and Clara+Chroma by combining both (3). …”

“…Examples of such technologies include the NBI™ system (Olympus®) (1); the photodynamic diagnosis (2) or the Storz Professional Image Enhancement System: Spies™ system (Karl-Storz®, Tuttlingen, Germany) integrated in the Karl-Storz® FlexXC™ ureteroscope that uses five different modalities of visual enhancement besides the standard white light. This system captures an image in white light through a red, green and blue (RGB) camera and performs a digital reprocessing to modify and generate the new image modality desired (3). …”

A felső húgyúti urothel sejtes tumorok kezelése-hasonlóságok és különbségek a húgyhólyag urothelialis tumoraival

“…Az egyre növekvő, ám még csak kísér-leti jelleggel alkalmazott eljárások a biopsziás mintavétel diagnosztikus korlátozottságának javítását célozzák. Ezek közül az optikai koherencia-tomográfia, az endoluminalis ultrahangvizsgálat, a konfokális lézer endomikroszkópia, a multipa ramet rikus MRI, a 11C kolin PET/CT és a nagy felbontású ure tero endoszkópia emelhető ki (16)(17)(18)(19)(20). A két tumortípus diagnosztikus lépései kis különbségektől eltekintve megegyeznek.…”