Real time urethral and ureteral assessment during radical cystectomy using ex vivo optical imaging

Esperto, Francesco; Prata, Francesco; Civitella, A.; Tuzzolo, P.; Romei, L.; Crimi, Vito Giuseppe; Cacciatore, Loris; Taffon, Chiara; Crescenzi, A.; Scarpa, R.M.; Papalia, Rocco

doi:10.1016/s0302-2838(21)01199-4

Cited by 1 publication

(3 citation statements)

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“…The studies included in our review evaluated surgical margins of bladder, kidney, and conjunctival tumors. 29–31 Esperto et al 29 reported perfect concordance between FCM and FS, with high sensitivity (88%) and specificity (81%) for urethral margins when compared with the FFPE. Vreuls et al 30 investigated the use of FCM in partial nephrectomies and demonstrated perfect concordance (100%) on the presence of tumor, with both FCM and FFPE identifying two PSMs in six tumor specimens with sensitivity and specificity of 100%.…”

Section: Resultsmentioning

confidence: 99%

“…Fourteen studies were included in this systematic review, evaluating breast cancer, [18][19][20][21][22][23][24][25][26][27][28][29][30][31] prostate cancer, 20,27 brain tumors, [26][27][28] kidney, 29 bladder, 30 and conjunctival tumors. 31 Of these, six studies used the VivaScope FCM (München, Germany), four used the Histolog FCM (Lausanne, Switzerland), three used the Carl Zeiss FCM (Jena, Germany), and one used a multimodal microscope that combined fluorescence microscopy, OCT, and FCM.…”

Section: Results Of the Included Studiesmentioning

confidence: 99%

“…Esperto et al 29 and Vreuls et al 30 both presented their findings in bladder and renal cancer, respectively, as abstracts. However, we anticipate that more accurate and comprehensive results will be published upon the release of their full reports.…”

Section: Other Cancersmentioning

confidence: 99%

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Accuracy of Ex-vivo Fluorescence Confocal Microscopy in Margin Assessment of Solid Tumors: A Systematic Review

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Fluorescence confocal microscopy (FCM) is a novel technology that enables rapid high-resolution digital imaging of non-formalin-fixed tissue specimens and offers real-time positive surgical margin identification. In this systematic review, we evaluated the accuracy metrics of ex vivo FCM for intraoperative margin assessment of different tumor types. A systematic search of MEDLINE via PubMed, Embase, Cochrane Central Register of Controlled Trials, Web of Science, and Scopus was performed for relevant papers (PROSPERO ID: CRD42022372558). We included 14 studies evaluating four types of microscopes in six different tumor types, including breast, prostate, central nervous system, kidney, bladder, and conjunctival tumors. Using the Quality Assessment of Diagnostic Accuracy Studies tool, we identified a high risk of bias in patient selection (21%) and index test (36%) of the included studies. Overall, we found that FCM has good accuracy metrics in all tumor types, with high sensitivity and specificity (>80%) and almost perfect concordance (>90%) against final pathology results. Despite these promising findings, the quality of the available evidence and bias concerns highlight the need for adequately designed studies to further define the role of ex vivo FCM in replacing the frozen section as the tool of choice for intraoperative margin assessment:

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Section: Resultsmentioning

confidence: 99%