Feature Of The Week 2/6/11: Investigation into using Optical Coherence Tomography for Grading Urothelial Carcinoma - Recent Work from Academic Medical Center Amsterdam and University of Twente
Feature Of The Week 2/6/11: Achieving the goal of a real-time in-situ high-resolution optical biopsy using OCT would be a tremendous boost to medicine and mankind. However is it quite a complex and difficult challenge that has not been fully realized to date. Many people believe this challenge will be realized in the not too distant future as understanding, approaches, and technology is improved due to progress at various prestigious research institutions around the world. Below is a review of some recent work from such institutions - the Academic Medical Center Amsterdam and the University of Twente.
Real-time grading of bladder urothelial carcinoma (UC) is clinically important, but the current standard for grading (histopathology) cannot provide this information. Based on Optical Coherence Tomography (OCT) measured optical attenuation (µt) the grade of bladder UC could potentially be assessed in real-time. We evaluated ex vivo whether µt differs between different grades of UC and benign bladder tissue.
Materials & Methods
Human bladder tissue specimens were examined ex vivo by 850 nm OCT using dynamic focusing. Three observers independently determined the µt from the OCT-images and 3 pathologists independently reviewed the corresponding histology slides. For both methods a consensus diagnosis was made..
We included 76 OCT scans from 54 bladder samples obtained in 20 procedures on 18 patients. The median (interquartile range) µt of benign tissue was 5.75 mm-1 (4.77-6.14) versus 5.52 mm-1 (3.47-5.90), 4.85 mm-1 (4.25-6.50) and 5.62 mm-1 (5.01-6.29) for grade 1, 2 and 3 UC, respectively (p=0.732). Interobserver agreement of histopathology was “substantial” (Kappa 0.62, 95%CI 0.54-0.70) compared to “almost perfect” (ICC 0.87, 95%CI 0.80-0.92) for OCT.
Quantitative OCT analysis (by µt) did not detect morphological UC changes. This may be due to factors typical for an ex vivo experimental setting..
For more information see recent Article. Courtesy Evelyne C. C. Cauberg and Daniel M. de Bruin.