Validation of confocal laser endomicroscopy features of bladder cancer: The next step towards real-time histologic grading

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dc.authorid0000-0002-6308-1763
dc.contributor.authorLiem, Esmée I.M.L.
dc.contributor.authorFreund, Jan Erik
dc.contributor.authorSavci-Heijink, Cemile Dilara
dc.contributor.authorDelarosette, Johan Joseph Maria
dc.contributor.authorKamphuis, Guido Maarten
dc.contributor.authorBaard, Joyce
dc.contributor.authorLiao, Joseph C.
dc.contributor.authorvan Leeuwen, Ton G.J.M.
dc.contributor.authorDe Reijke, Theo M.M.
dc.contributor.authorDe Bruin, Daniël Martijn
dc.date.accessioned10.07.201910:49:13
dc.date.accessioned2019-07-10T19:37:18Z
dc.date.available10.07.201910:49:14
dc.date.available2019-07-10T19:37:18Z
dc.date.issued2020
dc.departmentİstanbul Medipol Üniversitesi, Uluslararası Tıp Fakültesi, Cerrahi Tıp Bilimleri Bölümü, Üroloji Ana Bilim Dalı
dc.description.abstractConfocal laser endomicroscopy (CLE) is an optical imaging technique that allows for real-time in vivo microscopic imaging of bladder tissue. In this first validation of CLE features, we confirm that the proposed CLE features suffice for real-time tumour grading.Background: Cystoscopy enables the visualisation of suspicious bladder lesions but lacks the ability to provide real-time histopathologic information. Confocal laser endomicroscopy (CLE) is a probe-based optical technique that can provide real-time microscopic images. This high-resolution optical imaging technique may enable real-time tumour grading during cystoscopy. Objective: To validate and adapt CLE criteria for bladder cancer diagnosis and grading. Design, setting, and participants: Prospectively, 73 patients scheduled for transurethral resection of bladder tumour(s) were included. CLE imaging was performed intraoperatively prior to en bloc resection. Histopathology was the reference standard for comparison. Intervention: Cystoscopic CLE imaging. Outcome measurements and statistical analysis: Three independent observers evaluated the CLE images to classify tumours as low- or high-grade urothelial carcinoma (UC), or benign lesions. Interobserver agreement was calculated with Fleiss kappa analysis and diagnostic accuracy with 2 × 2 tables. Results and limitations: Histopathology of 66 lesions (53 patients) revealed 25 low-grade UCs, 27 high-grade UCs, and 14 benign lesions. For low-grade UC, most common features were papillary configuration (100%), distinct cell borders (81%), presence of fibrovascular stalks (79%), cohesiveness of cells (77%), organised cell pattern (76%), and monomorphic cells (67%). A concordance between CLE-based classification and histopathology was found in 19 cases (76%). For high-grade UC, pleomorphic cells (77%), indistinct cell borders (77%), papillary configuration (67%), and disorganised cell pattern (60%) were the most common features. A concordance with histopathology was found in 19 cases (70%). In benign lesions, the most prevalent features were disorganised cell pattern (57%) and pleomorphic cells (52%), and a concordance with histopathology was found in four cases (29%). Conclusions: The CLE criteria enable identification of UC. CLE features correlate to histopathologic features that may enable real-time tumour grading. However, flat lesions remain difficult to classify. Patient summary: Confocal laser endomicroscopy may enable real-time cancer differentiation during cystoscopy, which is important for prognosis and disease management.
dc.description.sponsorshipCure Brain Cancer Foundationen_US
dc.description.sponsorshipCure for Cancer Foundationen_US
dc.identifier.citationLiem, E., Freund, J., Savci-Heijink, C., Delarosette, J., Kamphuis, G., Baard, J. ... De Bruin, D. (2020). Validation of confocal laser endomicroscopy features of bladder cancer: The next step towards real-time histologic grading. Journal of European Urology Focus, 6(1), 81-87. https://dx.doi.org/10.1016/j.euf.2018.07.012
dc.identifier.doi10.1016/j.euf.2018.07.012
dc.identifier.endpage87
dc.identifier.issn2405-4569
dc.identifier.issue1
dc.identifier.scopusqualityQ1
dc.identifier.startpage81
dc.identifier.urihttps://hdl.handle.net/20.500.12511/1377
dc.identifier.urihttps://dx.doi.org/10.1016/j.euf.2018.07.012
dc.identifier.volume6
dc.identifier.wosqualityQ1
dc.indekslendigikaynakWeb of Science
dc.indekslendigikaynakScopus
dc.indekslendigikaynakPubMed
dc.language.isoen
dc.publisherElsevier
dc.relation.ispartofEuropean Urology Focusen_US
dc.relation.publicationcategoryMakale - Uluslararası Hakemli Dergi - Kurum Öğretim Elemanı
dc.rightsinfo:eu-repo/semantics/openAccess
dc.subjectBladder Cancer Grading
dc.subjectConfocal Laser Endomicroscopy
dc.subjectNon–Muscle-İnvasive Bladder Carcinoma
dc.subjectSensitivity
dc.subjectSpecificity
dc.subjectUrothelial carcinoma
dc.titleValidation of confocal laser endomicroscopy features of bladder cancer: The next step towards real-time histologic grading
dc.typeArticle

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