Confocal laser endomicroscopy for upper tract urothelial carcinoma: Validation of the proposed criteria and proposal of a scoring system for real-time tumor grading

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dc.authorid0000-0002-6308-1763
dc.contributor.authorFreund, Jan Erik
dc.contributor.authorLiem, Esmee I.M.L.
dc.contributor.authorSavcı-Heijink, Cemile Dilara
dc.contributor.authorBaard, Joyce
dc.contributor.authorKamphuis, Guido Maarten
dc.contributor.authorde la Rosette, Jean J. M. C. H.
dc.contributor.authorde Bruin, Daniël Martijn
dc.date.accessioned10.07.201910:49:13
dc.date.accessioned2019-07-10T19:35:35Z
dc.date.available10.07.201910:49:14
dc.date.available2019-07-10T19:35:35Z
dc.date.issued2019
dc.departmentİstanbul Medipol Üniversitesi, Uluslararası Tıp Fakültesi, Cerrahi Tıp Bilimleri Bölümü, Üroloji Ana Bilim Dalı
dc.description.abstractPurpose: Confocal laser endomicroscopy (CLE) is a fluorescence-based fiber-optic imaging technique with the potential for intraoperative grading of upper tract urothelial carcinoma (UTUC). This study aims to (1) investigate the prevalence of the previously proposed CLE criteria for bladder cancer in papillary UTUC, (2) estimate the diagnostic value of CLE for UTUC grading and (3) propose a scoring system for a more quantifiable approach of CLE-based grading of UTUC. Materials and methods: Ureteroscopic CLE was performed in patients with UTUC. Following CLE imaging, co-localized biopsies were taken for histopathologic comparison. Postoperatively, two blinded raters assessed the CLE images. Results: Fifty-three papillary UTUCs (34 low grade and 19 high grade) were imaged with CLE in 36 patients. All the previously described CLE criteria were identifiable in varying proportions. After excluding 10 non-diagnostic recordings (5 low grade and 5 high grade) due to insufficient image quality, the histopathologic grade was correctly identified with CLE in 26 low-grade UTUCs (90%) and in 12 high-grade UTUCs (86%). The most prevalent CLE criteria with the highest diagnostic potential were cellular organization, morphology and cohesiveness of cells. A scoring system was proposed with these criteria, which yielded similar diagnostic accuracies. Conclusions: Based on the previously proposed criteria, CLE enables accurate grading of papillary UTUC at a non-diagnostic rate of 19%. The most prevalent CLE criteria with the highest diagnostic potential for grading of papillary UTUC are cellular organization, morphology and cohesiveness of cells. The proposed scoring system may simplify the assessment of CLE images for UTUC grading but external validation is required.
dc.identifier.citationFreund, J. E., Liem, E. I.M.L., Savcı-Heijink, C. D., Baard, J., Kamphuis, G. M., de la Rosette, J. J. M. C. H. ve de Bruin, D. M. (2019). Confocal laser endomicroscopy for upper tract urothelial carcinoma: Validation of the proposed criteria and proposal of a scoring system for real-time tumor grading. World Journal of Urology, 37(10), 2155-2164. https://dx.doi.org/10.1007/s00345-019-02646-5
dc.identifier.doi10.1007/s00345-019-02646-5
dc.identifier.endpage2164
dc.identifier.issn0724-4983
dc.identifier.issn1433-8726
dc.identifier.issue10
dc.identifier.scopusqualityQ1
dc.identifier.startpage2155
dc.identifier.urihttps://hdl.handle.net/20.500.12511/855
dc.identifier.urihttps://dx.doi.org/10.1007/s00345-019-02646-5
dc.identifier.volume37
dc.identifier.wosqualityQ1
dc.indekslendigikaynakWeb of Science
dc.indekslendigikaynakScopus
dc.indekslendigikaynakPubMed
dc.language.isoen
dc.publisherSpringer Verlag
dc.relation.ispartofWorld Journal of Urologyen_US
dc.relation.publicationcategoryMakale - Uluslararası Hakemli Dergi - Kurum Öğretim Elemanı
dc.rightsAttribution 4.0 International*
dc.rightsinfo:eu-repo/semantics/openAccess
dc.rights.urihttps://creativecommons.org/licenses/by/4.0/*
dc.subjectCLE
dc.subjectConfocal Laser Endomicroscopy
dc.subjectHistologic Grading
dc.subjectOptical Imaging
dc.subjectUrothelial Carcinoma of the Upper Urinary Tract
dc.subjectUTUC
dc.titleConfocal laser endomicroscopy for upper tract urothelial carcinoma: Validation of the proposed criteria and proposal of a scoring system for real-time tumor grading
dc.typeArticle

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