dc.contributor.author | Liem, Esmée I.M.L. | |
dc.contributor.author | Freund, Jan Erik | |
dc.contributor.author | Savci-Heijink, Cemile Dilara | |
dc.contributor.author | Delarosette, Johan Joseph Maria | |
dc.contributor.author | Kamphuis, Guido Maarten | |
dc.contributor.author | Baard, Joyce | |
dc.contributor.author | Liao, Joseph C. | |
dc.contributor.author | van Leeuwen, Ton G.J.M. | |
dc.contributor.author | De Reijke, Theo M.M. | |
dc.contributor.author | De Bruin, Daniël Martijn | |
dc.date.accessioned | 10.07.201910:49:13 | |
dc.date.accessioned | 2019-07-10T19:37:18Z | |
dc.date.available | 10.07.201910:49:14 | |
dc.date.available | 2019-07-10T19:37:18Z | |
dc.date.issued | 2020 | en_US |
dc.identifier.citation | Liem, 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 | en_US |
dc.identifier.issn | 2405-4569 | |
dc.identifier.uri | https://hdl.handle.net/20.500.12511/1377 | |
dc.identifier.uri | https://dx.doi.org/10.1016/j.euf.2018.07.012 | |
dc.description.abstract | Confocal 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. | en_US |
dc.description.sponsorship | Cure Brain Cancer Foundation | en_US |
dc.description.sponsorship | Cure for Cancer Foundation | en_US |
dc.language.iso | eng | en_US |
dc.publisher | Elsevier | en_US |
dc.rights | info:eu-repo/semantics/openAccess | en_US |
dc.subject | Bladder Cancer Grading | en_US |
dc.subject | Confocal Laser Endomicroscopy | en_US |
dc.subject | Non–Muscle-İnvasive Bladder Carcinoma | en_US |
dc.subject | Sensitivity | en_US |
dc.subject | Specificity | en_US |
dc.subject | Urothelial carcinoma | en_US |
dc.title | Validation of confocal laser endomicroscopy features of bladder cancer: The next step towards real-time histologic grading | en_US |
dc.type | article | en_US |
dc.relation.ispartof | European Urology Focus | en_US |
dc.department | İstanbul Medipol Üniversitesi, Uluslararası Tıp Fakültesi, Cerrahi Tıp Bilimleri Bölümü, Üroloji Ana Bilim Dalı | en_US |
dc.authorid | 0000-0002-6308-1763 | en_US |
dc.identifier.volume | 6 | en_US |
dc.identifier.issue | 1 | en_US |
dc.identifier.startpage | 81 | en_US |
dc.identifier.endpage | 87 | en_US |
dc.relation.publicationcategory | Makale - Uluslararası Hakemli Dergi - Kurum Öğretim Elemanı | en_US |
dc.identifier.doi | 10.1016/j.euf.2018.07.012 | en_US |
dc.identifier.wosquality | Q1 | en_US |
dc.identifier.scopusquality | Q1 | en_US |