Published December 11, 2019 | Version v1
Journal article Open

Morpho-molecular ex vivo detection and grading of non-muscle-invasive bladder cancer using forward imaging probe based multimodal optical coherence tomography and Raman spectroscopy

Creators

  • 1. Center for Medical Physics and Biomedical Engineering, Medical University of Vienna, Waehringer Guertel 18-20, 4L, 1090 Vienna, Austria
  • 2. Leibniz Institute of Photonic Technology (Leibniz-IPHT), Albert-Einstein-Straße 9, Jena, Germany.
  • 3. Gisela and Erwin Sick Chair of Micro-optics, Department of Microsystems Engineering, University of Freiburg, Freiburg, Germany
  • 4. Department of Urology, Copenhagen University, Herlev/Gentofte hospital, Borgmester Ib Juuls Vej 23A, DK-2730 Herlev, Copenhagen, Denmark
  • 5. Department of Pathology, Copenhagen University, Herlev/Gentofte hospital, Borgmester Ib Juuls Vej 23A, DK-2730 Herlev, Copenhagen, Denmark
  • 6. Technical University of Denmark, Department of Health Technology (DTU Health Tech), Ørsteds Plads, Building 345C, DK-2800Kgs. Lyngby, Denmark
  • 7. Leibniz Institute of Photonic Technology (Leibniz-IPHT), Albert-Einstein-Straße 9, Jena, Germany. & Institute of Physical Chemistry, Friedrich Schiller University Jena, Helmholtzweg 4, 07743 Jena, Germany
  • 8. Leibniz Institute of Photonic Technology (Leibniz-IPHT), Albert-Einstein-Straße 9, Jena, Germany. E-mail: iwan.schie@leibniz-ipht.de & University of Applied Sciences-Jena, Department of Medical Engineering and Biotechnology, Carl-Zeiss-Promenade 2, 07745 Jena, Germany

Description

Non-muscle-invasive bladder cancer affects millions of people worldwide, resulting in significant discomfort to the patient and potential death. Today, cystoscopy is the gold standard for bladder cancer assessment, using white light endoscopy to detect tumor suspected lesion areas, followed by resection of these areas and subsequent histopathological evaluation. Not only does the pathological examination take days, but due to the invasive nature, the performed biopsy can result in significant harm to the patient. Nowadays, optical modalities, such as optical coherence tomography (OCT) and Raman spectroscopy (RS), have proven to detect cancer in real time and can provide more detailed clinical information of a lesion, e.g. its penetration depth (stage) and the differentiation of the cells (grade). In this paper, we present an ex vivo study performed with a combined piezoelectric tube-based OCT-probe and fiber optic RS-probe imaging system that allows large field-of-view imaging of bladder biopsies, using both modalities and co-registered visualization, detection and grading of cancerous bladder lesions. In the present study, 119 examined biopsies were characterized, showing that fiber-optic based OCT provides a sensitivity of 78% and a specificity of 69% for the detection of non-muscle-invasive bladder cancer, while RS, on the other hand, provides a sensitivity of 81% and a specificity of 61% for the grading of low- and high-grade tissues. Moreover, the study shows that a piezoelectric tube-based OCT probe can have significant endurance, suitable for future long-lasting in vivo applications. These results also indicate that combined OCT and RS fiber probe-based characterization offers an exciting possibility for label-free and morpho-chemical optical biopsies for bladder cancer diagnostics.

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Morpho-molecular ex vivo detection and grading of non-muscle-invasive bladder cancer using forward imaging probe based multimodal optical coherence tomography and Raman spectroscopy.pdf

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Additional details

Funding

European Commission
FBI – Multimodal, Functional Bio-Photonic Imaging 721766
European Commission
MIB – Multi-modal, Endoscopic Biophotonic Imaging of Bladder Cancer for Point-of-Care Diagnosis 667933

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