TAIPEI, TAIWAN (UroToday.com) - Introduction and Objectives: Optical Coherence Tomography (OCT) has potential to provide real-time information on UUT-UC grade and stage. In this study we compare a) biopsy and b) OCT with gold standard histopathology of the resected specimen (HRS) for grading and staging of low- and high-grade UUT-UC.
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Methods: 16 patients with UUT-UC underwent diagnostic URS, including OCT and biopsy of places with visible tumour. The 2.7 Fr OCT probe was delivered through the ureteroscopes work channel. Subsequently biopsy was performed. At a later stage, patients underwent nephroureterectomy. For staging by OCT, in-house developed protocols were used and visible lesions were divided in invasive and non-invasive. For grading, the decrease of light intensity [mm-1] was quantified. Biopsies were examined at the pathology department. OCT and biopsy diagnosis were compared to HRS.
Results: 9 patients showed noninvasive UUT-UC and 7 Patients invasive UUT-UC. Staging with OCT matched with HRS (87.6%). Stage on biopsies matched in 56.25% with HRS. 7 Patients had low-grade UUT-UC, 9 patients high-grade UUTUC. In lesions with HRS confirmed low-grade UUT-UC median (interquartile range) loct is 2.3 mm-1 (1.9–2.7) compared to 3.4 mm-1 (2.7–3.7) (p-value 0.03) in HRS confirmed high-grade UUT-UC. ROC analyses of low grade compered to high grade showed an area under the curve of 0.86 (95% confidence interval 0.66–1.06, p-value 0.01). Biopsy diagnosis on grade matched in 68.75% with HRS.
Conclusions: OCT is a high potential emerging tool for optical staging and grading in UUT-UC. Large cohort studies should confirm the values on sensitivity and specificity of this study.
Source of Funding: Urologie 1973 foundation and Cure for Cancer foundation.
|View an interview with MTJ Bus and DM de Bruin, two of the authors of this study.|
Presented by MTJ Bus, DM de Bruin, DJ Faber, MP Laguna Pes, TG van Leeuwen, TM de Reijke, and JJ de la Rosette at the 32nd World Congress of Endourology & SWL - September 3 - 7, 2014 - Taipei, Taiwan
Academic Medical Center, The Netherlands