#WCE2014 - Optical coherence tomography as a tool for in vivo staging and grading of upper urinary tract urothelial cell carcinoma: Comparison with biopsies and histopathology of the resected specimen - Interview

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.

wceMethods: 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