Ex-vivo study in nephroureterectomy specimens defining the role of 3-D upper urinary tract visualization using optical coherence tomography and endoluminal ultrasound

Minimal invasive endoscopic treatment for upper urinary tract urothelial carcinoma (UUT-UC) is advocated in patients with low-risk disease and limited tumor volume. Diagnostic ureterorenoscopy combined with biopsy is the diagnostic standard. This study aims to evaluate two alternative diagnostic techniques for UUT-UC: optical coherence tomography (OCT) and endoluminal ultrasound (ELUS). Following nephroureterectomy, OCT, ELUS, and computed tomography (CT) were performed of the complete nephroureterectomy specimen. Visualization software (AMIRA®) was used for reconstruction and coregistration of CT, OCT, and ELUS. Finally, CT was used to obtain exact probe localization. Coregistered OCT and ELUS datasets were compared with histology. Coregistration with three-dimensional CT makes exact data matching possible in thisex-vivosetting to compare histology with OCT and ELUS. In OCT images of normal-appearing renal pelvis and ureter, urothelium, lamina propria, and muscularis were visible. With ELUS, all anatomical layers of the ureter could be distinguished, besides the urothelial layer. ELUS identified suspect lesions, although exact staging and differentiation between noninvasive and invasive lesions were not possible. OCT provides high-resolution imaging of normal ureter and ureter lesions. ELUS, however, is of limited value as it cannot differentiate between noninvasive and invasive tumors.

Journal of medical imaging (Bellingham, Wash.). 2018 Feb 12 [Epub]

Mieke T J Bus, Paul Cernohorsky, Daniel M de Bruin, Sybren L Meijer, Geert J Streekstra, Dirk J Faber, Guido M Kamphuis, Patricia J Zondervan, Marcel van Herk, Maria P Laguna Pes, Maik J Grundeken, Martin J Brandt, Theo M de Reijke, Jean J M C H de la Rosette, Ton G van Leeuwen

University of Amsterdam, Academic Medical Center, Department of Urology, Amsterdam, The Netherlands., University of Amsterdam, Academic Medical Center, Department of Plastic, Reconstructive and Hand Surgery, Amsterdam, The Netherlands., University of Amsterdam, Academic Medical Center, Department of Pathology, Amsterdam, The Netherlands., University of Amsterdam, Academic Medical Center, Department of Biomedical Engineering and Physics, Amsterdam, The Netherlands., University of Amsterdam, Academic Medical Center, Department of Cardiology, Amsterdam, The Netherlands.

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