Mp42-04 Ex-vivo Real Time Imaging of Cold Cup Biopsies After Turbt as an Intraoperative Tool for Resection Depth Diagnosis: a Feasibility Study
Year: 2020
Type: article
Abstract: You have accessJournal of UrologyImaging/Radiology: Uroradiology II (MP42)1 Apr 2020MP42-04 EX-VIVO REAL TIME IMAGING OF COLD CUP BIOPSIES AFTER TURBT AS AN INTRAOPERATIVE TOOL FOR RESECTION DEPTH DIAGNOSIS: A FEASIBILITY STUDY Patrick-Julien Treacy*, Matthieu Durand, Ina Pavlova, John P. Sfakianos, Reza Mehrazin, Ugo Giovanni Falagario, Ethan Wajswol, Flora Barthe, Nikos Tzavaras, Daniel Chevallier, Ashutosh K. Tewari, and Peter Wiklund Patrick-Julien Treacy*Patrick-Julien Treacy* More articles by this author , Matthieu DurandMatthieu Durand More articles by this author , Ina PavlovaIna Pavlova More articles by this author , John P. SfakianosJohn P. Sfakianos More articles by this author , Reza MehrazinReza Mehrazin More articles by this author , Ugo Giovanni FalagarioUgo Giovanni Falagario More articles by this author , Ethan WajswolEthan Wajswol More articles by this author , Flora BartheFlora Barthe More articles by this author , Nikos TzavarasNikos Tzavaras More articles by this author , Daniel ChevallierDaniel Chevallier More articles by this author , Ashutosh K. TewariAshutosh K. Tewari More articles by this author , and Peter WiklundPeter Wiklund More articles by this author View All Author Informationhttps://doi.org/10.1097/JU.0000000000000891.04AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookLinked InTwitterEmail Abstract INTRODUCTION AND OBJECTIVE: Multiphoton microscopy (MPM) is a non-linear optical imaging technology, allow a process-free imaging of fresh tissue up to a depth of 0.5 mm, with a combined signal of autofluorescence (AF) and second harmonic generation (SHG). The absence of bladder muscle in a Trans-Urethral Resection of Bladder Tumor (TURBT) increases risk of residual disease, recurrence and understaging, and there is a need for intra-operative diagnosis of resection depth in order to avoid for unnecessary 2nd look TURBT. The objective of the study was to evaluate the detection rate of bladder muscle and residual tumor cells on a cold cup biopsy of a resected bladder wall, after TURBT, using the MPM as a real-time imaging. METHODS: Cold cup biopsies were taken intra-operatively, in final part of procedure, directly after TURBT. Tissue was stored in PBS solution combined with fluorescent dyes (orange acridine and rhodamine). MPM Imaging of the tissue was first done, with z stack images of 100 micrometer depth for 3D imaging. After imaging, tissue was fixed in formalin and sent to biorepository for standard histopathology comparison. RESULTS: 9 patients were included in this feasibility study. MPM allowed to show nuclear atypia of the carcinoma cells, elastin fibers (AF, green channel), collagen fibers (SHG, blue channel) of the lamina propria, and the large bundles of regularly oriented muscle fibers, later confirmed by H and E staining histopathology. There was an 88.8% accuracy on resection depth (8/9 patients), with 6 patients having a resection not including bladder muscle after histology results. MPM average procedure time from biopsy to formalin fixation was 16.2 minutes (12-20 min). Presence of tumor cells on Multiphoton images were confirmed with final pathology showing positive surgical margins on 1 patient (Figure 1A). CONCLUSIONS: MPM could be an interesting intra operative tool in order to evaluate both depth and margins of a TURBT, in order to avoid for unnecessary 2nd look procedure in case of resection not including bladder muscle. Source of Funding: None © 2020 by American Urological Association Education and Research, Inc.FiguresReferencesRelatedDetails Volume 203Issue Supplement 4April 2020Page: e604-e604 Advertisement Copyright & Permissions© 2020 by American Urological Association Education and Research, Inc.MetricsAuthor Information Patrick-Julien Treacy* More articles by this author Matthieu Durand More articles by this author Ina Pavlova More articles by this author John P. Sfakianos More articles by this author Reza Mehrazin More articles by this author Ugo Giovanni Falagario More articles by this author Ethan Wajswol More articles by this author Flora Barthe More articles by this author Nikos Tzavaras More articles by this author Daniel Chevallier More articles by this author Ashutosh K. Tewari More articles by this author Peter Wiklund More articles by this author Expand All Advertisement PDF downloadLoading ...
Source: The Journal of Urology
Language: English
Subfield: Pulmonary and Respiratory Medicine
Field: Medicine
Domain: Health Sciences
Open Access status: bronze
OpenAlex ID: W3021551380