Special Section on Pioneers in Biomedical Optics: Prof. Tayyaba Hasan

High-magnification vascular imaging to reject false-positive sites in situ during Hexvix® fluorescence cystoscopy

[+] Author Affiliations
Blaise Lovisa

Ecole Polytechnique Fédérale de Lausanne, Medical Photonics Group, Station 6, CH-1015 Lausanne, Switzerland

Patrice Jichlinski

CHUV University Hospital, Department of Urology, CH-1011 Lausanne, Switzerland

Bernd-Claus Weber

Richard Wolf GmbH, Pforzheimerstrausse 32, D-75438 Knittlingen, Germany

Daniela Aymon

CHUV University Hospital, Department of Urology, CH-1011 Lausanne, Switzerland

Hubert van den Bergh, Georges Wagnières

Ecole Polytechnique Fédérale de Lausanne, Medical Photonics Group, Station 6, CH-1015 Lausanne, Switzerland

J. Biomed. Opt. 15(5), 051606 (September 02, 2010). doi:10.1117/1.3484257
History: Received March 24, 2010; Revised May 27, 2010; Accepted June 02, 2010; Published September 02, 2010; Online September 02, 2010
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Fluorescence imaging for detection of non-muscle-invasive bladder cancer is based on the selective production and accumulation of fluorescing porphyrins—mainly, protoporphyrin IX—in cancerous tissues after the instillation of Hexvix®. Although the sensitivity of this procedure is very good, its specificity is somewhat limited due to fluorescence false-positive sites. Consequently, magnification cystoscopy has been investigated in order to discriminate false from true fluorescence positive findings. Both white-light and fluorescence modes are possible with the magnification cystoscope, allowing observation of the bladder wall with magnification ranging between 30× for standard observation and 650×. The optical zooming setup allows adjusting the magnification continuously in situ. In the high-magnification (HM) regime, the smallest diameter of the field of view is 600microns and the resolution is 2.5microns when in contact with the bladder wall. With this cystoscope, we characterized the superficial vascularization of the fluorescing sites in order to discriminate cancerous from noncancerous tissues. This procedure allowed us to establish a classification based on observed vascular patterns. Seventy-two patients subject to Hexvix® fluorescence cystoscopy were included in the study. Comparison of HM cystoscopy classification with histopathology results confirmed 3233 (97%) cancerous biopsies and rejected 1720 (85%) noncancerous lesions.

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© 2010 Society of Photo-Optical Instrumentation Engineers

Citation

Blaise Lovisa ; Patrice Jichlinski ; Bernd-Claus Weber ; Daniela Aymon ; Hubert van den Bergh, et al.
"High-magnification vascular imaging to reject false-positive sites in situ during Hexvix® fluorescence cystoscopy", J. Biomed. Opt. 15(5), 051606 (September 02, 2010). ; http://dx.doi.org/10.1117/1.3484257


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