MP54-18 QUANTITATIVE AND QUALITATIVE MULTIMODAL OPTICAL ANALYSIS TO DISCRIMINATE UROTHELIAL CARCINOMA GRADES

Abstract

You have accessJournal of UrologyBladder Cancer: Basic Research & Pathophysiology I1 Apr 2018MP54-18 QUANTITATIVE AND QUALITATIVE MULTIMODAL OPTICAL ANALYSIS TO DISCRIMINATE UROTHELIAL CARCINOMA GRADES Benjamin PRADERE, Fanny Poulon, Steeve Doizi, Olivier Cussenot, Eva Compérat, Darine Abi Haidar, and Olivier Traxer Benjamin PRADEREBenjamin PRADERE More articles by this author , Fanny PoulonFanny Poulon More articles by this author , Steeve DoiziSteeve Doizi More articles by this author , Olivier CussenotOlivier Cussenot More articles by this author , Eva CompératEva Compérat More articles by this author , Darine Abi HaidarDarine Abi Haidar More articles by this author , and Olivier TraxerOlivier Traxer More articles by this author View All Author Informationhttps://doi.org/10.1016/j.juro.2018.02.1709AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookTwitterLinked InEmail INTRODUCTION AND OBJECTIVES In the framework of urologic oncology, mini-invasive procedures have increased the last decades particularly for urothelial carcinoma. One of the essential step in the management of this disease stay the diagnostic, which strongly impacts the treatment choice. The histopathologic evaluation of the grade of the tumor is a keystone of the diagnosis, and its recognition is not possible with a macroscopic evaluation. Nowadays, this specific intraoperative characteristic evaluation remains difficult despite the emergence of new technologies which use exogenous fluorophore. In our study, we assessed the use of an optical multimodal technique based on endogenous fluorescence combining qualitative and quantitative analysis for the diagnostic of urothelial carcinoma grades. METHODS Urothelial samples from bladder and upper urinary tract were prospectively included (IRB-00003835) and analyzed on a specific optical multimodal setup based on endogenous fluorescence.The analysis included qualitative analyses with two-photons fluorescence imaging (TPF) and quantitative analyses with spectral analyses and fluorescence lifetime imaging (FLIM). Qualitative analyses were compared with pathological examination. Quantitative analyses was performed with a 870nm excitation wavelength, in the spectral analysis we evaluated the spectra, the redox ratio (NADH and FAD) and the fluorescence lifetime for each sample. RESULTS We identified 3 major urothelial aspects by TPF. All this samples were correlated with pathological examinations, and permitted to differentiate healthy tissue from low and high grade urothelial carcinoma. In the quantitative analysis, the spectral results shown that the intensity level of the emitted spectra was correlated with the histopathological characteristics: the higher the grade was, the lower was the fluorescence signal. The redox ratio analysis was significantly higher in the healthy urothelium compared with tumors samples (p<0.001). Moreover, we were able to discriminate low grade from high grade tumors, the low grade had a significantly higher redox ratio (p=0.002). We were able to identify the cells structure in the FLIM images and to compare the different grade. This analysis also permitted to discriminate the different origins. The average lifetime in low grade tumor appeared shorter on our images and in the histogram shown significant differences between healthy, low grade and high grade urothelial carcinoma: healthy vs. low grade (p = 0.002), healthy vs. high grade (p < 0.001) and high grade vs. low grade (p < 0.001). CONCLUSIONS Those results show that multimodal optical analysis was able to discriminate low grade from high grade urothelial carcinoma without using exogenous fluorophore. This is a promising technology for the development of an optical fiber setup designed for an intraoperative diagnosis of urothelial carcinoma in the area of endourology. © 2018FiguresReferencesRelatedDetails Volume 199Issue 4SApril 2018Page: e719 Advertisement Copyright & Permissions© 2018MetricsAuthor Information Benjamin PRADERE More articles by this author Fanny Poulon More articles by this author Steeve Doizi More articles by this author Olivier Cussenot More articles by this author Eva Compérat More articles by this author Darine Abi Haidar More articles by this author Olivier Traxer More articles by this author Expand All Advertisement Advertisement PDF downloadLoading ...