Preliminary Report on Analysis of Bladder-Wall Vasculature Using Conjunctival Microvascular Analysis in Patients with and without Transitional-Cell Carcinoma

Abstract

To develop a technique to analyze the bladder microvasculature during cystoscopy to assess the conjuctival microvascular morphology at the capillary level. This technique could be an adjunct to visual examination of the bladder during cystoscopy for diseases that are presumed to affect the vasculature. Subjects with transitional-cell carcinoma (TCC) were chosen because of their frequency of cystoscopy. A total of 12 male patients, ages 45 to 80 years, underwent cystoscopy: four without TCC and eight with TCC by bladder biopsy. The images were digitally recorded and enhanced using a custom image-analysis system. The blood vessel length (VL) and diameter (VD) and blood vessel volume (BVV) were measured. The VD was significantly greater in TCC than in non-TCC patients only in the lower-order vessels. The VL was significantly longer in TCC than in non-TCC, again in the lower-order vessels. In the higherorder vessels, the VL was significantly shorter in TCC than in non-TCC. The BVV in the lower-order vessels was significantly greater in TCC than in non-TCC patients. Differences exist in the morphology of surface microvessels between TCC and non-TCC bladders. Using the current technique, capillaries (VD < 10 microm) are not visible, so refinement of imaging and recording technologies is required to measure capillaries in order to simulate microvascular morphometry in the conjuctiva.