Guide Atlas of Endomicroscopy

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    • Introduction Urothelial carcinomas are common cancers that pose significant management challenges and healthcare burdens. Confocal Laser Endomicroscopy: Principles CLE is based on confocal microscopy, a mainstay tool of basic science research for high-resolution cellular and subcellular imaging.

      Open in a separate window. Technical Considerations The technique of CLE in the lower urinary tract has been described in a step-by-step video [ 35 ]. Imaging Diagnostic Criteria for Bladder Cancer Prior works by our group have established a preliminary set of optical diagnostic criteria for normal urothelium, benign inflammatory lesions, low-grade tumors, and high-grade tumors [ 13 , 31 , 38 ].

      Inter-Observer Variance and Diagnostic Accuracy Novel imaging technologies necessitate inter-observer agreement studies to evaluate variability among observers in interpreting acquired images. CLE in the Upper Tract Previously, ex vivo CLE imaging of the renal pelvis and proximal ureter showed similarity between upper tract and bladder urothelial cells and lamina propria Fig. Future Outlooks Optical diagnosis of urothelial carcinoma using CLE, while promising, remains at the early stage of clinical integration. Conclusion The advent of novel imaging technologies has a transformative potential in cancer detection and management.

      Acknowledgement The authors thank current and past members of the Liao Laboratory, particularly Katherine Wu and Kathy Mach, for technical support and helpful discussions. Footnotes Conflict of Interest Dr. Human and Animal Rights and Informed Consent This article does not contain any studies with human or animal subjects performed by any of the authors.

      Cancer Statistics Working Group. Cancer statistics, Cancer J. Kirkali Z, et al. Bladder cancer: epidemiology, staging and grading, and diagnosis. Bladder cancer. Sylvester RJ, et al. Emerging optical techniques in advanced cystoscopy for bladder cancer diagnosis: A review of the current literature. Indian J. IJU J.

      European guidelines for the diagnosis and management of upper urinary tract urothelial cell carcinomas: update. Hall MC, et al. Prognostic factors, recurrence, and survival in transitional cell carcinoma of the upper urinary tract: a year experience in patients. Upper tract urothelial carcinoma. Bladder recurrence after surgery for upper urinary tract urothelial cell carcinoma: frequency, risk factors, and surveillance.

      The past, present and future of cystoscopy: the fusion of cystoscopy and novel imaging technology. BJU Int. New optical imaging technologies for bladder cancer: considerations and perspectives. Wu K, et al. Schmidbauer J, et al. Improved detection of urothelial carcinoma in situ with hexaminolevulinate fluorescence cystoscopy.

      Fradet Y, et al. A comparison of hexaminolevulinate fluorescence cystoscopy and white light cystoscopy for the detection of carcinoma in situ in patients with bladder cancer: a phase III, multicenter study. Jocham D, et al. Improved detection and treatment of bladder cancer using hexaminolevulinate imaging: a prospective, phase III multicenter study. Kolozsy Z. Daniltchenko DI, et al. Long-term benefit of 5-aminolevulinic acid fluorescence assisted transurethral resection of superficial bladder cancer: 5-year results of a prospective randomized study. Residual tumor discovered in routine second transurethral resection in patients with stage T1 transitional cell carcinoma of the bladder.

      Brausi M, et al. Margulis V, et al. Outcomes of radical nephroureterectomy: a series from the Upper Tract Urothelial Carcinoma Collaboration. Ureterorenoscopic biopsy and urinary cytology according to the WHO classification underestimate tumor grading in upper urinary tract urothelial carcinoma. High rate of pathologic upgrading at nephroureterectomy for upper tract urothelial carcinoma.

      Smith AK, et al. Inadequacy of biopsy for diagnosis of upper tract urothelial carcinoma: implications for conservative management. Tavora F, et al. Small endoscopic biopsies of the ureter and renal pelvis: pathologic pitfalls. Cutress ML, et al. Ureteroscopic and percutaneous management of upper tract urothelial carcinoma UTUC : systematic review.

      Is nephroureterectomy necessary in all cases of upper tract transitional cell carcinoma?

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      Long-term results of conservative endourologic management of upper tract transitional cell carcinoma in individuals with a normal contralateral kidney. Lopez A, Liao JC.

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      Emerging endoscopic imaging technologies for bladder cancer detection. Sonn GA, et al. Confocal laser endomicroscopy: technical advances and clinical applications. Bronchoscopic advances: on the way to the cells. Fibered confocal microscopy of bladder tumors: an ex vivo study. Probe-based confocal laser endomicroscopy of the urinary tract: the technique. Wallace MB, et al.

      The safety of intravenous fluorescein for confocal laser endomicroscopy in the gastrointestinal tract. Becker V, et al. High-resolution miniprobe-based confocal microscopy in combination with video mosaicing with video Gastrointest. Chang TC, et al. Interobserver agreement of confocal laser endomicroscopy for bladder cancer. Aron M, et al. Understanding interobserver agreement: the kappa statistic. The learning curve, accuracy, and interobserver agreement of endoscope-based confocal laser endomicroscopy for the differentiation of colorectal lesions.

      Interobserver agreement and accuracy among international experts with probe-based confocal laser endomicroscopy in predicting colorectal neoplasia.

      Atlas of Endomicroscopy

      Lee YC, et al. Kiesslich R, et al.

      Gaddam S, et al. Optical biopsy of upper tract urothelial carcinoma with confocal laser endomicroscopy. A smart atlas for endomicroscopy using automated video retrieval. Image Anal. Software for automated classification of probe-based confocal laser endomicroscopy videos of colorectal polyps. World J. Hsiung P-L, et al. Detection of colonic dysplasia in vivo using a targeted heptapeptide and confocal microendoscopy. Becker A, et al. Receptor-targeted optical imaging of tumors with near-infrared fluorescent ligands. Sturm MB, et al. Targeted imaging of esophageal neoplasia with a fluorescently labeled peptide: first-in-human results.

      Miller SJ, et al.