Urologic Survey (Basic Science)

Optical Coherencetomography for Bladder Cancer-Ready as a Surrogate for Optical Biopsy? Results of a Prospective Mono-Centre Study

J Urol Surg 2014;1(1):50-50

EDITORIAL COMMENT Nowadays, there is no perfect noninvasive diagnostic technique for bladder cancer. Cystoscopy and transurethral resection (TUR) are stil gold standard for the diagnosis of muscle invasive bladder cancer. On the other hand, Optical CoherenceTomography (OCT) can be alternative in the future. OCT was the first applied for opthalmology. OCT provides layer by layer images from target tissues with high-resolution, optical cross-sectional tomographic imaging. OCT’s concept is similar to ultrasound, differently it use light for detection. OCT’s resolution may vary from 20 microns (μm) up to 1 μm that depends on optical system and lightsource. The image penetration depth of OCT can reach to 2-3 mm. Recently, there are many research about OCT for the diagnosis of urogenital tumors in the literature. In this study, A.Karl reported sensitivity and specificty of OCT for detecting the presence of malignant lession as 100% and %65. But, this small study includes only 52 patients who have 166 suspicious lesions. Specifity of OCT was inadequate due to false positive images, in this report. Contrary, there were no false negative lesions and its sensitivity was 100% depend on all invasive tumors detected and staged correctly beyond the lamina propria. False positive results were associated with edema, inflammation and scar. The overall OCT sensitivity, specificity, accuracy, negative and positive predictive values are reported as 75-100%, 65-98%, 92%, 75% and 100% in the literature. We need more large-scale studies about this topic. It will be promissing technique for diagnostics of urogenital malignant lesions. OCT (optical biopsy) will progress with tecnical development and it will be alternative method for staging of bladder cancer. Fehmi Narter MD