Two‐photon optical imaging, spectral and fluorescence lifetime analysis to discriminate urothelial carcinoma grades

• Published in: Journal of biophotonics 2018-11, Vol.11 (11), p.e201800065-n/a
• Main Authors: Pradère, Benjamin, Poulon, Fanny, Compérat, Eva, Lucas, Ivan T., Bazin, Dominique, Doizi, Steeve, Cussenot, Olivier, Traxer, Olivier, Abi Haidar, Darine
• Format: Article
• Language: English
• Subjects: Bioengineering; Bladder cancer; bladder tumor; Cancer; Chemical Sciences; Diagnosis; Diagnostic systems; Disease control; endomicroscopy; Evaluation; Fluorescence; fluorescence lifetime imaging; Human health and pathology; Imaging; Invasiveness; Life Sciences; Medical imaging; Microscopy; New technology; Optical analysis; Optical fibers; Qualitative analysis; Quantitative analysis; Second harmonic generation; Spectral analysis; spectroscopy; Tumors; two‐photon imaging; Urology; Urology and Nephrology; Urothelial carcinoma
• ISSN: 1864-063X; 1864-0648
• DOI: 10.1002/jbio.201800065

In the framework of urologic oncology, mini‐invasive procedures have increased in the last few decades particularly for urothelial carcinoma. One of the essential elements in the management of this disease is still the diagnosis, which strongly influences the choice of treatment. The histopathologic evaluation of the tumor grade is a keystone of diagnosis, and tumor characterization is not possible with just a macroscopic evaluation. Even today intraoperative evaluation remains difficult despite the emergence of new technologies which use exogenous fluorophore. This study assessed an optical multimodal technique based on endogenous fluorescence, combining qualitative and quantitative analysis, for the diagnostic of urothelial carcinoma. It was found that the combination of two‐photon fluorescence, second harmonic generation microscopy, spectral analysis and fluorescence lifetime imaging were all able to discriminate tumor from healthy tissue, and to determine the grade of tumors. Spectral analysis of fluorescence intensity and the redox ratio used as quantitative evaluations showed statistical differences between low‐grade and high‐grade tumors. These results showed that multimodal optical analysis is a promising technology for the development of an optical fiber setup designed for an intraoperative diagnosis of urothelial carcinoma in the area of endo‐urology. In urologic oncology, quality and rapidity of diagnosis is an influent element in the choice of treatment. Intraoperative imaging techniques could help in real‐time the surgeon in decision making. This paper presents a new technology for intraoperative assessment of the nature of bladder tissue. A multimodal tools with two‐photon exciton and quantitative‐qualitative detection. Histological landmarks were found in two‐photon images of biopsy and quantitative measurements gave numerical indicators of malignancy.