Human bladder cancer diagnosis using multiphoton microscopy

Sushmita Mukherjee; James S. Wysock; Casey K. Ng; Mohammed Akhtar; Sven Perner; Ming-Ming Lee; Mark A. Rubin; Frederick R. Maxfield; Watt W. Webb; Douglas S. Scherr

doi:10.1117/12.808314

23 February 2009 Human bladder cancer diagnosis using multiphoton microscopy

Sushmita Mukherjee, James S. Wysock, Casey K. Ng, Mohammed Akhtar, Sven Perner, Ming-Ming Lee, Mark A. Rubin, Frederick R. Maxfield, Watt W. Webb, Douglas S. Scherr

Author Affiliations +

Proceedings Volume 7161, Photonic Therapeutics and Diagnostics V; 716117 (2009) https://doi.org/10.1117/12.808314
Event: SPIE BiOS, 2009, San Jose, California, United States

Abstract

At the time of diagnosis, approximately 75% of bladder cancers are non-muscle invasive. Appropriate diagnosis and surgical resection at this stage improves prognosis dramatically. However, these lesions, being small and/or flat, are often missed by conventional white-light cystoscopes. Furthermore, it is difficult to assess the surgical margin for negativity using conventional cystoscopes. Resultantly, the recurrence rates in patients with early bladder cancer are very high. This is currently addressed by repeat cystoscopies and biopsies, which can last throughout the life of a patient, increasing cost and patient morbidity. Multiphoton endoscopes offer a potential solution, allowing real time, noninvasive biopsies of the human bladder, as well as an up-close assessment of the resection margin. While miniaturization of the Multiphoton microscope into an endoscopic format is currently in progress, we present results here indicating that Multiphoton imaging (using a bench-top Multiphoton microscope) can indeed identify cancers in fresh, unfixed human bladder biopsies. Multiphoton images are acquired in two channels: (1) broadband autofluorescence from cells, and (2) second harmonic generation (SHG), mostly by tissue collagen. These images are then compared with gold standard hematoxylin/eosin (H&E) stained histopathology slides from the same specimen. Based on a "training set" and a very small "blinded set" of samples, we have found excellent correlation between the Multiphoton and histopathological diagnoses. A larger blinded analysis by two independent uropathologists is currently in progress. We expect that the conclusion of this phase will provide us with diagnostic accuracy estimates, as well as the degree of inter-observer heterogeneity.

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Sushmita Mukherjee, James S. Wysock, Casey K. Ng, Mohammed Akhtar, Sven Perner, Ming-Ming Lee, Mark A. Rubin, Frederick R. Maxfield, Watt W. Webb, and Douglas S. Scherr "Human bladder cancer diagnosis using multiphoton microscopy", Proc. SPIE 7161, Photonic Therapeutics and Diagnostics V, 716117 (23 February 2009); https://doi.org/10.1117/12.808314

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