Multiphoton Microscopy: A Potential Intraoperative Tool for the Detection of Carcinoma In Situ in Human Bladder

Context Urothelial carcinoma in situ (CIS) is a precursor of invasive bladder cancer, which if left untreated, will likely progress to more aggressive disease. Approximately 50% of CIS lesions are missed on routine cystoscopy owing to their flat architecture. Furthermore, many benign but abnormal-appearing areas may be biopsied owing to lack of cellular resolution of cystoscopes. Multiphoton microscopy (MPM) is an optical imaging technique that generates subcellular-resolution three-dimensional images from unfixed tissue without using exogenous dyes. Objective To assess the diagnostic potential of MPM in identifying and differentiating benign from malignant flat bladder lesions, especially CIS. Design Seventy-eight specimens (benign = 46, CIS = 23, invasive = 9, as diagnosed on histopathology) were obtained from flat bladder mucosa via transurethral resection of bladder, cold cup biopsy, or cystectomy, imaged fresh with a commercial benchtop MPM, and submitted for routine histopathology. Multiphoton microscopy and hematoxylin-eosin diagnoses were compared. Results In 77 of 78 specimens (99%), accurate MPM diagnoses (benign/malignant) were given on the basis of their architectural and cytologic features (nuclear to cytoplasmic ratio, pleomorphism, polarity/organization of urothelial layers, etc). The sensitivity and specificity were 97% and 100%, respectively, with positive (malignant) and negative (benign) predictive values of 100% and 98%, respectively. The interobserver agreement, κ, was 0.93. Conclusions Our study demonstrates the capability of MPM to identify and differentiate benign from malignant flat bladder lesions, especially CIS. With the advent of MPM endoscopes, we foresee their potential as a biopsy guidance tool for early detection and treatment of CIS, thus reducing the rate of biopsies with benign diagnoses and their associated complications.

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Low-Grade Ductal Carcinoma In Situ

American Journal of Clinical Pathology ◽

10.1093/ajcp/aqz179 ◽

2019 ◽

Vol 153 (3) ◽

pp. 360-367 ◽

Cited By ~ 1

Author(s):

Sarah A Alghamdi ◽

Kritika Krishnamurthy ◽

Sofia A Garces Narvaez ◽

Khaled J Algashaamy ◽

Jessica Aoun ◽

...

Keyword(s):

Ductal Carcinoma In Situ ◽

Carcinoma In Situ ◽

Interobserver Agreement ◽

Interobserver Variability ◽

Ductal Carcinoma ◽

Grading System ◽

Low Grade ◽

Interobserver Reproducibility ◽

Tiered System

Abstract Objectives We aimed to determine the interobserver reproducibility in diagnosing low-grade ductal carcinoma in situ (DCIS). We also aimed to compare the interobserver variability using a proposed two-tiered grading system as opposed to the current three-tiered system. Methods Three expert breast pathologists and one junior pathologist identified low-grade DCIS from a set of 300 DCIS slides. Months later, participants were asked to grade the 300 cases using the standard three-tiered system. Results Using the two-tiered system, interobserver agreement among breast pathologists was considered moderate (κ = 0.575). The agreement was similar (κ = 0.532) with the junior pathologist included. Using the three-tiered system, pathologists’ agreement was poor (κ = 0.235). Conclusions Pathologists’ reproducibility on diagnosing low-grade DCIS showed moderate agreement. Experience does not seem to influence reproducibility. Our proposed two-tiered system of low vs nonlow grade, where the intermediate grade is grouped in the nonlow category has shown improved concordance.

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Galactography with Tomosynthesis Technique (Galactomosynthesis) – Renaissance of a Method?

Geburtshilfe und Frauenheilkunde ◽

10.1055/a-0594-2277 ◽

2018 ◽

Vol 78 (05) ◽

pp. 493-498 ◽

Cited By ~ 3

Author(s):

Rüdiger Schulz-Wendtland ◽

Caroline Preuss ◽

Peter Fasching ◽

Christian Loehberg ◽

Michael Lux ◽

...

Keyword(s):

High Resolution ◽

Ductal Carcinoma In Situ ◽

Carcinoma In Situ ◽

Ductal Carcinoma ◽

Imaging Technique ◽

Nipple Discharge ◽

Full Field ◽

Contrast Enhanced ◽

First Time

Abstract Introduction For decades, conventional galactography was the only imaging technique capable of showing the mammary ducts. Today, diagnosis is based on a multimodal concept which combines high-resolution ultrasound with magnetic resonance (MR) mammography and ductoscopy/galactoscopy and has a sensitivity and specificity of up to 95%. This study used tomosynthesis in galactography for the first time and compared the synthetic digital 2D full-field mammograms generated with this technique with the images created using the established method of ductal sonography. Both methods should be able to detect invasive breast cancers and their precursors such as ductal carcinoma in situ (DCIS) as well as being able to identify benign findings. Material and Methods Five patients with pathological nipple discharge were examined using ductal sonography, contrast-enhanced 3D galactography with tomosynthesis and the synthetic digital 2D full-field mammograms generated with the latter method. Evaluation of the images created with the different imaging modalities was done by three investigators with varying levels of experience with complementary breast diagnostics (1, 5 and 15 years), and their evaluations were compared with the histological findings. Results All 3 investigators independently evaluated the images created with ductal sonography, contrast-enhanced 3D galactography with tomosynthesis, and generated synthetic digital 2D full-field mammograms. Their evaluations were compared with the histopathological assessment of the surgical specimens resected from the 5 patients. There was 1 case of invasive breast cancer, 2 cases with ductal carcinoma in situ and 2 cases with benign findings. All 3 investigators made more mistakes when they used the standard imaging technique of ductal sonography to diagnose suspicious lesions than when they used contrast-enhanced galactography with tomosynthesis and the generated synthetic digital 2D full-field mammograms. Conclusion This is the first time breast tomosynthesis was used in galactography (galactomosynthesis) to create digital 3-dimensional images of suspicious findings. When used together with the generated synthetic digital 2D full-field mammograms, it could be a useful complementary procedure for the diagnosis of breast anomalies and could herald a renaissance of this method. Compared with high-resolution ductal ultrasound, the investigators achieved better results with contrast-enhanced galactography using tomosynthesis and the generated synthetic digital 2D full-field mammograms, as confirmed by histopathological findings.

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Three-dimensional in-situ imaging of cracks in concrete using diffuse ultrasound

Structural Health Monitoring ◽

10.1177/1475921717690938 ◽

2017 ◽

Vol 17 (2) ◽

pp. 279-284 ◽

Cited By ~ 10

Author(s):

Yuxiang Zhang ◽

Eric Larose ◽

Ludovic Moreau ◽

Grégoire d’Ozouville

Keyword(s):

Wind Tunnel ◽

Multiple Scattering ◽

Structural Changes ◽

Imaging Technique ◽

Three Dimensional ◽

Three Dimensions ◽

Thick Wall ◽

Pressure Changes ◽

Diffuse Ultrasound

Locadiff, an innovative imaging technique based on diffuse waves, has recently been developed in order to image mechanical changes in heterogeneous, geological, or man-made materials. This manuscript reports the on-site application of Locadiff to locate several pre-existing cracks on an aeronautical wind tunnel made of pre-stressed concrete. Using 32 transducers working at ultrasonic frequencies (80–220 kHz) where multiple scattering occurs, we monitor during 15 min an area of 2.5 m×2.5 m of a 35-cm-thick wall. With the wind tunnel in its routine operation, structural changes around the cracks are detected, thanks to their closing or opening due to slight pressure changes. By mapping the density of such microstructure changes in the bulk of the material, locating three pre-existing cracks is properly performed in three dimensions.

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Evolution of the three-dimensional collagen structure in vascular walls during deformation: an in situ mechanical testing under multiphoton microscopy observation

Biomechanics and Modeling in Mechanobiology ◽

10.1007/s10237-014-0630-4 ◽

2014 ◽

Vol 14 (4) ◽

pp. 693-702 ◽

Cited By ~ 6

Author(s):

Mathieu Nierenberger ◽

Guillaume Fargier ◽

Saïd Ahzi ◽

Yves Rémond

Keyword(s):

Mechanical Testing ◽

Multiphoton Microscopy ◽

Three Dimensional ◽

Collagen Structure ◽

Microscopy Observation ◽

Vascular Walls ◽

In Situ Mechanical Testing

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Results of Two Years Expenience with Fluorescence Bronchoscopy in Detection of Preinvasive Bronchial Neoplasia

Diagnostic and Therapeutic Endoscopy ◽

10.1155/dte.5.77 ◽

1999 ◽

Vol 5 (2) ◽

pp. 77-84 ◽

Cited By ~ 31

Author(s):

Ben J. W. Venmans ◽

Ton J. M. Van Boxem ◽

Egbert F. Smit ◽

Pieter E. Postmus ◽

Tom G. Sutedja

Keyword(s):

At Risk ◽

Patient Group ◽

Carcinoma In Situ ◽

Separate Analysis ◽

Predictive Values ◽

Neoplastic Lesions ◽

Preinvasive Lesions ◽

Bronchial Biopsies

The aim of the study was to determine whether use of fluorescence bronchoscopy improves the detection of preinvasive neoplastic bronchial lesions. The data of all patients who underwent fluorescence bronchoscopy and in whom bronchial biopsies were taken, were analyzed. Most patients were at risk for preinvasive lesions. A total of 174 bronchoscopies were performed in 95 patients. Of the 681 representative biopsies, 31 were found to be moderate dysplastic, 39 were found to be severe dysplastic and 9 exhibited carcinoma in situ. These 79 preinvasive lesions were found in 34 patients. The respective results of fluorescence bronchoscopy in addition to conventional bronchoscopy and of conventional bronchoscopy alone for detection of preinvasive lesions were: sensitivity 85% (67/79) and 59% (47/79); specificity 60% (351/581) and 85% (493/581); positive predictive values of 23% (67/297) and 35% (47/135); negative predictive values of 97% (351/363) and 94% (493/525). A separate analysis of only the first bronchoscopy of each patient showed similar results. Results of fluoresence bronchoscopy were better in the second part of the patient group. We conclude that after a learning period fluorescence bronchoscopy can increase the yield of finding preinvasive neoplastic lesions when used in addition to conventional bronchoscopy.

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