Multiphoton microscopy in the evaluation of human bladder biopsies.

TitleMultiphoton microscopy in the evaluation of human bladder biopsies.
Publication TypeJournal Article
Year of Publication2012
AuthorsJain M, Robinson BD, Scherr DS, Sterling J, Lee M-M, Wysock J, Rubin MA, Maxfield FR, Zipfel WR, Webb WW, Mukherjee S
JournalArch Pathol Lab Med
Volume136
Issue5
Pagination517-26
Date Published2012 May
ISSN1543-2165
KeywordsAdult, Biopsy, Early Detection of Cancer, Female, Humans, Image Interpretation, Computer-Assisted, Male, Microscopy, Fluorescence, Multiphoton, Sensitivity and Specificity, Urinary Bladder Neoplasms
Abstract

CONTEXT: Multiphoton microscopy (MPM) is a nonlinear imaging approach, providing cellular and subcellular details from fresh (unprocessed) tissue by exciting intrinsic tissue emissions. With miniaturization and substantially decreased cost on the horizon, MPM is an emerging imaging technique with many potential clinical applications.

OBJECTIVES: To assess the imaging ability and diagnostic accuracy of MPM for human bladder biopsies.

DESIGN: Seventy-seven fresh bladder biopsies were imaged by MPM and subsequently submitted for routine surgical pathology diagnosis. Twelve cases were excluded because of extensive cautery artifact that prohibited definitive diagnosis. Comparison was made between MPM imaging and gold standard sections for each specimen stained with hematoxylin-eosin.

RESULTS: In 57 of 65 cases (88%), accurate MPM diagnoses (benign or neoplastic) were given based on the architecture and/or the cytologic grade. The sensitivity and specificity of MPM in our study were 90.4% and 76.9%, respectively. A positive (neoplastic) diagnosis on MPM had a high predictive value (94%), and negative (benign) diagnoses were sustained on histopathology in two-thirds of cases. Architecture (papillary versus flat) was correctly determined in 56 of 65 cases (86%), and cytologic grade (benign/low grade versus high grade) was assigned correctly in 38 of 56 cases (68%).

CONCLUSIONS: The MPM images alone provided sufficient detail to classify most lesions as either benign or neoplastic using the same basic diagnostic criteria as histopathology (architecture and cytologic grade). Future developments in MPM technology may provide urologists and pathologists with additional screening and diagnostic tools for early detection of bladder cancer. Additional applications of such emerging technologies warrant exploration.

DOI10.5858/arpa.2011-0147-OA
Alternate JournalArch Pathol Lab Med
PubMed ID22540300
Grant ListP41 RR04224 / RR / NCRR NIH HHS / United States
1 KL2 RR024997-01 / RR / NCRR NIH HHS / United States
1R01 EB006736 / EB / NIBIB NIH HHS / United States
Related Faculty: 
Brian Robinson, M.D.

Pathology & Laboratory Medicine 1300 York Avenue New York, NY 10065 Phone: (212) 746-6464
Surgical Pathology: (212) 746-2700