The impact of real-time 3d imaging by ultra-high speed optical coherence tomography in urothelial carcinoma

BACKGROUND Optical coherence tomography (OCT) has become a promising diagnostic tool in many medical fields. In particular, noninvasive real-time optical biopsy of internal organs is one of the most attractive applications of OCT, enabling in situ diagnosis of carcinoma at an early stage. We used an ultra-high speed OCT system for real-time three-dimensional (3D) imaging of three excised specimens of advanced urothelial carcinoma (UC) and investigated the association of the images with results from histopathological examination. CASE PRESENTATIONS Case 1 was a 69-year-old man underwent radical cystectomy for muscle-invasive UC (pT2). Case 2 was a 53-year-old man underwent laparoscopic nephroureterectomy and partial cystectomy for left ureter carcinoma (pT2) and case 3 was a 77-year-old woman underwent radical cystectomy for advanced bladder carcinoma (pT3b). Real-time 3D OCT images of normal bladder wall and ureter showed three layers, including the urothelium, lamina propria, and muscularis layer. In contrast, normal structure was not seen in the muscle-invasive UC area or the scar tissue area. CONCLUSIONS This study highlighted a new diagnostic method with potential application for UC diagnosis. We will investigate more cases in the future and expect improvement in the diagnosing efficiency of carcinoma in situ or organ-confined muscle-invasive cancer by cystoscopy or ureteroscopy with ultra-high speed OCT.