Clinical significance of multispectral imaging in cystoscopic examination / 中华泌尿外科杂志

ABSTRACT

Objective To explore the imaging characteristics and clinical value of multispectral cystoscopy.Methods From May 2011 to May 2013,31 male and 4 female patients were included in this study,including benign prostatic hyperplasia in 14 patients,bladder tumor in 16 patients,upper urinary tract disease alone in 5 patients.The mean age in this group was 56 years (range 43 to 84 years).All patients accepted the bladder CT scan for diagnosis.TURBT procedure and pathological examination were performed in those patients with bladder tumor.Under the epidural anesthesia,the 27 F resectoscope was inserted to bladder through the urethra.Then,the conventional light source was replaced by multispectral endoscope light source.The white light,UV-light (401.0 nm),blue light (467.6 nm),green light (534.2nm),red light (660.6 nm),and near-infrared light (763.8 nm) were used,subseqently.Meanwhile,the following data were recorded,such as the visibility of bladder cavity,the color of bladder tumors and bladder mucosa,the density of blood vessels,three-dimensional structure of blood vessels,the mobility between mucosa and submucosa.Results When UV-light and near-infrared light irradiated bladders,there were not any imaging on monitor.However,the bladder mucosa and submucosa blood vessels were showed clearly and constituted the three-dimensional blood vessel network when using green light.The density of blood vessels in mucosal and submucosal layer was increased but less clarity when using blue light.The mucosal surface was covered in red when using red light,which vascular and mucosal can not able to be distinguished.Among 16 patients who were accepted the TURBT procedure,seven cases with T1 stage tumors were resected to the submucosa by TURBT.The superficial muscle layer with integrity structure could be observed under white light.While,blood vessels were not appeared when using green light.In six cases with Ta stage tumors,the clear connection of blood spots between mucous blood vessels and the blood vessel from the tumor could be observed under the green-light conditions.In three patients with Tis stage tumors,the mucosal blood vessels were normal under the white-light after tumor resection.However,structural disorder could be found under the green-light,which should be highly suspected as Tis stage tumors.Conclusions Without any photosensitizer or fluorescent dye,tumor blood vessels and bladder mucosal vascular can be showed under the green light.This technique is useful for identify the minimal tumor and evaluate the carcinoma infiltrated depth.