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Master Thesis

L’imagerie multiphotonique comme outil de diagnostic de la profondeur d’une résection de tumeur de vessie : résultats d’une étude préliminaire de faisabilité

Abstract : Background: multiphoton microscopy (MPM) is a non-linear optical imaging technology, allowing process-free imaging of fresh tissue up to a depth of 0.5 mm, with a combined signal of autofluorescence (AF) and second harmonic generation (SHG). The absence of bladder muscle in a Trans-urethral resection of bladder tumor (TURBT) increases the risk of residual disease, recurrence and understaging, and an intra-operative assessment of resection depth and margins may avoid unnecessary second TURBT.
Objective: to test the feasibility of multiphoton microscopy in the detection of bladder muscle in cold cup biopsies of patients undergoing TURBT, as a real-time imaging tool.
Methods: prospective feasibility study. Cold cup biopsies were taken intra-operatively from the resection bed during TURBT. Tissue was stored inphosphate buffered solution (PBS) solution combined with fluorescent dyes (orange acridine and rhodamine). MPM Imaging of the tissue was done first, with z stack images of 100 micrometer maximum depth for 3D imaging. After MPM imaging, tissue was fixed in formalin and sent to the biorepository for standard histopathology. A correlation analysis was performed between MPM tissue detection and final histopathology results.
Results: 10 patients were included in this pilot study. Tissue was properly imaged for all patients, although 3 of them had artifacts. MPM average procedure time from biopsy to formalin fixation was 16.2 minutes (12-20 min). The first layer seen on cold cup biopsy after resection using MPM was muscularis propria for 5 patients out of 10. On final pathology, resection depth was correctly performed for only 4 patients out of 10 (resection including bladder muscle). We found an 80 % sensibility on resection depth between first layer identified on MPM and final pathology (8/10 patients), and 100% correlation with final histopathology in specimens for the assessment of detrusor muscle.
Conclusions: this study supports the use of MPM as a novel intra operative tool which can evaluate cold cup biopsies during TURBT for resection depth, and potentially avoid unnecessary second look procedures.
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Master Thesis
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https://dumas.ccsd.cnrs.fr/dumas-03510298
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Submitted on : Tuesday, January 4, 2022 - 2:35:47 PM
Last modification on : Wednesday, February 9, 2022 - 3:19:00 AM

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Patrick-Julien Treacy. L’imagerie multiphotonique comme outil de diagnostic de la profondeur d’une résection de tumeur de vessie : résultats d’une étude préliminaire de faisabilité. Médecine humaine et pathologie. 2020. ⟨dumas-03510298⟩

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