Bladder cancer detection by fluorescence imaging with Hexvix: optimization of the excitation light during high magnification cystoscopy

Blaise Lovisa; Patrice Jichlinski; Daniela Aymon; Bernd-Claus Weber; Hubert van den Bergh; Georges Wagnières

doi:10.1117/12.831565

7 July 2009 Bladder cancer detection by fluorescence imaging with Hexvix: optimization of the excitation light during high magnification cystoscopy

Blaise Lovisa, Patrice Jichlinski, Daniela Aymon, Bernd-Claus Weber, Hubert van den Bergh, Georges Wagnières

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Proceedings Volume 7368, Clinical and Biomedical Spectroscopy; 73681I (2009) https://doi.org/10.1117/12.831565
Event: European Conferences on Biomedical Optics, 2009, Munich, Germany

Abstract

Fluorescence cystoscopy has been recently acknowledged as a useful method to detect early superficial bladder cancer, even flat lesions. After the instillation of hexaminolevulinic acid (Hexvix®) in the bladder for about an hour, photoactivable porphyrins (PaP), mainly protoporphyrin IX (PpIX) accumulate in the cancerous cells. Although we observe a selective production of PpIX and an outstanding sensitivity of this method, false positive (FP) lesions negatively impact its specificity. Carcinogenesis often combines with angiogenesis, and thus changes in vascular architecture. Therefore, the visualization of the vascular modifications on the fluorescence positive sites is likely to differentiate false and true positive (TP). New methods including high magnification (HM) cystoscopy are being investigated by our group, and will yield a reduced number of biopsies and a better characterization of the fluorescence positive sites. In this study, we are using a dedicated rigid cystoscope, allowing conventional magnification during "macroscopic" observation, as well as image acquisition with HM when the endoscope is in contact with the tissue. Each observed site is biopsied and described by histopathological analysis. The vascular organization (tortuosity, vascular loops, vascular area and diameter) of the fluorescence positive sites was characterized in situ. Intrinsic contrast between the vessels and the tissue was enhanced with an optimization of the spectral design. Preliminary results are presented here.

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Blaise Lovisa, Patrice Jichlinski, Daniela Aymon, Bernd-Claus Weber, Hubert van den Bergh, and Georges Wagnières "Bladder cancer detection by fluorescence imaging with Hexvix: optimization of the excitation light during high magnification cystoscopy", Proc. SPIE 7368, Clinical and Biomedical Spectroscopy, 73681I (7 July 2009); https://doi.org/10.1117/12.831565

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KEYWORDS

Luminescence

Cystoscopy

Bladder

Endoscopy

Bladder cancer

Optical filters

Endoscopes

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