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32 Multispectral imaging allows real time dual-fluorescent guided cystoscopy in a preclinical model
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Multispectral imaging allows real time dual-fluorescent guided cystoscopy in a preclinical model Eur Urol Suppl 2016;15(3);e32
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Kriegmair M. 1 , Theuring M. 2 , Dimitriadis N.2 , Grychtol B. 2 , Deliolanis N.2 , Ritter M. 1 1 University
Medical Center Mannheim, Dept. of Urology, Mannheim, Germany, 2 Fraunhofer-Institut, Projektgruppe für Automatisierung In
Der Medizin und Biotechnologie, Mannheim, Germany INTRODUCTION & OBJECTIVES: Urothelial cancer of the bladder is the second most common urogenital malignancy. The majority of the detected tumours is non-muscle invasive and can be threatened by endoscopic resection. Photodynamic diagnosis (PDD) enables fluorescent-guided detection of cancerous lesions and consequently increases the detection rate resulting in deferred recurrence. A major drawback is that tumor resection in PDD mode is virtually not feasible due to the low emission of light. This could be solved by the employment of multispectral imaging displaying white light and PDD fluorescence images simultaneously. MATERIAL & METHODS: We used a multispectral LED light source to consecutively illuminate the bladder with fluorescence excitation and white (red, green and blue LEDs) light. Using a PCO edge 5.5 camera equipped with a multiband emission filter and a conventional endoscope with a 30° angled optic (Hopkins II KARL STORZ GmbH & Co. KG), we performed a cystoscopy of porcine bladders. Diluted fluorophores chlorin e6 (Apocare Pharma GmbH) and fluorescein (Fluoreszein SE Thilo, Novartis International AG) were injected with a flexible injection needle (Urotech GmbH). The corresponding peak excitation wavelength were 385 nm and 470 nm, respectively. RESULTS: Overall cystoscopy of three porcine bladders was performed. In each bladder the camera system allowed to identify both orifices within a short time. Submucosal injection of 1ml of the fluorophores was possible. Injected areas could be displayed by the respective fluorescent signal in all three cases. Using digital overlay, it is possible to simultaneously display in real time the white light image and the fluorescence signal on one screen. CONCLUSIONS: Multispectral endoscopy facilitates the simultaneous illustration of different fluorescence and white light images. This could enable displaying PDD fluorescing signals during a conventional white-light or narrow-band imaging cystoscopy. Further, the presented technology allows the simultaneous detection and visualization of multiple fluorophores, which might gain in importance for future diagnostic techniques.
Multispectral imaging allows real time dual-fluorescent guided cystoscopy in a preclinical model Eur Urol Suppl 2016;15(3);e32
Print! Print!
Kriegmair M. 1 , Theuring M. 2 , Dimitriadis N.2 , Grychtol B. 2 , Deliolanis N.2 , Ritter M. 1 1 University
Medical Center Mannheim, Dept. of Urology, Mannheim, Germany, 2 Fraunhofer-Institut, Projektgruppe für Automatisierung In
Der Medizin und Biotechnologie, Mannheim, Germany INTRODUCTION & OBJECTIVES: Urothelial cancer of the bladder is the second most common urogenital malignancy. The majority of the detected tumours is non-muscle invasive and can be threatened by endoscopic resection. Photodynamic diagnosis (PDD) enables fluorescent-guided detection of cancerous lesions and consequently increases the detection rate resulting in deferred recurrence. A major drawback is that tumor resection in PDD mode is virtually not feasible due to the low emission of light. This could be solved by the employment of multispectral imaging displaying white light and PDD fluorescence images simultaneously. MATERIAL & METHODS: We used a multispectral LED light source to consecutively illuminate the bladder with fluorescence excitation and white (red, green and blue LEDs) light. Using a PCO edge 5.5 camera equipped with a multiband emission filter and a conventional endoscope with a 30° angled optic (Hopkins II KARL STORZ GmbH & Co. KG), we performed a cystoscopy of porcine bladders. Diluted fluorophores chlorin e6 (Apocare Pharma GmbH) and fluorescein (Fluoreszein SE Thilo, Novartis International AG) were injected with a flexible injection needle (Urotech GmbH). The corresponding peak excitation wavelength were 385 nm and 470 nm, respectively. RESULTS: Overall cystoscopy of three porcine bladders was performed. In each bladder the camera system allowed to identify both orifices within a short time. Submucosal injection of 1ml of the fluorophores was possible. Injected areas could be displayed by the respective fluorescent signal in all three cases. Using digital overlay, it is possible to simultaneously display in real time the white light image and the fluorescence signal on one screen. CONCLUSIONS: Multispectral endoscopy facilitates the simultaneous illustration of different fluorescence and white light images. This could enable displaying PDD fluorescing signals during a conventional white-light or narrow-band imaging cystoscopy. Further, the presented technology allows the simultaneous detection and visualization of multiple fluorophores, which might gain in importance for future diagnostic techniques.