Transurethral resections are commonly used for bladder cancer diagnosis, treatment and follow-up. Cancer staging relies
largely on the analysis of muscle in the resections; however, muscle presence is uncertain at the time of the resection. An
extemporaneous quality control tool would be of great use to certify the presence of muscle in the resection, and
potentially formulate a primo-diagnosis, in order to ensure optimum patient care. Full-field optical coherence
tomography (FFOCT) offers a fast and non-destructive method of obtaining images of biological tissues at ultrahigh
resolution (1μm in all 3 directions), approaching traditional histological sections. This study aimed to evaluate the
potential of FFOCT for the quality control and the primo-diagnosis of transurethral bladder resections. Over 70
transurethral bladder resections were imaged with FFOCT within minutes, shortly after excision, and before histological
preparation. Side-by-side comparison with histology allowed to establish reading criteria for the presence of muscle and
cancer in particular. Images of 24 specimens were read blindly by three non-pathologists readers: two resident urologists
and a junior bio-medical engineer, who were asked to notify the presence of muscle and tumor. Results showed that after
appropriate training, 96% accuracy could be obtained on both tumour and muscle detection. FFOCT is a fast and nondestructive
imaging technique that provides analysis results concordant with histology. Its implementation as a quality
control and primo-diagnosis tool for transurethral bladder resections in the urology suite is feasible and lets envision high
value for the patient.
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