Three-dimensional imaging of ureter with endoscopic optical coherence tomography.
OBJECTIVE
To verify the ability to identify the layered structures of the ureteral wall and to image a segment of the ureter in 3 dimensions with high-speed, endoscopic optical coherence tomography (EOCT).


METHODS
We imaged a porcine ureter ex vivo using a spectral-domain EOCT with a specially designed circumferential scanning fiber catheter. The images were correlated with the histologic findings to identify the corresponding structures. Three-dimensional images and en face images at different depths from the luminal surface were reconstructed from the multiple cross-sectional images to visualize the layered structure of a segment of the ureter from different perspectives.


RESULTS
The EOCT images clearly revealed all layers of the ureteral wall as shown in the histologic images. In particular, with the specially designed fiber catheter, the light beam was well centered during the rotation and pull back, allowing constant acquisition of high-fidelity images and unambiguous identification of the smooth muscle layers in all images. With high-speed EOCT, a segment of ureter (20 mm) can be imaged in <90 seconds at a high resolution.


CONCLUSIONS
With its ability to visualize all layers of the ureteral wall, EOCT offers the potential to stage urothelial cancers that have infiltrated the muscular wall (Stage T2). This information will be complimentary to the diagnostic information obtained through ureteroscopic biopsy and computed tomography urogram.
Department of Biomedical Engineering, Case Western Reserve University, Cleveland, Ohio 44106 OH, USA. hxw26@case.edu
Hui
H
Wang
Wei
W
Kang
Hui
H
Zhu
Gregory
G
MacLennan
Andrew M
AM
Rollins
D000818:Animals; D005260:Female; D021621:Imaging, Three-Dimensional; D013552:Swine; D041623:Tomography, Optical Coherence; D014513:Ureter / Q000033:anatomy & histology*; D018666:Ureteroscopy
Opt Express. 2003 Dec 29;11(26):3598-604
19471496
Int J Urol. 2003 Dec;10(12):627-30
14633064
Eur Urol. 2009 Dec;56(6):914-9
19674831
Int Braz J Urol. 2004 Mar-Apr;30(2):96-101
15703087
Radiographics. 2005 Nov-Dec;25(6):1609-27
16284138
Eur Urol. 2005 Sep;48(3):438-44
16115524
Nat Clin Pract Urol. 2007 Aug;4(8):432-43
17673914
Eur Urol. 2008 Apr;53(4):720-31
18207315
Clin Exp Ophthalmol. 2009 Jan;37(1):90-9
19338607
Adv Urol. 2009;:620604
19132098
Indian J Urol. 2008 Apr;24(2):159-63
19468390
Urology. 2009 Dec;74(6):1351-7
19660795
Eur Radiol. 2006 Oct;16(10):2259-64
16572332
BJU Int. 2007 May;99(5):973-7
17437428
J Endourol. 2001 Feb;15(1):67-74
11248923
Urology. 2009 Jun;73(6):1388-91
19362349
JACC Cardiovasc Interv. 2009 Nov;2(11):1035-46
19926041
Urology. 2008 Jul;72(1):133-7
18598789
Urology. 2004 Apr;63(4):647-50; discussion 650
15072870