title: Dynamic real-time microscopy of the urinary tract using confocal laser endomicroscopy.
abstract: OBJECTIVE
  To develop the diagnostic criteria for benign and neoplastic conditions of the urinary tract using probe-based confocal laser endomicroscopy (pCLE), a new technology for dynamic, in vivo imaging with micron-scale resolution. The suggested diagnostic criteria will formulate a guide for pCLE image interpretation in urology.
  
  
  METHODS
  Patients scheduled for transurethral resection of bladder tumor (TURBT) or nephrectomy were recruited. After white-light cystoscopy (WLC), fluorescein was administered as contrast. Different areas of the urinary tract were imaged with pCLE via direct contact between the confocal probe and the area of interest. Confocal images were subsequently compared with standard hematoxylin and eosin analysis.
  
  
  RESULTS
  pCLE images were collected from 66 participants, including 2 patients who underwent nephrectomy. We identified key features associated with different anatomic landmarks of the urinary tract, including the kidney, ureter, bladder, prostate, and urethra. In vivo pCLE of the bladder demonstrated distinct differences between normal mucosa and neoplastic tissue. Using mosaicing, a post hoc image-processing algorithm, individual image frames were juxtaposed to form wide-angle views to better evaluate tissue microarchitecture.
  
  
  CONCLUSIONS
  In contrast to standard pathologic analysis of fixed tissue with hematoxylin and eosin, pCLE provides real time microscopy of the urinary tract to enable dynamic interrogation of benign and neoplastic tissues in vivo. The diagnostic criteria developed in this study will facilitate adaptation of pCLE for use in conjunction with WLC to expedite diagnosis of urinary tract pathology, particularly bladder cancer.
authors: Department of Urology, Stanford Cancer Center, Stanford University School of Medicine, Stanford, California 94305-5118, USA.
authors: Katherine
authors: K
authors: Wu
authors: Jen-Jane
authors: JJ
authors: Liu
authors: Winifred
authors: W
authors: Adams
authors: Geoffrey A
authors: GA
authors: Sonn
authors: Kathleen E
authors: KE
authors: Mach
authors: Ying
authors: Y
authors: Pan
authors: Andrew H
authors: AH
authors: Beck
authors: Kristin C
authors: KC
authors: Jensen
authors: Joseph C
authors: JC
authors: Liao
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