1000/1000
Hot
Most Recent
Fluorescence confocal microscopy (FCM) represents a novel diagnostic technique able to provide real-time histological images from non-fixed specimens. As a consequence of its recent developments, FCM is gaining growing popularity in urological practice.
Author | Year | Pat. (n.) | Setting | CFM System | Procedure | Se. (%) | Sp. (%) | PPV (%) | NPV (%) | Main Outcomes |
---|---|---|---|---|---|---|---|---|---|---|
Lee [22] | 2019 | 75 | In vivo | Cellvizio | TURB | 91.7 (mal. vs. ben.) 94.5 (LGUC vs. HGUC) 71.4 (CIS vs. IT) |
73.9 (mal. vs. ben.) 66.7 (LGUC vs. HGUC) 81.3 (CIS vs. IT) |
93.6 (mal. vs. ben.) 89.7 (LGUC vs. HGUC) 83.3 (CIS vs. IT) |
68.0 (mal. vs. ben.) 80.0 (LGUC vs. HGUC) 68.4 (CIS vs. IT) |
CLE represents a promising technology to provide real-time reliable diagnosis and grading of UC. Moreover, it might improve RFS. |
Lucas [23] | 2019 | 53 | In vivo | Cellvizio + AI- image analysis | TURB | NR | NR | NR | NR | CLE accuracy regarding malignant vs. benign tissue distinction was 79%, while the HGUC vs. LGUC differentiation accuracy was 82%. |
Liem [24] | 2018 | 53 | In vivo | Cellvizio | TURB | 76.0 (LGUC) vs. 70.0 (HGUC) | 76.0 (LGUC) vs. 69.0 (HGUC) | NR | NR | Concordance between CLE-based classification and final histopathology was found in 19 LGUC cases (76%), 19 HGUC cases (70%), and 4 benign lesion cases (29%). |
Chang [10] | 2013 | 31 | Ex vivo | NR | TURB | 50.0 (LGUC) vs. 75.0 (HGUC) | 94.0 (LGUC) vs. 64.0 (HGUC) | NR | NR | Novice CLE observers achieved a diagnostic accuracy comparable to WLC-images-only observation after a short training. An expert CLE observer achieved higher accuracy rates compared to WLC-image-only analysis. |
Author | Year | Pat. (n.) | Setting | CFM System | Surgery | Se. (%) | Sp. (%) | PPV (%) | NPV (%) | Main Outcomes |
---|---|---|---|---|---|---|---|---|---|---|
Prata [25] | 2023 | 46 | Ex vivo | VivaScope 2500 | ORC | 53.8 (vs. H&E) |
90.9 (vs. H&E) |
90.9 (vs. H&E) |
83.3 (vs. H&E) |
CFM showed similar results compared to frozen section analysis for ureteral margins evaluation. |
Sanguedolce [26] | 2021 | 7 | In vivo | Cellvizio | URS | 71.4 (total) 100.0 (HG lesions) |
57.1 (for HG lesions only) | NR | NR | Real time concordance with definitive histology in UTUC biopsy: 71.4% (5/7 cases) |
Villa [27] | 2016 | 11 | In vivo | Cellvizio | f-URS | NR | NR | NR | NR | CLE allows clear recognition of UTUC histological features. |
Bui [28] | 2015 | 14 | In vivo | Cellvizio | f-URS | NR | NR | NR | NR | CLE provided images of papillary structures, fibrovascular stalks, and pleomorphism. Lamina propria was identified in normal areas. |
Author | Year | Pat. (n.) | Setting | CFM System | Se. (%) | Sp. (%) | PPV (%) | NPV (%) | Main Outcomes |
---|---|---|---|---|---|---|---|---|---|
Gobbo [32] | 2023 | NR (75 biopsy slides) |
Biopsy | VivaScope | NR | NR | NR | NR | Almost complete agreement was obtained for ISUP/WHO grade group I, IV, and V (k = 0.85). For the remaining noncancer stains, agreement was nearly complete (k = 0.81). |
Marenco [8] | 2020 | 57 biopsy-naive men | Biopsy | VivaScope | NR | NR | 85.0 (biopsy core) 83.8 (ROI level) |
95.1 (biopsy core) 85.7 (ROI level) |
CFM and H&E concordance was evaluated on the biopsy core and ROI level; Cohen’s k for agreement between the techniques was 0.81 for the biopsy core level and 0.69 for the ROI level. The PPV and NPV were high at biopsy core and ROI levels. |
Rocco [33] | 2020 | 8 | Surgical margins (periprostatic tissue) during RP | Vivascope | NR | NR | NR | NR | 7/8 patients had overall negative SM in the sampled areas. The agreement between CFM and H&E in regard to the discrimination between cancerous and noncancerous tissue was 100%. |
Puliatti [14] | 2019 | 13 | Biopsy (on RP surgical specimen) |
VivaScope | 83.3 | 93.5 | NR | NR | The overall diagnostic agreement between CFM and histopathological diagnoses was substantial with 91% correct diagnosis and an AUC of 0.884 (95% CI 0.840–0.920). |
Author | Year | Pat. (n.) | Setting | CFM System | Se. (%) | Sp. (%) | PPV (%) | NPV (%) | Main Outcomes |
---|---|---|---|---|---|---|---|---|---|
Mir [7] | 2020 | 4 | Ex vivo | VivaScope 2500 | NR | NR | NR | NR | Neoplastic and noncancer tissues were both detected in 100% of cases through CFM images analysis (one oncocytoma and three RCC). CFM images showed strong overlapping with traditional H&E-stained samples regarding cytoarchitectural features. |
Liu [34] | 2016 | 19 | Ex vivo | VR-SIM | 79.2 | 95.1 | 82.6 | 90.7 | CFM diagnostical outcomes were compared to traditional H&E staining; final accuracy was 89.2%. |
Su [16] | 2015 | 20 | Ex vivo | Cellvizio | NR | NR | NR | NR | CLE imaging properly evaluates normal renal parenchymal features. It allows a rapid distinction between cancer and normal tissue, as well as the possibility to distinguish between benign and malignant ones. Enhanced CLE images resolution was provided by topical fluorescein rather than by IV route administration. |