Mieke Bus

37 3 Table 1: Overview of five optical techniques, microscopy and white light ureterorenoscopy. optical principle aim stage of research maximal imaging depth advantage limitations OCT scattering real time information on pathohistological diagnosis human ureter in vivo 2-3mm information on tumour grade and stage, suitable for screening purposus of complete ureter diminished imaging depth range NBI absorption improved visualisation of tumours human ureter in vivo na improved tumour detection, no need of additional agents high rate of false positives (on bladder urothelium) SPIES absorption improved visualisation of tumours human ureter in vivo trial starting na improved tumour detection, no need of additional agents high rate of false positives (on bladder urothelium) PDD fluorescence improved visualisation of tumours human ureter in vivo na improved tumour detection administration of fluorescence agents needed, high rate of false positives CLE absorption/ reflection real time information on pathohistological diagnosis human ureter ex vivo 400 µm in vivo microscopy with high resolution images sensitivity to tissue movement Microscopy absorption/ reflection pathohistological diagnosis 20 µm high resolution, gold standard no real time information White light URS visualisation of urothelium na visualisation of tumours, treatment and biopsies in same session possible CIS lesions are easily missed, biopsies are often inconclusive, no real time information on tumour grade and stage OCT: Optical Coherence Tomography, NBI: Narrow Band Imaging, SPIES: Storz Professional Image Enhancement System, PDD: Photodynamic Diagnosis, CLE: Confocal Laser Endomicroscopy. NBI, SPIES and PDD have previously demonstrated a high rate of false positives on bladder urothelium. Future research should reveal if this high rate of false positives is also found in the upper urinary tract.