Baard Joyce, Freund Jan Erik, de la Rosette Jean J M C H, Laguna Maria P
Department of Urology, Academic Medical Center, Amsterdam, The Netherlands.
Curr Opin Urol. 2017 Mar;27(2):170-175. doi: 10.1097/MOU.0000000000000373.
Image enhancement techniques and optical diagnostic tools have emerged in the quest to improve diagnostics and treatment in patients with upper urinary tract carcinoma (UTUC). The aim of the present report is to describe their mechanisms of action and to assess the current evidence on applicability and utility in UTUC.
Image enhancement techniques including narrow band imaging, Image1 S, and photodynamic diagnosis aim at better visualization of malignant urothelium and especially flat tumours or carcinoma in situ which are often difficult to see with white light endoscopy. Conducted studies in the upper tract are scarce but first results show that tumour detection seems to be better for narrow band imaging and photodynamic diagnosis-guided inspection.Optical diagnostic tools as confocal laser endomicroscopy and optical coherence tomography aim at providing real time optical biopsies giving pathologic information. A pilot study of optical coherence tomography proved its feasibility to visualize, grade and stage low and high-grade UTUC.
Better visualization of suspect lesions and optical diagnostic techniques providing real time optical biopsies aim to facilitate in higher diagnostic precision and optimal individualized treatment of our patients with UTUC. As the disease is rare, studies are scarce but indispensable for future implication of these techniques.
在寻求改善上尿路癌（UTUC）患者的诊断和治疗过程中，图像增强技术和光学诊断工具应运而生。本报告的目的是描述它们的作用机制，并评估目前关于其在UTUC中的适用性和效用的证据。
包括窄带成像、Image1 S和光动力诊断在内的图像增强技术旨在更好地显示恶性尿路上皮，尤其是扁平肿瘤或原位癌，而这些在白光内镜检查中往往难以看清。在上尿路进行的研究很少，但初步结果表明，窄带成像和光动力诊断引导检查的肿瘤检测效果似乎更好。光学诊断工具如共聚焦激光内镜显微镜和光学相干断层扫描旨在提供实时光学活检，给出病理信息。一项光学相干断层扫描的初步研究证明了其对低级别和高级别UTUC进行可视化、分级和分期的可行性。
更好地显示可疑病变以及提供实时光学活检的光学诊断技术旨在提高我们UTUC患者的诊断精度和实现最佳个体化治疗。由于该疾病罕见，研究很少，但这些技术对未来的应用不可或缺。
