Kriegmair M C, Hein S, Schoeb D S, Zappe H, Suárez-Ibarrola R, Waldbillig F, Gruene B, Pohlmann P-F, Praus F, Wilhelm K, Gratzke C, Miernik A, Bolenz C
Klinik für Urologie, Universitätsmedizin Mannheim, Medizinische Fakultät Mannheim der Universität Heidelberg, Heidelberg, Deutschland.
Medizinische Fakultät, Klinik für Urologie, Sektion Urotechnologie, Universitätsklinikum Freiburg, Freiburg, Deutschland.
Urologe A. 2021 Jan;60(1):8-18. doi: 10.1007/s00120-020-01400-9. Epub 2020 Dec 10.
White light cystoscopy and the concise documentation of pathological findings are standard diagnostic procedures in urology. Additional imaging modalities and technical innovations may support clinicians in the detection of bladder tumors. Modern endoscopy systems provide ultra-high-resolution imaging and the option of digital contrast enhancement. Photodynamic diagnostics and narrow band imaging are well-established in clinical routine and have shown significant benefits in the detection of bladder cancer. By means of multispectral imaging, different modalities can now be combined in real-time. Probe-based procedures such as optical coherence tomography (OCT) or Raman spectroscopy can further contribute to advanced imaging through an "optical biopsy" which may primarily improve diagnostics in the upper urinary tract. The aim of all techniques is to optimize the detection rate in order to achieve a more accurate diagnosis, resection and lower recurrence rates. Current research projects aim to digitalize the documentation of endoscopy and also make it more patient- and user-friendly. In the future, the use of image processing and artificial intelligence may automatically support the surgeon during endoscopy.
白光膀胱镜检查及对病理结果的精确记录是泌尿外科的标准诊断程序。其他成像方式和技术创新可能有助于临床医生检测膀胱肿瘤。现代内窥镜系统提供超高分辨率成像以及数字对比增强选项。光动力诊断和窄带成像在临床常规中已得到广泛应用,并且在膀胱癌检测中显示出显著优势。借助多光谱成像,现在可以实时组合不同的成像方式。基于探头的程序,如光学相干断层扫描(OCT)或拉曼光谱,可以通过“光学活检”进一步促进先进成像,这可能主要改善上尿路的诊断。所有技术的目标都是优化检测率,以实现更准确的诊断、切除并降低复发率。当前的研究项目旨在将内窥镜检查的记录数字化,并使其对患者和用户更加友好。未来,图像处理和人工智能的应用可能在内窥镜检查期间自动辅助外科医生。