This study provides the characteristic optical coherence tomography pattern of nonproliferative and proliferative inflammation, and the characteristic appearance of severe dysplasia and transitional cell carcinoma. This technique may be useful as a guide for biopsy and for assisting in establishing resection margins.

The capabilities of cross-polarization optical coherence tomography (CP OCT) for early bladder-cancer detection are assessed in statistical study and compared with the traditional OCT. Unlike the traditional OCT that demonstrates images only in copolarization, CP OCT acquires images in cross-polarization and copolarization simultaneously. 116 patients with localized flat suspicious lesions in the bladder were enrolled, 360 CP OCT images were obtained and analyzed. CP OCT demonstrated sensitivity 93.7% (vs. 81.2%, <0.0001), specificity 84% (vs. 70.0%, <0.001) and accuracy 85.3% (vs. 71.5%, <0.001) in detecting flat malignant bladder lesions, which is significantly better than with the traditional OCT. Higher diagnostic efficacy of CP OCT in detecting early bladder cancer is associated with the ability to detect changes in epithelium and connective tissues.

The combined use of fluorescence cystoscopy and cross-polarization optical coherence tomography (CP OCT) with quantitative estimation of the OCT signal was assessed in 92 bladder zones. It demonstrated the diagnostic accuracy in detecting superficial bladder cancer of 93.6%, sensitivity 96.4%, specificity 92.1%, positive predictive value 87% and negative predictive value 97.9%. Quantitative estimation of OCT signal standard deviation in cross-polarization (CP OCT SD index) makes the visual criteria of CP OCT image assessment more objective. The level of CP OCT SD index for diagnosing superficial bladder cancer, including cancer in situ, was 4.32 dB and lower. When tumor is located on a postoperative scar, CP OCT SD index may be higher than the threshold level of 4.32 dB due to strong scattering and depolarization in scar fibrous tissue. A high inverse correlation was found between CP OCT SD index and the level expressed by p63, Ki-67, p53, CD44v6 markers.

This study provides the characteristic optical coherence tomography pattern of nonproliferative and proliferative inflammation, and the characteristic appearance of severe dysplasia and transitional cell carcinoma. This technique may be useful as a guide for biopsy and for assisting in establishing resection margins.

The aim of the study is to demonstrate the potential of cross-polarization optical coherence tomography (CP OCT) as a minimally invasive real-time technique for detection of bladder cancer against a background of severe inflammation.Materials and Methods. For the verification of CP OCT diagnostic data related to the condition of collagen comparison with highresolution microscopy inspection was performed and correlation of the results was calculated. The CP OCT study was performed on samples of tissue with muscle-invasive urothelial carcinoma T 2-3 N 0-х M 0 (G2, 3) in 18 patients ranging in age from 50 to 64 obtained in course of cystectomy with urine diversion into the intestinal vessel. In total, 60 regions of interest were selected and divided into four groups in accordance with the results of the histological analysis: areas with mild inflammation (group 1, control), 12 areas; areas with severe inflammation (group 2), 18 areas; areas with poorly differentiated urothelial carcinoma with invasion into the muscular layer (group 3), 24 areas; areas with cancer recurrence at the post-operative scar (group 4), 6 areas. Tissue changes at micro-structural level registered by CP OCT were investigated in detail with high-resolution microscopy (nonlinear microscopy and atomic force microscopy). Quantitative processing of all the obtained images enabled their direct comparison.