By Joseph C. Liao, Li-Ming Su
This ebook presents an summary of the present state-of-art in combining advances in biomedical imaging with intraoperative navigation and preoperative making plans for urologic surgical procedure. those advances carry nice promise in enhancing diagnostic and healing urologic interventions to enhance sufferer results. top specialists during this intriguing rising box covers early scientific and pre-clinical functions of optical, ultrasound, cross-sectional and computer-assisted imaging in urologic surgery.
Advances in Image-Guided Urologic Surgery presents a special and precious source for viewers with medical and examine curiosity in minimally invasive surgical procedure, endourology, urologic oncology, imaging and biomedical engineering.
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Additional info for Advances in Image-Guided Urologic Surgery
7 Carcinoma in situ visualized on WLI (left) appears more extensive by NBI (brown-black lesions) cystoscopy (right). Wide transurethral resection around visible lesions confirmed extensive carcinoma in situ (From Herr , with permission) Carcinoma in situ urine cytology, indicating carcinoma in situ (CIS), and additional biopsies have not led to increased toxicity. Negative tumor margins of suspicious lesions indicated by NBI also confirm a complete resection. 2 shows NBI enhances detection of biopsy-proved carcinoma in situ.
The first and only report shows in 27 patients that NBI ureteroscopy improved tumor detection rate involving the upper tracts by 23 % over WLI ureteroscopy . Further, five additional tumors were found in four patients (14 %). We have used NBI ureteroscopy to detect and verify complete TUR and fulguration of upper tract urothelial tumors in over 20 cases. Further investigations are needed before NBI ureteroscopy can be advocated in daily clinical practice. Conclusions NBI cystoscopy has become integrated into clinical practice to evaluate and manage bladder tumors.
Studies on sensitivity and specificity of OCT on real time classifying bladder lesions as benign or malignant show high overall sensitivity of 100 %, overall specificity of 89 %, positive predictive value of 75 %, negative predictive value of 100 % and an accuracy of 92 % . Positive predictive value for invasion into the lamina propria was 90 % . 1) but also suggest that disruptions of the bladder wall from erosion, scarring or granuloma could result in falsepositive results [15, 16]. In addition, for large tumours with extensive broadened urothelium, tumour depth will transcend OCT imaging depth and compromise the staging ability of OCT.