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World Journal of Urology

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Open Access 01-11-2019 | Urothelial Cancer | Topic Paper

Volumetric imaging: a potential tool to stage upper tract urothelial carcinoma

Authors: Alexandra Grahn, Nobuyuki Tanaka, Per Uhlén, Marianne Brehmer

Published in: World Journal of Urology | Issue 11/2019

Abstract

Purpose

To investigate whether volumetric imaging of tumor vasculature can be used to phenotypically characterize advanced upper tract urothelial carcinoma, and if this technique can distinguish aggressive invasive tumors from non-aggressive superficial ones.

Methods

In a pilot study, two TaG1 and two T3G3 formalin-fixed paraffin-embedded (FFPE) tumor samples were examined using the DIPCO pipeline (Tanaka et al. in Nature Biomed Eng 1(10):796–806. https://doi.org/10.1038/s41551-017-0139-0, 2017). Briefly, punch biopsies of FFPE tumors were deparaffinized, cleared, immunolabeled with the vessel marker CD34 and imaged with a light-sheet microscope. Thereafter, the three-dimensional (3D) vasculature of the tumors was analyzed and characterized using a specialized image processing software.

Results

We found that T3G3 tumors had increased CD34 density kurtosis and skewness compared to TaG1 tumors. This suggests that analysis of the 3D vasculature can distinguish between high-grade invasive and low-grade superficial tumors.

Conclusions

Volumetric imaging of tumor samples may represent novel methodology that can complement conventional histopathology. Volumetric imaging enabled us to differentiate between invasive and non-invasive upper tract urothelial carcinoma. The method is of particular interest in diagnostic work-up of patients with upper tract urothelial carcinoma as previous findings indicate that volumetric imaging of vascular patterns could be used to differentiate superficial and invasive urothelial carcinoma, irrespective of if the tumor sample was deep or superficial. However, further and more extensive studies are required before this method can be applied clinically.

Tanaka N, Kanatani S, Tomer R, Sahlgren C, Kronqvist P, Kaczynska D, Uhlén P et al (2017) Whole-tissue biopsy phenotyping of three-dimensional tumours reveals patterns of cancer heterogeneity. Nature Biomed Eng 1(10):796–806. https://doi.org/10.1038/s41551-017-0139-0 CrossRef

Rouprêt M, Babjuk M, Compérat E, Zigeuner R, Sylvester RJ, Burger M, Shariat SF et al (2018) European association of urology guidelines on upper urinary tract urothelial carcinoma: 2017 update. Eur Urol 73(1):111–122. https://doi.org/10.1016/j.eururo.2017.07.036 CrossRefPubMed

Seisen T, Peyronnet B, Dominguez-Escrig JL, Bruins HM, Yuan CY, Babjuk M, Rouprêt M et al (2016) Oncologic outcomes of kidney-sparing surgery versus radical nephroureterectomy for upper tract urothelial carcinoma: A systematic review by the EAU non-muscle invasive bladder cancer guidelines panel. Eur Urol 70(6):1052–1068. https://doi.org/10.1016/j.eururo.2016.07.014 CrossRefPubMed

Villa L, Haddad M, Capitanio U, Somani BK, Cloutier J, Doizi S, Traxer O et al (2018) Which patients with upper tract urothelial carcinoma can be safely treated with flexible ureteroscopy with holmium:YAG laser photoablation? Long-Term results from a high volume institution. J Urol 199(1):66–73. https://doi.org/10.1016/j.juro.2017.07.088 CrossRefPubMed

Scotland KB, Kleinmann N, Cason D, Hubbard L, Tanimoto R, Healy KA, Bagley DH et al (2018) Ureteroscopic management of large ≥ 2 cm upper tract urothelial carcinoma: a comprehensive twenty-three year experience. Urology. https://doi.org/10.1016/j.urology.2018.05.042 CrossRef

Elawdy MM, Taha DE, Elbaset MA, Abouelkheir RT, Osman Y (2016) Histopathologic characteristics of upper tract urothelial carcinoma with an emphasis on their effect on cancer survival: a single-institute experience with 305 patients with long-term follow-up. Clin Genitourinary Cancer 14(6):e609–e615. https://doi.org/10.1016/j.clgc.2016.04.017 CrossRef

Grahn A, Melle-Hannah M, Malm C, Jäderling F, Radecka E, Beckman M, Brehmer M (2017) Diagnostic accuracy of computed tomography urography and visual assessment during ureterorenoscopy in upper tract urothelial carcinoma. BJU Int 119(2):289–297. https://doi.org/10.1111/bju.13652 CrossRefPubMed

Baard J, de Bruin DM, Zondervan PJ, Kamphuis G, de la Rosette J, Laguna MP (2017) Diagnostic dilemmas in patients with upper tract urothelial carcinoma. Nature Rev Urol 14(3):181–191. https://doi.org/10.1038/nrurol.2016.252 CrossRef

Holmäng S, Johansson SL (2005) Urothelial carcinoma of the upper urinary tract: comparison between the WHO/ISUP 1998 consensus classification and WHO 1999 classification system. Urology 66(2):274–278. https://doi.org/10.1016/j.urology.2005.03.011 CrossRefPubMed

10.

Malm C, Brehmer M (2018) Clinical tumour characteristics predicting invasiveness in upper tract urothelial carcinoma. J Endourol 32:2. https://doi.org/10.1089/end.2018.29044.abstracts.index CrossRef

11.

M Brehmer, On behalf of the International Collaboration in Endourology (ICE) (2018) Reflections on personalized management of UTUC, LETTER TO THE EDITOR. World J Urol. https://doi.org/10.1007/s00345-018-2218-6 CrossRef

12.

Smith AK, Stephenson AJ, Lane BR, Larson BT, Thomas AA, Gong MC, Hansel DE et al (2011) Inadequacy of biopsy for diagnosis of upper tract urothelial carcinoma: implications for conservative management. Urology 78(1):82–86. https://doi.org/10.1016/j.urology.2011.02.038 CrossRefPubMed

13.

Wang JK, Tollefson MK, Krambeck AE, Trost LW, Thompson RH (2012) High rate of pathologic upgrading at nephroureterectomy for upper tract urothelial carcinoma. Urology 79(3):615–619. https://doi.org/10.1016/j.urology.2011.11.049 CrossRefPubMed

14.

Dev HS, Poo S, Armitage J, Wiseman O, Shah N, Al-Hayek S (2017) Investigating upper urinary tract urothelial carcinomas: a single-centre 10-year experience. World J Urol 35(1):131–138. https://doi.org/10.1007/s00345-016-1820-8 CrossRefPubMed

15.

Malm C, Grahn A, Jaremko G, Tribukait B, Brehmer M (2017) Diagnostic accuracy of upper tract urothelial carcinoma: how samples are collected matters. Scand J Urol 51(2):137–145. https://doi.org/10.1080/21681805.2017.1295102 CrossRefPubMed

16.

Territo A, Foerster B, Shariat SF, Rouprêt M, Gaya JM, Palou J, Breda A (2018) Diagnosis and kidney-sparing treatments for upper tract urothelial carcinoma: state of the art. Miner Urol Nefrol 70(3):242–251. https://doi.org/10.23736/S0393-2249.18.03058-8 CrossRef

17.

Tanaka N, Kaczynska D, Kanatani S, Sahlgren C, Mitura P, Stepulak A, Uhlén P et al (2018) Mapping of the three-dimensional lymphatic microvasculature in bladder tumours using light-sheet microscopy. Br J Cancer 118(7):995–999. https://doi.org/10.1038/s41416-018-0016-y CrossRefPubMedPubMedCentral

18.

Sfakianos JP, Cha EK, Iyer G, Scott SN, Zabor EC, Shah RH, Coleman JA et al (2015) Genomic characterization of upper tract urothelial carcinoma. Eur Urol 68(6):970–977. https://doi.org/10.1016/j.eururo.2015.07.039 CrossRefPubMedPubMedCentral

19.

Hanahan D, Weinberg RA (2011) Hallmarks of cancer: the next generation. Cell 144(5):646–674. https://doi.org/10.1016/j.cell.2011.02.013 CrossRefPubMed

20.

Weinberg R (2014) The biology of cancer. 2nd ed. Garland Science, Taylor & Francis Group, New York

21.

Nakanishi K, Hiroi S, Tominaga S, Aida S, Kasamatsu H, Matsuyama S, Kawai T et al (2005) Expression of hypoxia-inducible factor-1alpha protein predicts survival in patients with transitional cell carcinoma of the upper urinary tract. Clin Cancer Res 11(7):2583–2590. https://doi.org/10.1158/1078-0432.CCR-04-1685 CrossRefPubMed

22.

Ke HL, Wei YC, Yang SF, Li CC, Wu DC, Huang CH, Wu WJ (2008) Overexpression of hypoxia-inducible factor-1alpha predicts an unfavorable outcome in urothelial carcinoma of the upper urinary tract. Int J Urol 15(3):200–205. https://doi.org/10.1111/j.1442-2042.2007.01978.x CrossRefPubMed

Title: Volumetric imaging: a potential tool to stage upper tract urothelial carcinoma
Authors: Alexandra Grahn
Nobuyuki Tanaka
Per Uhlén
Marianne Brehmer
Publication date: 01-11-2019
Publisher: Springer Berlin Heidelberg
Keywords: Urothelial Cancer
Urothelial Cancer
Published in: World Journal of Urology / Issue 11/2019
Print ISSN: 0724-4983
Electronic ISSN: 1433-8726
DOI: https://doi.org/10.1007/s00345-019-02682-1

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Volumetric imaging: a potential tool to stage upper tract urothelial carcinoma

Abstract

Purpose

Methods

Results

Conclusions

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Abstract

Purpose

Methods

Results

Conclusions

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