Urodrill - a novel MRI-guided endoscopic biopsy technique to sample and molecularly classify muscle-invasive bladder cancer without fractionating the specimen during transurethral resection
(2023) In European Urology Open Science 53. p.78-82- Abstract
The current diagnostic pathway for patients with muscle-invasive bladder cancer (MIBC), which involves with computed tomography urography, cystoscopy, and transurethral resection of the bladder (TURB) to histologically confirm MIBC, delays definitive treatment. The Vesical Imaging-Reporting and Data System (VI-RADS) has been suggested for MIBC identification using magnetic resonance imaging (MRI), but a recent randomized trial reported misclassification in one-third of patients. We investigated a new endoscopic biopsy device (Urodrill) for histological confirmation of MIBC and assessment of molecular subtype by gene expression in patients with VI-RADS 4 and 5 lesions on MRI. In ten patients, Urodrill biopsies were guided by MR images to... (More)
The current diagnostic pathway for patients with muscle-invasive bladder cancer (MIBC), which involves with computed tomography urography, cystoscopy, and transurethral resection of the bladder (TURB) to histologically confirm MIBC, delays definitive treatment. The Vesical Imaging-Reporting and Data System (VI-RADS) has been suggested for MIBC identification using magnetic resonance imaging (MRI), but a recent randomized trial reported misclassification in one-third of patients. We investigated a new endoscopic biopsy device (Urodrill) for histological confirmation of MIBC and assessment of molecular subtype by gene expression in patients with VI-RADS 4 and 5 lesions on MRI. In ten patients, Urodrill biopsies were guided by MR images to the muscle-invasive portion of the tumor via a flexible cystoscope under general anesthesia. During the same session, conventional TURB was subsequently performed. A Urodrill sample was successfully obtained in nine of ten patients. MIBC was verified in six of nine patients, and seven of nine samples contained detrusor muscle. In seven of eight patients for whom a Urodrill biopsy sample was subjected to RNA sequencing, single-sample molecular classification according to the Lund taxonomy was feasible. No complications related to the biopsy device occurred. A randomized trial comparing this new diagnostic pathway for patients with VI-RADS 4 and 5 lesions and the current standard (TURB) is warranted. Patient summary: We report on a novel biopsy device for patients with muscle-invasive bladder cancer that facilitates histology analysis and molecular characterization of tumor samples.
(Less)
- author
- organization
-
- Urothelial cancer
- Urothelial Cancer Genomics (research group)
- LUCC: Lund University Cancer Centre
- Urology - urothelial cancer, Malmö (research group)
- Urological cancer, Malmö (research group)
- LU Profile Area: Light and Materials
- LTH Profile Area: Photon Science and Technology
- EpiHealth: Epidemiology for Health
- Radiology Diagnostics, Malmö (research group)
- publishing date
- 2023
- type
- Contribution to journal
- publication status
- published
- subject
- keywords
- Bladder, Endourology, Magnetic resonance imaging, Translational research, Transurethral resection
- in
- European Urology Open Science
- volume
- 53
- pages
- 5 pages
- publisher
- Elsevier
- external identifiers
-
- pmid:37304229
- scopus:85160657006
- ISSN
- 2666-1691
- DOI
- 10.1016/j.euros.2023.05.006
- language
- English
- LU publication?
- yes
- id
- 0e4a2d7a-0cb7-4e02-b63c-08db0d9ae049
- date added to LUP
- 2023-08-17 10:44:11
- date last changed
- 2024-11-02 20:36:58
@article{0e4a2d7a-0cb7-4e02-b63c-08db0d9ae049, abstract = {{<p>The current diagnostic pathway for patients with muscle-invasive bladder cancer (MIBC), which involves with computed tomography urography, cystoscopy, and transurethral resection of the bladder (TURB) to histologically confirm MIBC, delays definitive treatment. The Vesical Imaging-Reporting and Data System (VI-RADS) has been suggested for MIBC identification using magnetic resonance imaging (MRI), but a recent randomized trial reported misclassification in one-third of patients. We investigated a new endoscopic biopsy device (Urodrill) for histological confirmation of MIBC and assessment of molecular subtype by gene expression in patients with VI-RADS 4 and 5 lesions on MRI. In ten patients, Urodrill biopsies were guided by MR images to the muscle-invasive portion of the tumor via a flexible cystoscope under general anesthesia. During the same session, conventional TURB was subsequently performed. A Urodrill sample was successfully obtained in nine of ten patients. MIBC was verified in six of nine patients, and seven of nine samples contained detrusor muscle. In seven of eight patients for whom a Urodrill biopsy sample was subjected to RNA sequencing, single-sample molecular classification according to the Lund taxonomy was feasible. No complications related to the biopsy device occurred. A randomized trial comparing this new diagnostic pathway for patients with VI-RADS 4 and 5 lesions and the current standard (TURB) is warranted. Patient summary: We report on a novel biopsy device for patients with muscle-invasive bladder cancer that facilitates histology analysis and molecular characterization of tumor samples.</p>}}, author = {{Eriksson, Pontus and Berg, Johanna and Bernardo, Carina and Bobjer, Johannes and Brändstedt, Johan and Löfgren, Annica and Simoulis, Athanasios and Sjödahl, Gottfrid and Sundén, Fredrik and Wokander, Mats and Zackrisson, Sophia and Liedberg, Fredrik}}, issn = {{2666-1691}}, keywords = {{Bladder; Endourology; Magnetic resonance imaging; Translational research; Transurethral resection}}, language = {{eng}}, pages = {{78--82}}, publisher = {{Elsevier}}, series = {{European Urology Open Science}}, title = {{Urodrill - a novel MRI-guided endoscopic biopsy technique to sample and molecularly classify muscle-invasive bladder cancer without fractionating the specimen during transurethral resection}}, url = {{http://dx.doi.org/10.1016/j.euros.2023.05.006}}, doi = {{10.1016/j.euros.2023.05.006}}, volume = {{53}}, year = {{2023}}, }