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Urodrill - a novel MRI-guided endoscopic biopsy technique to sample and molecularly classify muscle-invasive bladder cancer without fractionating the specimen during transurethral resection

Eriksson, Pontus LU ; Berg, Johanna LU ; Bernardo, Carina LU orcid ; Bobjer, Johannes LU ; Brändstedt, Johan LU ; Löfgren, Annica LU ; Simoulis, Athanasios LU orcid ; Sjödahl, Gottfrid LU ; Sundén, Fredrik LU and Wokander, Mats , et al. (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.

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organization
publishing date
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
2024-04-20 00:52:36
@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}},
}