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Sophia Zackrisson, MD, PhD. Photo.

Sophia Zackrisson

Manager

Sophia Zackrisson, MD, PhD. Photo.

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

Author

  • Pontus Eriksson
  • Johanna Berg
  • Carina Bernardo
  • Johannes Bobjer
  • Johan Brändstedt
  • Annica Löfgren
  • Athanasios Simoulis
  • Gottfrid Sjödahl
  • Fredrik Sundén
  • Mats Wokander
  • Sophia Zackrisson
  • Fredrik Liedberg
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Summary, in English

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.

Department/s

  • Urothelial cancer
  • Urothelial Cancer Genomics
  • LUCC: Lund University Cancer Centre
  • Urology - urothelial cancer, Malmö
  • Urological cancer, Malmö
  • LU Profile Area: Light and Materials
  • LTH Profile Area: Photon Science and Technology
  • EpiHealth: Epidemiology for Health
  • Radiology Diagnostics, Malmö

Publishing year

2023

Language

English

Pages

78-82

Publication/Series

European Urology Open Science

Volume

53

Document type

Journal article (letter)

Publisher

Elsevier

Topic

  • Urology and Nephrology

Keywords

  • Bladder
  • Endourology
  • Magnetic resonance imaging
  • Translational research
  • Transurethral resection

Status

Published

Research group

  • Urothelial Cancer Genomics
  • Urology - urothelial cancer, Malmö
  • Urological cancer, Malmö
  • Radiology Diagnostics, Malmö

ISBN/ISSN/Other

  • ISSN: 2666-1691