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You are here: MEDICA Portal. Part VI: Optical Technologies. Bladder.

The Medical All-Rounder Called Light (Part 2)

The Medical All-Rounder Called Light (Part 2)

Part 2: The Pathologist and the Tip of the Endoscope

According to the German industry association Spectaris the second largest market for optical technologies in Germany is the medical technology segment. In 2005, 2.9 billion Euros of annual turnover was generated in Germany which includes eyeglass lenses, microscopes and laser as well as diagnostic scanner for the laboratory. Estimates for the area endoscopes and supplies state that the turnover regarding the international market will double within ten years.

Endoscopes are going to play an ever more important role in future. „The technical advances allow for ever more flexible endoscopes“, Herbert Stepp from the Laser Research Center at the University Munich, Germany explains. This is important since physicians want to reach distant parts within the body minimally invasive. The only catch being that the more flexible an endoscope is the less space it exhibits for optical systems. The solution could be the chip on the tip technique: Instead of filming via camera through a stiff tube as is done with a rigid endoscope a very small camera the size of a pinhead is being placed at the tip of the endoscope in order to look at the tissue at close range. „That way we can achieve a high image quality equivalent to a rigid endoscope but in the body of a flexible one“, Stepp says.

The microscope enters the body

Endoscopes may that way be ready to take over more jobs with one explicit aim: „We want to make visible what we cannot see with our eyes“, Stepp describes. The technologies used by the pathologist in the laboratory for examining tissue samples need to be placed on the tip of the endoscope. That already works with confocal microscopy which can be of help diagnosing colon cancer. Physicians moisten colon tissue with a contrasting agent and then a tiny probe containing confocal microscopy is pushed on location through the endoscope. A laser penetrates the tissue to a depth of 100 micrometers and reveals the colon cell structures such as the nucleus and the cytoplasm. „Since cell structures of the colon follow a very typical pattern, a change in this pattern between the cells indicates a possible colon carcinoma.“


Photo: Fluorescent parts of a bladder

Another technology useful on the the tip of endoscopes is the optical coherence tomography (OCT) which works like an ultrasound device but instead of using sound it sends infrared light into the body. This results in a three-dimensional image. Since a probe with OCT is already commercially available Stepp and colleagues investigate how OCT can help in better diagnosing bladder carcinoma. This is important since the diagnosis via endoscope based on fluorescent agents give many false-positive results.

„We need to look much closer here“, the physicist states. In case of suspecting malignant tissue in the bladder the OCT probe is being pushed through the endoscope and is being placed directly onto the bladder tissue in order to take a look into it. The physician is looking for the borderline between mucous membrane and connective tissue. „In case of malignant processes we observe a thickening of the mucous membrane. That way we hope to reduce false-positive results during the diagnosis of bladder cancer.“

- Part 1: The Medical All-Rounder Called Light
- Part 2: The Pathologist and the Tip of the Endoscope


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