Optical Coherence Tomography in Urologic Oncology: a Comprehensive Review

Introduction: Optical coherence tomography (OCT) is being investigated in urologic oncology for optical diagnosis. This comprehensive review analyzes the current state of development of OCT for bladder, upper urinary tract, kidney, prostate, testis, and penis cancer. Also, the potential role of OCT with regard to the current diagnostic pathways is critically appraised to guide future developments. Methods: Embase and Pubmed were systematically searched for English and German articles on OCT in humans up to December 2017. Reviews were excluded. Case reports were excluded, unless they presented a landmark in the development of OCT. Results: Out of 878 articles, 17 relevant articles on bladder, seven on kidney, five on upper urinary tract, four on prostate, and two on penile cancer were included. In these organs, in vivo OCT imaging is feasible with potential for qualitative and quantitative diagnosis, grading and staging in specific organs. The development of OCT has reached IDEAL stage 2b with 2b level of evidence. Relevant articles on testis cancer were lacking. Conclusion: OCT allows for non- or minimally invasive cancer diagnosis in the bladder, upper urinary tract, kidney, prostate, and penis. In some organs, OCT also may enable histologic grade and stage prediction. However, the current evidence is still at an exploratory level. With regard to the potential additional value of OCT in comparison to the current diagnostic pathways, OCT could become a diagnostic replacement or add-on test for urothelial carcinoma, penile carcinoma, and renal masses. Further research in these conditions should be encouraged.