ArticleJournal of clinical pathology2026
Rapid evaluation of muscularis propria in transurethral resection of bladder tumour specimens using non-linear microscopy (NLM).
Article in Journal of clinical pathology, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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Abstract
aimTransurethral resection of bladder tumour (TURBT) is the standard approach for diagnosing and staging non-muscle invasive bladder cancer. Accurate staging depends on the presence of muscularis propria (MP) in resected tumour specimens, and inadequate MP sampling may necessitate repeat procedures. Non-linear microscopy (NLM), a laser-scanning, non-destructive imaging technique, enables real-time evaluation of fresh tissue and has the potential to improve staging accuracy intraoperatively. METHODS AND
resultsWe retrospectively reviewed 94 TURBT pathology reports with high-grade urothelial carcinoma to assess MP sampling rates by tumour stage. MP was present in 55% (52/94) of cases, with variability across stages: 55% (23/42) in high-grade pTa, 39% (9/23) in pTis, 55% (11/20) in pT1 and 100% (9/9) in pT2. NLM was used to evaluate six fresh and 25 archived formalin-fixed, paraffin-embedded (FFPE) TURBT specimens. Fresh tissues were stained and imaged in real time, while thick sections from FFPE specimens were deparaffinised, imaged using NLM and converted to a digital format analogous to whole-slide images. NLM provided high-resolution imaging of MP as distinct, thick smooth muscle bundles in fresh specimens. Furthermore, NLM images of deparaffinised sections closely resembled conventional H&E histology, and a blinded reader achieved a sensitivity of 95% and specificity of 100% for MP detection.
conclusionThis proof-of-concept study supports the feasibility of NLM for intraoperative MP assessment during TURBT. By providing rapid, high-resolution and non-destructive tissue evaluation, NLM has the potential to improve staging accuracy, optimise intraoperative surgical decision-making and reduce the need for repeat TURBT.
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