Current and evolving uses of optical coherence tomography in the genitourinary tract

Optical coherence tomography is an emerging imaging modality that provides high-resolution, real-time, cross-sectional visualization of urologic tissue with promising results. Early studies have demonstrated detailed, accurate histologic information of tissues sampled. Optical coherence tomography (OCT) has also been applied in evaluating malignancy of the bladder, prostate, and kidney. In the bladder, it can assist in the identification, biopsy, and intraoperative resection of lesions suspicious for bladder cancer. Intraoperative use of OCT during radical prostatectomy can improve visualization of the neurovascular bundle and surgical margins. Several small, ex vivo studies have also shown promising results in the ability of OCT to demonstrate histopathologic alterations to renal morphology such as in renal ischemia and malignancy. In men with non-obstructive azoospermia, OCT has also been used in improving sperm retrieval rates by assisting in the identification of tubules with isolated foci of spermatogenesis. Common limitations of OCT include limited depth of penetration and limited number of current clinical studies.