{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,2,19]],"date-time":"2026-02-19T11:31:32Z","timestamp":1771500692833,"version":"3.50.1"},"reference-count":31,"publisher":"BMJ","issue":"3","funder":[{"name":"National Institutes of Health, National Cancer Institute","award":["5-R01-CA249151"],"award-info":[{"award-number":["5-R01-CA249151"]}]},{"name":"National Institutes of Health, National Cancer Institute","award":["5-R01-CA252216"],"award-info":[{"award-number":["5-R01-CA252216"]}]}],"content-domain":{"domain":["bmj.com"],"crossmark-restriction":true},"short-container-title":["J Clin Pathol"],"accepted":{"date-parts":[[2025,10,23]]},"published-print":{"date-parts":[[2026,3]]},"abstract":"<jats:sec>\n                    <jats:title>Aim<\/jats:title>\n                    <jats:p>Transurethral 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.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods and results<\/jats:title>\n                    <jats:p>We 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&amp;E histology, and a blinded reader achieved a sensitivity of 95% and specificity of 100% for MP detection.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>This 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.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1136\/jcp-2025-210368","type":"journal-article","created":{"date-parts":[[2025,11,5]],"date-time":"2025-11-05T06:55:25Z","timestamp":1762325725000},"page":"186-191","update-policy":"https:\/\/doi.org\/10.1136\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":0,"title":["Rapid evaluation of muscularis propria in transurethral resection of bladder tumour specimens using non-linear microscopy (NLM)"],"prefix":"10.1136","volume":"79","author":[{"given":"Timothy D","family":"Weber","sequence":"first","affiliation":[{"name":"Research Laboratory of Electronics, Massachusetts Institute of Technology, Cambridge, Massachusetts, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Boris","family":"Gershman","sequence":"additional","affiliation":[{"name":"Division of Urologic Surgery, Beth Israel Deaconess Medical Center, Boston, Massachusetts, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-4033-9856","authenticated-orcid":false,"given":"Lisha","family":"Wang","sequence":"additional","affiliation":[{"name":"Department of Pathology, Beth Israel Deaconess Medical Center, Boston, Massachusetts, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Seymour","family":"Rosen","sequence":"additional","affiliation":[{"name":"Department of Pathology, Beth Israel Deaconess Medical Center, Boston, Massachusetts, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"James G","family":"Fujimoto","sequence":"additional","affiliation":[{"name":"Research Laboratory of Electronics, Massachusetts Institute of Technology, Cambridge, Massachusetts, USA"},{"name":"Department of Electrical Engineering and Computer Science, Massachusetts Institute of Technology, Cambridge, Massachusetts, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0009-0007-4499-5221","authenticated-orcid":false,"given":"Yue","family":"Sun","sequence":"additional","affiliation":[{"name":"Department of Pathology, Beth Israel Deaconess Medical Center, Boston, Massachusetts, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"239","published-online":{"date-parts":[[2025,11,4]]},"reference":[{"key":"2026021902550848000_79.3.186.1","doi-asserted-by":"publisher","DOI":"10.3322\/CAAC.21834"},{"key":"2026021902550848000_79.3.186.2","doi-asserted-by":"publisher","DOI":"10.1097\/MOU.0000000000000078"},{"key":"2026021902550848000_79.3.186.3","doi-asserted-by":"publisher","DOI":"10.1158\/1055-9965.EPI-19-1534"},{"key":"2026021902550848000_79.3.186.4","doi-asserted-by":"crossref","first-page":"751","DOI":"10.1007\/s40273-023-01273-8","article-title":"Cost-Effectiveness and Economic Impact of Bladder Cancer Management: An Updated Review of the Literature","volume":"41","author":"Joyce","year":"2023","journal-title":"Pharmacoeconomics"},{"key":"2026021902550848000_79.3.186.5","doi-asserted-by":"publisher","DOI":"10.1016\/j.juro.201606.049"},{"key":"2026021902550848000_79.3.186.6","doi-asserted-by":"publisher","DOI":"10.1016\/j.eururo.2024.07.027"},{"key":"2026021902550848000_79.3.186.7","doi-asserted-by":"crossref","first-page":"1","DOI":"10.3233\/BLC-150022","article-title":"Management of T1 Urothelial Carcinoma of the Bladder: What Do We Know and What Do We Need To Know?","volume":"2","author":"Gershman","year":"2015","journal-title":"Bladder Cancer"},{"key":"2026021902550848000_79.3.186.8","unstructured":"National Comprehensive Cancer Network . 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