Capabilities of the cross-polarization optical coherent tomography in the visualization and differentiation of the prostatic neurovascular bundle elements

Currently radical prostatectomy and radical cystectomy are considered optimal methods of treatment in patients with localized prostate cancer and invasive bladder cancer. Preservation of the neurovascular bundles during these operations tends to reduce the complication rate in regard to the erectile dysfunction and urinary incontinence after the operation. We have proposed a method of cross-polarization optical coherent microscopy (CP-OCT) to be used for the visualization and differentiation of the structures and tissues in neurovascular bundles (NVB) in the area of the prostate. Investigational scanning of different tissues forming the NVB was done during the operation and ex vivo. Data derived from the scanning made possible to differentiate the optical properties of different tissues, which enables the intra-operative differentiation of the structures. The information obtained from the CP-OCT was compared to the results of the histological investigation of the correspondent tissue samples, which made possible to assess the sensitivity, specificity and diagnostic value of the method. The advantages of this visualization modality are the ability to receive the real time images of the NVB elements in vivo without additional trauma, to differentiate the related structures, and it’s applicability during both open and laparoscopic surgical operations.