Advancements in Endoscopic Optical Coherence Tomography for Urothelial Carcinoma: Research Progress and Clinical Applications

Background: This review summarizes recent advances in endoscopic optical coherence tomography for urothelial carcinoma, focusing on technical features, clinical applications, and future directions. Materials and Methods: This is a narrative review based on a literature review of databases such as PubMed, Embase, Web of Science, and the Cochrane Library, from January 2000 to March 2025. OCT imaging diagnosed with urothelial carcinoma. Studies meeting the following inclusion criteria are eligible, including reports describing the technical aspects or clinical applications (such as diagnosis, staging, intraoperative guidance, or postoperative monitoring) of OCT imaging in the care of patients with urothelial carcinoma. The results of the study have been categorised. Results: OCT demonstrated high-resolution imaging and real-time capabilities, enabling differentiation of malignant from normal urothelial tissues. Clinical studies confirmed its value in tumor staging and intraoperative guidance, with strong concordance to histopathology. OCT improved diagnostic sensitivity and specificity when combined with conventional cystoscopy and showed potential in monitoring treatment response and detecting recurrence. Discussion: OCT offers a non-invasive, precise imaging modality with significant advantages over traditional diagnostic methods. However, limitations remain, including restricted imaging depth and variability across clinical protocols. Standardization and broader clinical validation are needed to ensure consistent adoption. Conclusion: Endoscopic OCT represents a transformative tool for UC management. With further technological innovations and standardized protocols, it is expected to enhance early detection, intraoperative guidance, and long-term patient outcomes.