Ex Vivo Fluorescence Confocal Microscopy of MRI-Guided Targeted Prostate Biopsies for Rapid Detection of Clinically Significant Carcinomas-A Feasibility Study.

Autor: Titze U; Department of Pathology, Medical School and University Medical Center OWL, Klinikum Lippe Detmold, Bielefeld University, 32756 Detmold, Germany., Titze B; Department of Pathology, Medical School and University Medical Center OWL, Klinikum Lippe Detmold, Bielefeld University, 32756 Detmold, Germany., Hansen T; Department of Pathology, Medical School and University Medical Center OWL, Klinikum Lippe Detmold, Bielefeld University, 32756 Detmold, Germany.; MVZ for Histology, Cytology and Molecular Diagnostics Trier GmbH, 54296 Trier, Germany., Barth PJ; Gerhard-Domagk-Institute of Pathology, Münster University Hospital, University of Münster, 48149 Münster, Germany., Ali FA; Department of Urology, Medical School and University Medical Center OWL, Klinikum Lippe Detmold, Bielefeld University, 32756 Detmold, Germany., Schneider F; Department of Urology, Medical School and University Medical Center OWL, Klinikum Lippe Detmold, Bielefeld University, 32756 Detmold, Germany., Benndorf M; Department of Diagnostic and Interventional Radiology, Medical School and University Medical Center OWL, Klinikum Lippe Detmold, Bielefeld University, 32756 Detmold, Germany., Sievert KD; Department of Urology, Medical School and University Medical Center OWL, Klinikum Lippe Detmold, Bielefeld University, 32756 Detmold, Germany.
Jazyk: angličtina
Zdroj: Cancers [Cancers (Basel)] 2024 Feb 22; Vol. 16 (5). Date of Electronic Publication: 2024 Feb 22.
DOI: 10.3390/cancers16050873
Abstrakt: Background: MRI-guided prostate biopsies from visible tumor-specific lesions (TBx) can be used to diagnose clinically significant carcinomas (csPCa) requiring treatment more selectively than conventional systematic biopsies (SBx). Ex vivo fluorescence confocal microscopy (FCM) is a novel technique that can be used to examine TBx prior to conventional histologic workup.
Methods: TBx from 150 patients were examined with FCM on the day of collection. Preliminary findings were reported within 2 h of collection. The results were statistically compared with the final histology.
Results: 27/40 (68%) of the csPCa were already recognized in the intraday FCM in accordance with the results of conventional histology. Even non-significant carcinomas (cisPCa) of the intermediate and high-risk groups (serum prostate-specific antigen (PSA) > 10 or 20 ng/mL) according to conventional risk stratifications were reliably detectable. In contrast, small foci of cisPCa were often not detected or were difficult to distinguish from reactive changes.
Conclusion: The rapid reporting of preliminary FCM findings helps to reduce the psychological stress on patients, and can improve the clinical management of csPCa. Additional SBx can be avoided in individual cases, leading to lower rates of complications and scarring in the future surgical area. Additional staging examinations can be arranged without losing time. FCM represents a promising basis for future AI-based diagnostic algorithms.
Databáze: MEDLINE
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