Objective: To report the first application of ex vivo fluorescence confocal microscopy (FCM) - a novel optical technology that is capable of providing fast microscopic imaging of unfixed tissue specimens- in the urological field assessing its diagnostic accuracy for non neoplastic and cancerous prostate tissue (prostatic adenocarcinoma) compared to the 'gold standard' histopathological diagnoses. Patients and methods: In all, 89 specimens from 13 patients with clinically localised prostate cancer were enrolled into the study. All patients underwent robot-assisted laparoscopic radical prostatectomy with fresh prostatic tissue biopsies taken at the end of each intervention using an 18-G biopsy punch. Specimens were randomly assigned to the three collaborating pathologists for evaluation. Intra- and inter-observer agreement was tested by the means of Cohen's κ. The diagnostic performance was evaluated on receiver operating characteristic curve analysis. Results: The overall diagnostic agreement between FCM and histopathological diagnoses was substantial with a 91% correct diagnosis (κ = 0.75) and an area under the curve of 0.884 (95% confidence interval 0.840–0.920), 83.33% sensitivity, and 93.53% specificity. Conclusion: FCM seems to be a promising tool for enhanced specimens' reporting performance, given its simple application and very rapid microscopic image generation (<5 min/specimen). This technique may potentially be used for intraoperative pathological specimens' analysis.

Ex-vivo Fluorescence Confocal Microscopy : The First Application For Real-Time Pathologic Examination of Prostatic Tissue / S. Puliatti, L. Bertoni, G.M. Pirola, P. Azzoni, L. Bevilacqua, A. Eissa, A. Elsherbiny, M.C. Sighinolfi, J. Chester, B. Rocco, S. Micali, I. Bagni, L. Reggiani Bonetti, A. Maiorana, J. Malvehy, C. Longo, R. Montironi, G. Bianchi, G. Pellacani. - In: BJU INTERNATIONAL. - ISSN 1464-4096. - 124:3(2019), pp. 469-476. [10.1111/bju.14754]

Ex-vivo Fluorescence Confocal Microscopy : The First Application For Real-Time Pathologic Examination of Prostatic Tissue

B. Rocco;
2019

Abstract

Objective: To report the first application of ex vivo fluorescence confocal microscopy (FCM) - a novel optical technology that is capable of providing fast microscopic imaging of unfixed tissue specimens- in the urological field assessing its diagnostic accuracy for non neoplastic and cancerous prostate tissue (prostatic adenocarcinoma) compared to the 'gold standard' histopathological diagnoses. Patients and methods: In all, 89 specimens from 13 patients with clinically localised prostate cancer were enrolled into the study. All patients underwent robot-assisted laparoscopic radical prostatectomy with fresh prostatic tissue biopsies taken at the end of each intervention using an 18-G biopsy punch. Specimens were randomly assigned to the three collaborating pathologists for evaluation. Intra- and inter-observer agreement was tested by the means of Cohen's κ. The diagnostic performance was evaluated on receiver operating characteristic curve analysis. Results: The overall diagnostic agreement between FCM and histopathological diagnoses was substantial with a 91% correct diagnosis (κ = 0.75) and an area under the curve of 0.884 (95% confidence interval 0.840–0.920), 83.33% sensitivity, and 93.53% specificity. Conclusion: FCM seems to be a promising tool for enhanced specimens' reporting performance, given its simple application and very rapid microscopic image generation (<5 min/specimen). This technique may potentially be used for intraoperative pathological specimens' analysis.
#PCSM; #Prostate cancer; digital pathology; fluorescence confocal microscopy; RALP; Aged; Biopsy; Humans; Intraoperative Care; Male; Microscopy; Confocal; Microscopy; Fluorescence; Middle Aged; Prospective Studies; Prostatectomy; ROC Curve; Robotic Surgical Procedures; Prostate; Prostatic Neoplasms
Settore MED/24 - Urologia
Article (author)
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Utilizza questo identificativo per citare o creare un link a questo documento: https://hdl.handle.net/2434/876576
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