Ex Vivo Fluorescence Confocal Microscopy (FCM) of Prostate Biopsies Rethought: Opportunities of Intraoperative Examinations of MRI-Guided Targeted Biopsies in Routine Diagnostics

The diagnosis of prostate carcinoma (PCa) requires time- and material-consuming histopathological examinations. Ex vivo fluorescence confocal microscopy (FCM) can detect carcinoma foci in diagnostic biopsies intraoperatively. MRI-guided and systematic biopsies were identified in a dataset of our pre...

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Published in:	Diagnostics (Basel) Vol. 12; no. 5; p. 1146
Main Authors:	Sievert, Karl-Dietrich, Hansen, Torsten, Titze, Barbara, Schulz, Birte, Omran, Ahmad, Brockkötter, Lukas, Gunnemann, Alfons, Titze, Ulf
Format:	Journal Article
Language:	English
Published:	Switzerland MDPI AG 05-05-2022 MDPI
Subjects:	Anxiety Biopsy Cancer therapies confocal microscopy digital pathology Histology Magnetic resonance imaging Microscopy Patients Prostate cancer Radiation Surveillance targeted biopsies Tumors Ultrasonic imaging prostate cancer confocal microscopy digital pathology targeted biopsies
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Abstract	The diagnosis of prostate carcinoma (PCa) requires time- and material-consuming histopathological examinations. Ex vivo fluorescence confocal microscopy (FCM) can detect carcinoma foci in diagnostic biopsies intraoperatively. MRI-guided and systematic biopsies were identified in a dataset of our previously published study cohort. Detection rates of clinically relevant tumors were determined in both groups. A retrospective blinded trial was performed to determine how many tumors requiring intervention were detectable via FCM analysis of MRI-guided targeted biopsies alone. MRI-guided targeted biopsies revealed tumors more frequently than systematic biopsies. Carcinomas in need of intervention were reliably represented in the MRI-guided biopsies and were identified in intraoperative FCM microscopy. Combined with serum PSA levels and clinical presentation, 91% of the carcinomas in need of intervention were identified. Intraoperative FCM analysis of MRI-guided biopsies is a promising approach for the efficient diagnosis of PCa. The method allows a timely assessment of whether a tumor disease requiring intervention is present and can reduce the psychological stress of the patient in the waiting period of the histological finding. Furthermore, this technique can lead to reduction of the total number of biopsies needed for the diagnosis of PCa.
AbstractList	Background: The diagnosis of prostate carcinoma (PCa) requires time- and material-consuming histopathological examinations. Ex vivo fluorescence confocal microscopy (FCM) can detect carcinoma foci in diagnostic biopsies intraoperatively. Methods: MRI-guided and systematic biopsies were identified in a dataset of our previously published study cohort. Detection rates of clinically relevant tumors were determined in both groups. A retrospective blinded trial was performed to determine how many tumors requiring intervention were detectable via FCM analysis of MRI-guided targeted biopsies alone. Results: MRI-guided targeted biopsies revealed tumors more frequently than systematic biopsies. Carcinomas in need of intervention were reliably represented in the MRI-guided biopsies and were identified in intraoperative FCM microscopy. Combined with serum PSA levels and clinical presentation, 91% of the carcinomas in need of intervention were identified. Conclusions: Intraoperative FCM analysis of MRI-guided biopsies is a promising approach for the efficient diagnosis of PCa. The method allows a timely assessment of whether a tumor disease requiring intervention is present and can reduce the psychological stress of the patient in the waiting period of the histological finding. Furthermore, this technique can lead to reduction of the total number of biopsies needed for the diagnosis of PCa. The diagnosis of prostate carcinoma (PCa) requires time- and material-consuming histopathological examinations. Ex vivo fluorescence confocal microscopy (FCM) can detect carcinoma foci in diagnostic biopsies intraoperatively. MRI-guided and systematic biopsies were identified in a dataset of our previously published study cohort. Detection rates of clinically relevant tumors were determined in both groups. A retrospective blinded trial was performed to determine how many tumors requiring intervention were detectable via FCM analysis of MRI-guided targeted biopsies alone. MRI-guided targeted biopsies revealed tumors more frequently than systematic biopsies. Carcinomas in need of intervention were reliably represented in the MRI-guided biopsies and were identified in intraoperative FCM microscopy. Combined with serum PSA levels and clinical presentation, 91% of the carcinomas in need of intervention were identified. Intraoperative FCM analysis of MRI-guided biopsies is a promising approach for the efficient diagnosis of PCa. The method allows a timely assessment of whether a tumor disease requiring intervention is present and can reduce the psychological stress of the patient in the waiting period of the histological finding. Furthermore, this technique can lead to reduction of the total number of biopsies needed for the diagnosis of PCa. BACKGROUNDThe diagnosis of prostate carcinoma (PCa) requires time- and material-consuming histopathological examinations. Ex vivo fluorescence confocal microscopy (FCM) can detect carcinoma foci in diagnostic biopsies intraoperatively. METHODSMRI-guided and systematic biopsies were identified in a dataset of our previously published study cohort. Detection rates of clinically relevant tumors were determined in both groups. A retrospective blinded trial was performed to determine how many tumors requiring intervention were detectable via FCM analysis of MRI-guided targeted biopsies alone. RESULTSMRI-guided targeted biopsies revealed tumors more frequently than systematic biopsies. Carcinomas in need of intervention were reliably represented in the MRI-guided biopsies and were identified in intraoperative FCM microscopy. Combined with serum PSA levels and clinical presentation, 91% of the carcinomas in need of intervention were identified. CONCLUSIONSIntraoperative FCM analysis of MRI-guided biopsies is a promising approach for the efficient diagnosis of PCa. The method allows a timely assessment of whether a tumor disease requiring intervention is present and can reduce the psychological stress of the patient in the waiting period of the histological finding. Furthermore, this technique can lead to reduction of the total number of biopsies needed for the diagnosis of PCa.
Author	Titze, Ulf Brockkötter, Lukas Sievert, Karl-Dietrich Hansen, Torsten Titze, Barbara Schulz, Birte Omran, Ahmad Gunnemann, Alfons
AuthorAffiliation	1 Department of Urology, University Hospital OWL of the University of Bielefeld, Campus Lippe, 32756 Detmold, Germany; karl-dietrich.sievert@klinikum-lippe.de (K.-D.S.); ahmad.omran@klinikum-lippe.de (A.O.); lukas.brockkoetter@klinikum-lippe.de (L.B.); alfons.gunnemann@klinikum-lippe.de (A.G.) 2 Institute of Pathology, University Hospital OWL of the University of Bielefeld, Campus Lippe, 32756 Detmold, Germany; torsten.hansen@klinikum-lippe.de (T.H.); barbara.titze@klinikum-lippe.de (B.T.); birte.schulz@klinikum-lippe.de (B.S.)
AuthorAffiliation_xml	– name: 1 Department of Urology, University Hospital OWL of the University of Bielefeld, Campus Lippe, 32756 Detmold, Germany; karl-dietrich.sievert@klinikum-lippe.de (K.-D.S.); ahmad.omran@klinikum-lippe.de (A.O.); lukas.brockkoetter@klinikum-lippe.de (L.B.); alfons.gunnemann@klinikum-lippe.de (A.G.) – name: 2 Institute of Pathology, University Hospital OWL of the University of Bielefeld, Campus Lippe, 32756 Detmold, Germany; torsten.hansen@klinikum-lippe.de (T.H.); barbara.titze@klinikum-lippe.de (B.T.); birte.schulz@klinikum-lippe.de (B.S.)
Author_xml	– sequence: 1 givenname: Karl-Dietrich surname: Sievert fullname: Sievert, Karl-Dietrich organization: Department of Urology, University Hospital OWL of the University of Bielefeld, Campus Lippe, 32756 Detmold, Germany – sequence: 2 givenname: Torsten orcidid: 0000-0001-7885-0580 surname: Hansen fullname: Hansen, Torsten organization: Institute of Pathology, University Hospital OWL of the University of Bielefeld, Campus Lippe, 32756 Detmold, Germany – sequence: 3 givenname: Barbara surname: Titze fullname: Titze, Barbara organization: Institute of Pathology, University Hospital OWL of the University of Bielefeld, Campus Lippe, 32756 Detmold, Germany – sequence: 4 givenname: Birte surname: Schulz fullname: Schulz, Birte organization: Institute of Pathology, University Hospital OWL of the University of Bielefeld, Campus Lippe, 32756 Detmold, Germany – sequence: 5 givenname: Ahmad surname: Omran fullname: Omran, Ahmad organization: Department of Urology, University Hospital OWL of the University of Bielefeld, Campus Lippe, 32756 Detmold, Germany – sequence: 6 givenname: Lukas surname: Brockkötter fullname: Brockkötter, Lukas organization: Department of Urology, University Hospital OWL of the University of Bielefeld, Campus Lippe, 32756 Detmold, Germany – sequence: 7 givenname: Alfons surname: Gunnemann fullname: Gunnemann, Alfons organization: Department of Urology, University Hospital OWL of the University of Bielefeld, Campus Lippe, 32756 Detmold, Germany – sequence: 8 givenname: Ulf surname: Titze fullname: Titze, Ulf organization: Institute of Pathology, University Hospital OWL of the University of Bielefeld, Campus Lippe, 32756 Detmold, Germany
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Cites_doi	10.1056/NEJMe1103829 10.1111/j.1464-410X.1995.tb07422.x 10.1056/NEJMoa2100852 10.1016/S0140-6736(16)32401-1 10.1037/0278-6133.25.3.348 10.1111/bju.14754 10.3390/cancers13225685 10.1111/his.13712 10.1590/s1677-5538.ibju.2018.0099 10.1007/s00345-020-03112-3 10.3390/cancers14020368 10.2307/2529310 10.1038/pcan.2008.21 10.1016/S0090-4295(97)00490-1 10.1016/j.eururo.2019.04.043 10.1136/bmjopen-2013-003901 10.1117/1.2981828 10.1007/s00428-019-02738-y 10.1016/S0022-5347(17)38664-0 10.3322/caac.21660 10.1016/j.eururo.2019.06.023 10.1038/modpathol.2013.158 10.1016/j.euo.2020.08.009 10.1016/S0022-5347(05)64180-8 10.1111/ecc.12233 10.1016/j.juro.2011.03.147 10.1093/jnci/90.12.925 10.3390/diagnostics11101829 10.1016/j.annonc.2020.06.011 10.1016/j.urology.2003.11.017 10.1016/j.eururo.2019.02.033 10.21037/qims-20-895 10.3390/ijerph19084825 10.1177/001316447303300309 10.1159/000499264 10.1056/NEJMoa1910038 10.1111/his.12008
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Snippet	The diagnosis of prostate carcinoma (PCa) requires time- and material-consuming histopathological examinations. Ex vivo fluorescence confocal microscopy (FCM)... Background: The diagnosis of prostate carcinoma (PCa) requires time- and material-consuming histopathological examinations. Ex vivo fluorescence confocal... BACKGROUNDThe diagnosis of prostate carcinoma (PCa) requires time- and material-consuming histopathological examinations. Ex vivo fluorescence confocal...
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StartPage	1146
SubjectTerms	Anxiety Biopsy Cancer therapies confocal microscopy digital pathology Histology Magnetic resonance imaging Microscopy Patients Prostate cancer Radiation Surveillance targeted biopsies Tumors Ultrasonic imaging
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Title	Ex Vivo Fluorescence Confocal Microscopy (FCM) of Prostate Biopsies Rethought: Opportunities of Intraoperative Examinations of MRI-Guided Targeted Biopsies in Routine Diagnostics
URI	https://www.ncbi.nlm.nih.gov/pubmed/35626301 https://www.proquest.com/docview/2670126207 https://search.proquest.com/docview/2671269832 https://pubmed.ncbi.nlm.nih.gov/PMC9140526 https://doaj.org/article/098d6965c389430f878647502c5f2feb
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