Digital frozen section of the prostate surface during radical prostatectomy: a novel approach to evaluate surgical margins

Rocco, Bernardo; Cimadamore, Alessia; Bonetti, Luca Reggiani; Bertoni, Laura; Puliatti, Stefano; Eissa, Ahmed; Spandri, Valentina; Azzoni, Paola; Dinneen, Eoin; Shaw, G.; Nathan, Senthil; Micali, Salvatore; Bianchi, Giampaolo; Maiorana, Antonino; Pellacani, Giovanni; Montironi, Rodolfo

doi:10.1111/bju.15108

Cited by 26 publications

(28 citation statements)

References 8 publications

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“…Similarly, real-time control of surgical margins could be useful during radical prostatectomy to spare neurovascular bundle tissue as much as possible, while ensuring negative surgical margins [23][24][25][26][27].…”

Section: Discussionmentioning

confidence: 99%

Digital Biopsy with Fluorescence Confocal Microscope for Effective Real-time Diagnosis of Prostate Cancer: A Prospective, Comparative Study

Rocco

Sandri

Spandri

et al. 2021

European Urology Oncology

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Background: A microscopic analysis of tissue is the gold standard for cancer detection. Hematoxylin-eosin (HE) for the reporting of prostate biopsy (PB) is conventionally based on fixation, processing, acquisition of glass slides, and analysis with an analog microscope by a local pathologist. Digitalization and real-time remote access to images could enhance the reporting process, and form the basis of artificial intelligence and machine learning. Fluorescence confocal microscopy (FCM), a novel optical technology, enables immediate digital image acquisition in an almost HE-like resolution without requiring conventional processing. Objective: The aim of this study is to assess the diagnostic ability of FCM for prostate cancer (PCa) identification and grading from PB. Design, setting, and participants: This is a prospective, comparative study evaluating FCM and HE for prostate tissue interpretation. PBs were performed (March to June 2019) at a single coordinating unit on consecutive patients with clinical and laboratory indications for assessment. FCM digital images (n = 427) were acquired immediately from PBs (from 54 patients) and stored; corresponding glass slides (n = 427) undergoing the conventional HE processing were digitalized and stored as well. A panel of four international pathologists with diverse background participated in the study and was

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Section: Discussionmentioning

confidence: 99%

Digital Biopsy with Fluorescence Confocal Microscope for Effective Real-time Diagnosis of Prostate Cancer: A Prospective, Comparative Study

Rocco

Sandri

Spandri

et al. 2021

European Urology Oncology

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“…After the removal of duplicates, the records were screened by the title and abstract to identify all the articles concerned with the use of FCM in the examination of prostatic tissues. Overall, six clinical studies were identified (1,(8)(9)(10)(11)(12). Other articles dealing with historical aspects and technological background of confocal microscopy (13)(14)(15)(16) were additionally discussed.…”

Section: Methodsmentioning

confidence: 99%

Current and future perspectives of digital microscopy with fluorescence confocal microscope for prostate tissue interpretation: a narrative review

et al. 2021

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Fluorescence confocal microscopy (FCM) is an optical imaging technique providing digital microscopical images of fresh tissue in a real time fashion, without conventional processing. FCM has been widely applied in several fields of dermatology, including the detection of basal cell carcinoma and of cutaneous inflammatory diseases. The aim of the paper is to provide an overview of FCM applications in the field of prostate tissue interpretation and prostate cancer (PCa) detection. A Literature search (PubMed & Web of Science) was performed to identify articles concerned with the clinical and surgical applications of FCM in prostatic and periprostatic tissues interpretation. Overall, six articles were identified. All articles investigated the level of agreement between FCM and conventional histopathological analysis (hematoxylineosin, HE) for the discrimination between normal and PCa tissues. An investigative article on prostate samples retrieved from radical prostatectomy (RP) specimens and an atlas of FCM digital images from the same series were found. Two prospective clinical trials, comparing FCM and HE, pointed out a "substantial" to "almost perfect" discriminative performance of FCM for the diagnosis of PCa on prostate biopsy core.Finally, two studies investigated the intra-operative role of FCM during RP for the control of surgical dissection. In this setting, FCM could be used to analyse samples retrieved from suspicious peri-prostatic areas; FCM has also been tested for an en-face evaluation of flat slices obtained from the systematic sampling of the posterolateral aspects of the prostate, in a NeuroSAFE-like approach. Generally, FCM provides digital microscopical images of fresh tissue in a real time fashion, without requiring conventional processing.Currently, available studies confirmed a high concordance with conventional pathology for the detection of PCa. Further studies are required to validate the technology, to evaluate ISUP score attribution and to implement the fields of application of FCM for the treatment of prostate diseases.

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“…Our group has acquired some experience on this with prostate biopsies to check for the presence of cancer and, at the time of the radical prostatectomy procedure, for the evaluation of the surgical margins. 5 As an example of smart working from home, one of us (AC) was able to evaluate virtual slides of surgical margins displayed on a high-definition TV screen at Viewpoint home and at night in the USA, whereas a radical prostatectomy was performed in the morning in Europe.…”

Section: Confocal Microscopy and Smart Workingmentioning

confidence: 99%

Digital pathology and COVID-19 and future crises: pathologists can safely diagnose cases from home using a consumer monitor and a mini PC

et al. 2020

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Digital frozen section of the prostate surface during radical prostatectomy: a novel approach to evaluate surgical margins

Cited by 26 publications

References 8 publications

Digital Biopsy with Fluorescence Confocal Microscope for Effective Real-time Diagnosis of Prostate Cancer: A Prospective, Comparative Study

Digital Biopsy with Fluorescence Confocal Microscope for Effective Real-time Diagnosis of Prostate Cancer: A Prospective, Comparative Study

Current and future perspectives of digital microscopy with fluorescence confocal microscope for prostate tissue interpretation: a narrative review

Digital pathology and COVID-19 and future crises: pathologists can safely diagnose cases from home using a consumer monitor and a mini PC

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