Riassunto analitico
INTRODUCTION AND AIM
Ex-vivo fluorescence confocal microscopy (FCM) is a novel optical technology that provides within few minutes optical microscopic imaging of freshly excised tissue. Images are produced on a nuclear level, with H&E like appearance and resolution. It has been mainly used for “real-time” pathological examination of dermatological malignancies and it has also shown to be a promising tool for fast pathological examination of prostatic tissues. Based upon the benefits of FCM tested in different surgical settings, we aim to explore the diagnostic performance of FCM applied to prostate needle biopsy in order to fasten microscopical reading of cores and to gain a real-time diagnosis.
MATERIAL AND METHODS
A total of 429 specimen were collected from 54 patients who underwent mpMRI fusion + saturation prostate biopsy at our center. Images of FCM and the corresponding H&E were randomly assigned to three collaborating pathologists for evaluation. Intra- and inter-observer agreement was tested by the means of Cohen’s κ.
RESULTS
The overall diagnostic agreement between FCM and histopathological diagnoses was substantial with a 93,44% correct diagnosis (κ = 0.79), 80,00% sensitivity and 96,92% specificity. Positive and negative predictive values were 86,96% and 94,97%, respectively.
CONCLUSION
Fluorescence Confocal Microscopy detects prostate cancer in fresh biopsy specimen with high accuracy. The specimen preparation is simple and can also be performed by the treating surgeon. It provides digital images that can be shared to a remote pathologist for interpretation. It is time-efficient and has a great potential to be use in order to improve the efficacy of the diagnostic procedure.
|
