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Ex Vivo Fluorescence Confocal Microscopy of MRI-Guided Targeted Prostate Biopsies for Rapid Detection of Clinically Sig-Nificant Carcinomas – a Feasibility Study.
Titze, U.; Titze, B.; Hansen, T.; Barth, P.J.; Ali, F.A.; Schneider, F.; Benndorf, M.; Sievert, K.-D. Ex Vivo Fluorescence Confocal Microscopy of MRI-Guided Targeted Prostate Biopsies for Rapid Detection of Clinically Significant Carcinomas—A Feasibility Study. Cancers2024, 16, 873.
Titze, U.; Titze, B.; Hansen, T.; Barth, P.J.; Ali, F.A.; Schneider, F.; Benndorf, M.; Sievert, K.-D. Ex Vivo Fluorescence Confocal Microscopy of MRI-Guided Targeted Prostate Biopsies for Rapid Detection of Clinically Significant Carcinomas—A Feasibility Study. Cancers 2024, 16, 873.
Titze, U.; Titze, B.; Hansen, T.; Barth, P.J.; Ali, F.A.; Schneider, F.; Benndorf, M.; Sievert, K.-D. Ex Vivo Fluorescence Confocal Microscopy of MRI-Guided Targeted Prostate Biopsies for Rapid Detection of Clinically Significant Carcinomas—A Feasibility Study. Cancers2024, 16, 873.
Titze, U.; Titze, B.; Hansen, T.; Barth, P.J.; Ali, F.A.; Schneider, F.; Benndorf, M.; Sievert, K.-D. Ex Vivo Fluorescence Confocal Microscopy of MRI-Guided Targeted Prostate Biopsies for Rapid Detection of Clinically Significant Carcinomas—A Feasibility Study. Cancers 2024, 16, 873.
Abstract
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 hours 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 (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 reduce the psychological stress on patients an can improve the clinical management of csPCa. Additional SBx can be avoided in individual cases, leading to lower rates of complications and scaring 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.
Medicine and Pharmacology, Oncology and Oncogenics
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