Prostate histoscanning in clinically localized biopsy proven prostate cancer - an accuracy study
Macek P, Barret E, Sanchez-Salas R, Galiano M, Rozet F, Ahallal Y, Gaya JM, Durand M, Mascle L, Giedelman C, Lunelli L, Validire P, Nesvadba M, Cathelineau X. J Endourol. 2013 Sep 15. [Epub ahead of print]

Abstract

Objectives: To assess the accuracy of prostate histoscanning (PHS) for spatial detection and localization of PCa. Patients and methods: Prospective, single center study from January to September 2012 was conducted. Inclusion criterion was biopsy confirmed PCa in patients scheduled for radical prostatectomy. Totally, 98 patients were included in the study. Results of PHS were compared against whole-mount step sectioning by Stanford technique. Lower limit of 0.1 cm3was used for PHS. Dedicated 12-sector form was used for spatial correlation. Urologist and pathologist were blinded for each other results. Sensitivity, specificity and receiver operating characteristic curves were calculated with logistic regression model for covariates. Results: PHS performance for detection of PCa lesions ≥ 0.1 cm3 had sensitivity 60%, specificity 66%, area under curve (AUC) 0.63. Posterior and anterior sectors achieved sensitivity 77%, specificity 39% and 28% and 84%, respectively. Model containing PHS positivity within given sector reached sensitivity 73.4%, specificity 65.7%, AUC 0.75. In logistic regression model the performance of PHS was affected by sector location, rectal distance, index and total cancer volume (all p < 0.0001) and bladder fullness (p = 0.02).The best PHS accuracy was present in mid posterior sectors. Conclusions: PHS has a potential for clinical practice, especially if PHS positivity within given sectors is taken into account. Trained operator is important. More studies are necessary to test different detection limits in various clinical settings, such as targeted biopsies and image guided focal therapy.