One-Day Prostate Cancer Diagnosis: Biparametric Magnetic Resonance Imaging and Digital Pathology by Fluorescence Confocal Microscopy

被引:4
|
作者
Falagario, Ugo Giovanni [1 ]
Selvaggio, Oscar [1 ]
Sanguedolce, Francesca [2 ]
Milillo, Paola [3 ]
Sighinolfi, Maria Chiara [4 ]
Bruno, Salvatore Mariano [1 ]
Recchia, Marco [1 ]
Bettocchi, Carlo [1 ]
Busetto, Gian Maria [1 ]
Macarini, Luca [3 ]
Rocco, Bernardo [4 ]
Cormio, Luigi [1 ,5 ]
Carrieri, Giuseppe [1 ]
机构
[1] Univ Foggia, Dept Urol & Organ Transplantat, I-71122 Foggia, Italy
[2] Univ Foggia, Dept Pathol, I-71122 Foggia, Italy
[3] Univ Foggia, Dept Radiol, I-71122 Foggia, Italy
[4] Univ Milan, Dept Urol, ASST Santi Paolo & Carlo, Dipartimento Sci Salute, I-20142 Milan, Italy
[5] Bonomo Teaching Hosp, Dept Urol, I-76123 Andria, Italy
关键词
biparametric magnetic resonance imaging; digital pathology; fluorescence confocal microscopy; prostate cancer; RISK; MEN; MRI; PSA;
D O I
10.3390/diagnostics12020277
中图分类号
R5 [内科学];
学科分类号
1002 ; 100201 ;
摘要
In this prospective observational study, we tested the feasibility and efficacy of a novel one-day PCa diagnosis path based on biparametric magnetic resonance (bpMRI) and digital pathology by fluorescence confocal microscopy (FCM). Patients aged 55-70 years scheduled for PBx due to increased PSA levels (3-10 ng/mL) and/or abnormal digitorectal examination were enrolled. All patients underwent bpMRI and PBx with immediate FCM evaluation of biopsy cores. Patients were asked to fill out a dedicated Patient Satisfaction Questionnaire. Patients' satisfaction rates and concordance between digital pathology and standard HE evaluation were the outcomes of interest. Twelve patients completed our one-day PCa diagnosis path. BpMRI showed suspicious lesions in 7 patients. Digital pathology by FCM identified PCa in 5 (41.7%) of the 12 patients. Standard pathology confirmed the diagnosis made through digital pathology in all the cases. At a per patient level, high concordance between the methods was achieved in Gleason Grading (4 out of 5 patients). The level of agreement in the number of positive cores was lower but did not affect the choice of treatment in any of the 5 PCa cases. At a per core level, the agreement was very high for the diagnosis of anyPCa (96.2%) and csPCa (97.3%), with a k coefficient of 0.90 and 0.92, respectively (near perfect agreement). In conclusion, one-day PCa diagnosis by FCM represents a feasible, reliable, and fast diagnostic method that provides significant advantages in optimizing time and resources, leading to patients having a higher quality standard of care perception.
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页数:10
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