MP53-13 DIAGNOSIS OF HIGH GRADE PROSTATIC CANCER USING DIFFUSE REFLECTANCE SPECTROSCOPY (2014)

You have accessJournal of UrologyProstate Cancer: Detection & Screening II1 Apr 2014MP53-13 DIAGNOSIS OF HIGH GRADE PROSTATIC CANCER USING DIFFUSE REFLECTANCE SPECTROSCOPY Priya N. Werahera, Edward A. Jasion, Yongjun Liu, M. Scott Lucia, Adrie van Bokhoven, Holly T. Sullivan, E. David Crawford, Paul D. Maroni, Fernando J. Kim, John W. Daily, and Francisco G. La Rosa Priya N. WeraheraPriya N. Werahera More articles by this author , Edward A. JasionEdward A. Jasion More articles by this author , Yongjun LiuYongjun Liu More articles by this author , M. Scott LuciaM. Scott Lucia More articles by this author , Adrie van BokhovenAdrie van Bokhoven More articles by this author , Holly T. SullivanHolly T. Sullivan More articles by this author , E. David CrawfordE. David Crawford More articles by this author , Paul D. MaroniPaul D. Maroni More articles by this author , Fernando J. KimFernando J. Kim More articles by this author , John W. DailyJohn W. Daily More articles by this author , and Francisco G. La RosaFrancisco G. La Rosa More articles by this author View All Author Informationhttps://doi.org/10.1016/j.juro.2014.02.1644AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookTwitterLinked InEmail Introduction and Objectives High grade (HG) prostatic carcinoma (PCa) that includes Gleason patterns 4 and 5 indicate worse clinical outcome for patients. Due to sampling errors, transrectal ultrasound guided prostate biopsies often fail to diagnose HG PCa. Consequently, patients are often upgraded following prostatectomy. Diffuse reflectance spectra (DRS) depend on tissue morphology/architecture; hence DRS may be useful to differentiate cancer grades. We investigated whether DRS can be used to diagnose HG PCa. Methods A 15 gauge minimally invasive optical biopsy needle with a light sensitive sensor was prototyped to take prostate biopsies after measuring DRS with a laboratory fluorometer. The optical sensor consists of eight 100 micron fibers for tissue excitation and a single 200 micron fiber to capture DRS. We obtained correlative biopsy cores from surgically excised prostates after measuring DRS between 500-700nm. Histopathology of tissue within the measurement window was correlated with corresponding spectra. Gleason score 3+3 cancer was classified as low grade (LG), Gleason score ≥7 as HG, and otherwise as benign. Partial least square analysis of tissue spectra was performed to identify partial least square components (PLSCs) as potential classifiers. Using linear support vector machine (SVM) and leave-one-out cross validation method, statistically significant PLSCs (P<0.05) were tested for their ability to classify biopsy tissue. Results A total of 187 biopsies taken from 20 prostates were studied. By histopathology we classified 29 as HG cancer, 49 as LG, and 109 as benign within the measurement window. Four different SVMs, each with different sets of PLSCs were used for binary classification of prostate tissue as summarized in the table. Conclusions An optical biopsy needle adjunct with DRS has sufficient accuracy to differentiate HG carcinoma from LG carcinoma and benign tissue in clinical settings. This method may be applied for more precise targeting of HG PCa lesions, providing more accurate assessment of grade of the disease, with the consequent improvement of patient care. To confirm these findings, DRS data from in vivo studies are required. We anticipate that the presence of blood flow may affect tissue morphology in a positive manner as angiogenesis becomes a major contributing factor to further improve diagnosis of HG carcinoma. Prostate Tissue Classification Using Diffuse Reflectance Spectra Classification Type Sensitivity Specificity Negative Predictive Value Positive Predictive Value High Grade versus Benign 76% 80% 93% 50% High Grade versus Low Grade 76% 73% 84% 63% Low Grade versus Benign 65% 71% 82% 50% Malignant versus Benign 70% 73% 77% 65% © 2014FiguresReferencesRelatedDetails Volume 191Issue 4SApril 2014Page: e593 Advertisement Copyright & Permissions© 2014MetricsAuthor Information Priya N. Werahera More articles by this author Edward A. Jasion More articles by this author Yongjun Liu More articles by this author M. Scott Lucia More articles by this author Adrie van Bokhoven More articles by this author Holly T. Sullivan More articles by this author E. David Crawford More articles by this author Paul D. Maroni More articles by this author Fernando J. Kim More articles by this author John W. Daily More articles by this author Francisco G. La Rosa More articles by this author Expand All Advertisement Advertisement PDF downloadLoading ...