Detecting Positive Surgical Margins Using Single Optical Fiber Probe During Radical Prostatectomy: A Pilot Study

Abstract

To investigate for the potential of detection of positive surgical margins by the elastic light single-scattering spectroscopy (ELSSS) system with a single optical fiber probe during radical prostatectomy. ELSSS spectra in the 450- to 750-nm wavelength regions were obtained from a total of 31 benign tissue samples and 14 malignant tissue samples from 18 patients. The ELSSS spectral data were assessed by comparing these against the "gold standard" histopathology results. Data were analyzed using principal component analysis , followed by linear discriminant analysis. Receiver operating characteristic curve analysis was used for differentiating performance. Classification based on the discriminant score provided a sensitivity of 86% and a specificity of 97%, in differentiating benign from malignant surgical margins of prostate tissues, with a positive predictive value of 0.92, a negative predictive value of 0.94, and the area under the receiver operating characteristic curve of 0.87. The ELSSS system can accurately distinguish between benign and malignant surgical margins of prostate tissues with a high positive predictive value and negative predictive value. It is a promising technique, and it may be a valuable new tool for determining positive surgical margins during radical prostatectomy.