MP09-14 STIMULATED RAMAN HISTOLOGY ALLOWS FOR RAPID PATHOLOGIC EXAMINATION OF UNPROCESSED, FRESH PROSTATE BIOPSIES

Abstract

You have accessJournal of UrologyCME1 May 2022MP09-14 STIMULATED RAMAN HISTOLOGY ALLOWS FOR RAPID PATHOLOGIC EXAMINATION OF UNPROCESSED, FRESH PROSTATE BIOPSIES Miles P. Mannas, Derek Jones, Fang-Ming Deng, Deepthi Hoskoppal, Jonathan Melamed, Daniel Orringer, and Samir S. Taneja Miles P. MannasMiles P. Mannas More articles by this author , Derek JonesDerek Jones More articles by this author , Fang-Ming DengFang-Ming Deng More articles by this author , Deepthi HoskoppalDeepthi Hoskoppal More articles by this author , Jonathan MelamedJonathan Melamed More articles by this author , Daniel OrringerDaniel Orringer More articles by this author , and Samir S. TanejaSamir S. Taneja More articles by this author View All Author Informationhttps://doi.org/10.1097/JU.0000000000002531.14AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookLinked InTwitterEmail Abstract INTRODUCTION AND OBJECTIVE: Delay between prostate biopsy (PB) and pathologic diagnosis leads to a concern of inadequate sampling and repeated biopsy. Stimulated Raman Histology (SRH) is a novel microscopic technique allowing real time, label-free, high-resolution microscopic images of unprocessed, un-sectioned tissue. We evaluated the accuracy of pathologist interpretation of PB SRH as compared to traditional hematoxylin and eosin (H&E) stained slides. METHODS: Men undergoing prostatectomy were included in an IRB approved prospective study. 18-gauge PB cores, taken ex vivo from prostatectomy specimen, were scanned in a SRH microscope at 20 microns depth over 10-14 minutes using two Raman shifts: 2845cm-1 and 2930cm-1, to create SRH images. The cores were then processed as per normal pathologic protocols.16 PB containing benign/prostate cancer histology were used as a SRH training cohort for 4 GU pathologists (1, 3, 2x >15 yrs experience), who were then tested on a set of 32 PB imaged by SRH and processed by traditional H&E. Sensitivity, specificity, and concordance for PCa detection on SRH relative to a consensus H&E were assessed. With a two-sided alpha level of 5%, it was calculated 32 SRH imaged biopsies would provide 90% power to detect concordance (k). RESULTS: PB cores were imaged in 2-3 separate strips (8-11 minutes) shown in Figure 1. In identifying any cancer, pathologists achieved moderate concordance (k=0.570; p<0.001) which improved when identifying GGG 2-5 PCa only (k=0.640, p<0001; sensitivity 96.4%; specificity 58.3%). After individual assessment was completed a pathology consensus conference was held for the interpretation of the SRH PB. In identifying any prostate cancer, pathologists achieved near perfect concordance (k=0.925; p<0.001; sensitivity 95.6%; specificity 100%). When evaluating SRH in a consensus conference, the group prediction of Gleason score improved to moderate concordance (k=0.470; p<0.001). CONCLUSIONS: SRH produces high quality microscopic images that allow for accurate identification of PCa in real-time without need for sectioning or tissue-processing. Individual pathologist performance varied highly suggesting potential for improvement with further training. Source of Funding: NIH Grant: UL1TR001445 © 2022 by American Urological Association Education and Research, Inc.FiguresReferencesRelatedDetails Volume 207Issue Supplement 5May 2022Page: e141 Advertisement Copyright & Permissions© 2022 by American Urological Association Education and Research, Inc.MetricsAuthor Information Miles P. Mannas More articles by this author Derek Jones More articles by this author Fang-Ming Deng More articles by this author Deepthi Hoskoppal More articles by this author Jonathan Melamed More articles by this author Daniel Orringer More articles by this author Samir S. Taneja More articles by this author Expand All Advertisement PDF DownloadLoading ...