Abstract
Gleason score is a highly prognostic factor for prostate cancer describing the microscopic architecture of the tumor tissue. The standard procedure for evaluating Gleason scores, namely biopsy, is to remove prostate tissue for observation under microscope. Currently, biopsies are guided by transrectal ultrasound (TRUS). Due to the low sensitivity of TRUS to prostate cancer (PCa), non-guided and saturated biopsies are frequently employed, unavoidably causing pain, damage to the normal prostate tissues and other complications. More importantly, due to the limited number of biopsy cores, current procedure could either miss early stage small tumors or undersample aggressive cancers. Photoacoustic (PA) measurement has the unique capability of evaluating tissue microscopic architecture information at ultrasonic resolution. By frequency domain analysis of the broadband PA signal, namely PA spectral analysis (PASA), the microscopic architecture within the assessed tissue can be quantified. This study investigates the feasibility of evaluating Gleason scores by PASA. Simulations with the classic Gleason patterns and experiment measurements from human PCa tissues have demonstrated strong correlation between the PASA parameters and the Gleason scores.
Highlights
During the past decades, prostate cancer (PCa), with an annual incident rate much higher than any other cancer, is the most commonly diagnosed cancer in American men [1]
The results from this study suggest that PA spectral analysis (PASA) could provide diagnosis of PCa by quantifying the microscopic architectures in the cancerous tissues
The simulation with the classic Gleason patterns and the experiment on human PCa tissues have demonstrated the feasibility of quantifying the Gleason grades/score with the recently developed PASA method
Summary
Prostate cancer (PCa), with an annual incident rate much higher than any other cancer, is the most commonly diagnosed cancer in American men [1]. Several serum and urine based biomarkers (e.g. 4Kscore, phi, PCA3, MiPS) have been advanced that improve upon the PSA for predicting the presence of PCa on biopsy [19, 22,23,24] None of these markers are specific for high grade aggressive PCa. Elevated serum PSA, along with results from these tests or physical examination (e.g. digital rectal exam), will lead to ultrasound (US) guided, transrectal US (TRUS) biopsy, the standard procedure for evaluating the presence and aggressiveness of PCa. The microscopic architecture of the biopsied tissues, stained and visualized by standard hematoxylin and eosin (H&E) or immunohistochemical (IHC) histology, are evaluated by pathologists. Repeated biopsies are performed in patients with negative initial biopsies yet continuously increased PSA levels, leading to added diagnostic costs, anxiety, pain, potential infection, and unrecoverable damage to the neurovascular bundles and erectile dysfunction [30]
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