You have accessJournal of UrologyProstate Cancer: Localized: Ablative Therapy (MP46)1 Sep 2021MP46-14 INTRAOPERATIVE DIGITAL ANALYSIS OF ABLATION MARGINS (DAAM) BY FLUORESCENT CONFOCAL MICROSCOPY TO IMPROVE THE ACCURACY OF PARTIAL PROSTATE GLAND CRYOABLATION: A PILOT STUDY Ugo Falagario, Oscar Selvaggio, Salvatore Bruno, Marco Recchia, Maria Chiara Sighinolfi, Francesca Sanguedolce, Ardeshir Rastinehad, Rafael Sanchez-Salas, Eric Barret, Bernardo Rocco, Luigi Cormio, and Giuseppe Carrieri Ugo FalagarioUgo Falagario More articles by this author , Oscar SelvaggioOscar Selvaggio More articles by this author , Salvatore BrunoSalvatore Bruno More articles by this author , Marco RecchiaMarco Recchia More articles by this author , Maria Chiara SighinolfiMaria Chiara Sighinolfi More articles by this author , Francesca SanguedolceFrancesca Sanguedolce More articles by this author , Ardeshir RastinehadArdeshir Rastinehad More articles by this author , Rafael Sanchez-SalasRafael Sanchez-Salas More articles by this author , Eric BarretEric Barret More articles by this author , Bernardo RoccoBernardo Rocco More articles by this author , Luigi CormioLuigi Cormio More articles by this author , and Giuseppe CarrieriGiuseppe Carrieri More articles by this author View All Author Informationhttps://doi.org/10.1097/JU.0000000000002067.14AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookLinked InTwitterEmail Abstract INTRODUCTION AND OBJECTIVE: Partial gland cryoablation (PGC) aims at destroying prostate cancer (PCa) foci while sparing the unaffected prostate tissue and the functionally-relevant structures around the prostate. Magnetic Resonance Imaging (MRI) has boosted PGC but available evidence suggest that ablation margins may be positive due to MRI-invisible lesions.This pilot study aimed at determining the potential role of intraoperative digital analysis of ablation margins (DAAM) by fluoresce confocal microscopy (FCM) of biopsy cores taken during prostate PGC. METHODS: Ten patients with low to intermediate risk PCa scheduled for PGC were enrolled.Based on mpMRI findings and biopsy results, two to four 2.4 mm cryo-needles were inserted transperineally using a template grid and with the help of an Electromagnetically Tracked MRI/US Fusion system (Navigo, UC-Care). After creation of the ice balls, 7 to 10 biopsy cores, depending on prostate volume, were taken transperineally from ablation margins and untreated areas of the prostate (Figure 1).The cores were prepared for FMC (VivaScope® 2500 M-G4, VivaScope GmbH, Munich, Germany) in the OR by a urologist following the manufacturer guidelines. The obtained digital FCM images were sent for “real-time” pathology review to two dedicated uropathologists. RESULTS: DAAM, always completed within the frame of PGC treatment (median time 25 minutes), pointed out presence of PCa in 1/10 cores taken from 1 patient, thus prompting placement of another cryo-needle to treat this area. Standard HE evaluation confirmed 75 cores to be cancer-free while displayed a GG 4 PCa in 7% of the core positive at FCM. CONCLUSIONS: Intraoperative DAAM by FCM proved to be feasible and reliable. This strategy potentially allows to reduce disease recurrence by extending treatment to previously unsuspected areas of PCa as well as to reduce functional complications by limiting treatment to the affected areas while sparing surrounding structures. Source of Funding: None © 2021 by American Urological Association Education and Research, Inc.FiguresReferencesRelatedDetails Volume 206Issue Supplement 3September 2021Page: e819-e819 Advertisement Copyright & Permissions© 2021 by American Urological Association Education and Research, Inc.MetricsAuthor Information Ugo Falagario More articles by this author Oscar Selvaggio More articles by this author Salvatore Bruno More articles by this author Marco Recchia More articles by this author Maria Chiara Sighinolfi More articles by this author Francesca Sanguedolce More articles by this author Ardeshir Rastinehad More articles by this author Rafael Sanchez-Salas More articles by this author Eric Barret More articles by this author Bernardo Rocco More articles by this author Luigi Cormio More articles by this author Giuseppe Carrieri More articles by this author Expand All Advertisement Loading ...