Prostate cancer treatment is shifting from radical to focal therapy. Instant tumor visualization on a microscopic level is crucial for clinical application of focal therapy. Optical coherence tomography (OCT) produces instant tissue visualization on a µm scale and the attenuation of OCT signal as a measure of tissue organization. The objective is to correlate qualitative and quantitative OCT analysis with histopathology.
Twenty prostates were analyzed by needle based OCT after radical prostatectomy. For precise correlation, whole mount histology slides were cut through the OCT trajectory. OCT images were classified in eight histological categories. Two reviewers independently performed assessment of the OCT images into these categories. Quantitative attenuation coefficient was used to discriminate stroma and malignant tissue. Sensitivity and specificity for detection of malignancy on OCT was calculated.
Visual analyses showed that OCT can reliably differentiate between fat, cystic and regular atrophy and benign glands. Differentiation of benign stroma and inflammation and also malignancy Gleason 3 and 4 is more difficult. Sensitivity and specificity for detection of malignancy on OCT were calculated at 77% and 75%. Quantitative analysis by means of the attenuation coefficient for differentiation between stroma and malignancy showed no significant difference (4.39 mm-1 vs. 5.31 mm-1).
Precise correlation of histology and OCT is possible and helps us to understand what we see and measure on OCT. Visual malignancy detection shows reasonable sensitivity and specificity. Our future studies focus on improving discrimination of malignancy with OCT for example by combining an extra imaging modality.
Abel Swaan, Berrend B. G. Muller, Rob A. A. van Kollenburg, Daniel M. de Bruin, Dick H.J.C. M. Sterenborg, Jean J.M.C. H. de la Rosette, Ton G. van Leeuwen, and Dirk J. Faber, "One to one correlation of needle based optical coherence tomography with histopathology: a qualitative and quantitative analysis in 20 prostatectomy specimens (Conference Presentation)," Proc. SPIE 10038, Therapeutics and Diagnostics in Urology: Lasers, Robotics, Minimally Invasive, and Advanced Biomedical Devices, 1003807 (Presented at SPIE BiOS: January 28, 2017; Published: 19 April 2017); https://doi.org/10.1117/12.2250119.5369935442001.
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