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van Breugel SJ, Low I, Christie ML, Pokorny MR, Nagarajan R, Holtkamp HU, Srinivasa K, Amirapu S, Nieuwoudt MK, Simpson MC, Zargar-Shoshtari K, Aguergaray C. Raman spectroscopy system for real-time diagnosis of clinically significant prostate cancer tissue. JOURNAL OF BIOPHOTONICS 2023; 16:e202200334. [PMID: 36715344 DOI: 10.1002/jbio.202200334] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/31/2022] [Revised: 01/24/2023] [Accepted: 01/25/2023] [Indexed: 05/17/2023]
Abstract
Prostate cancer (PCa) is a significant healthcare problem worldwide. Current diagnosis and treatment methods are limited by a lack of precise in vivo tissue analysis methods. Real-time cancer identification and grading could dramatically improve current protocols. Here, we report the testing of a thin optical probe using Raman spectroscopy (RS) and classification methods to detect and grade PCa accurately in real-time. We present the first clinical trial on fresh ex vivo biopsy cores from an 84 patient cohort. Findings from 2395 spectra measured on 599 biopsy cores show high accuracy for diagnosing and grading PCa. We can detect clinically significant PCa from benign and clinically insignificant PCa with 90% sensitivity and 80.2% specificity. We also demonstrate the ability to differentiate cancer grades with 90% sensitivity and specificity ≥82.8%. This work demonstrates the utility of RS for real-time PCa detection and grading during routine transrectal biopsy appointments.
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Affiliation(s)
- Suse J van Breugel
- The Photon Factory, University of Auckland, Auckland, New Zealand
- School of Chemical Sciences, University of Auckland, Auckland, New Zealand
- The Dodd-Walls Centre for Photonic and Quantum Technologies, University of Otago, Dunedin, New Zealand
| | - Irene Low
- Counties Manukau District Healthboard, Auckland, New Zealand
| | - Mary L Christie
- Counties Manukau District Healthboard, Auckland, New Zealand
| | - Morgan R Pokorny
- Counties Manukau District Healthboard, Auckland, New Zealand
- Auckland District Healthboard, Auckland, New Zealand
| | - Ramya Nagarajan
- Counties Manukau District Healthboard, Auckland, New Zealand
- Faculty of Medical and Health Sciences, University of Auckland, Auckland, New Zealand
| | - Hannah U Holtkamp
- The Photon Factory, University of Auckland, Auckland, New Zealand
- School of Chemical Sciences, University of Auckland, Auckland, New Zealand
| | - Komal Srinivasa
- Auckland District Healthboard, Auckland, New Zealand
- Faculty of Medical and Health Sciences, University of Auckland, Auckland, New Zealand
| | - Satya Amirapu
- Faculty of Medical and Health Sciences, University of Auckland, Auckland, New Zealand
| | - Michel K Nieuwoudt
- The Photon Factory, University of Auckland, Auckland, New Zealand
- School of Chemical Sciences, University of Auckland, Auckland, New Zealand
- The Dodd-Walls Centre for Photonic and Quantum Technologies, University of Otago, Dunedin, New Zealand
- The MacDiarmid Institute for Advanced Materials and Nanotechnology, Victoria University of Wellington, Wellington, New Zealand
| | - M Cather Simpson
- The Photon Factory, University of Auckland, Auckland, New Zealand
- School of Chemical Sciences, University of Auckland, Auckland, New Zealand
- The Dodd-Walls Centre for Photonic and Quantum Technologies, University of Otago, Dunedin, New Zealand
- The MacDiarmid Institute for Advanced Materials and Nanotechnology, Victoria University of Wellington, Wellington, New Zealand
- Department of Physics, University of Auckland, Auckland, New Zealand
| | - Kamran Zargar-Shoshtari
- Counties Manukau District Healthboard, Auckland, New Zealand
- Auckland District Healthboard, Auckland, New Zealand
- Faculty of Medical and Health Sciences, University of Auckland, Auckland, New Zealand
| | - Claude Aguergaray
- The Photon Factory, University of Auckland, Auckland, New Zealand
- The Dodd-Walls Centre for Photonic and Quantum Technologies, University of Otago, Dunedin, New Zealand
- Department of Physics, University of Auckland, Auckland, New Zealand
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Ma Z, Wang X, Zhang W, Gao K, Wang L, Qian L, Mu J, Zheng Z, Cao X. Developing a predictive model for clinically significant prostate cancer by combining age, PSA density, and mpMRI. World J Surg Oncol 2023; 21:83. [PMID: 36882854 PMCID: PMC9990202 DOI: 10.1186/s12957-023-02959-1] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/14/2022] [Accepted: 02/22/2023] [Indexed: 03/09/2023] Open
Abstract
PURPOSE The study aimed to construct a predictive model for clinically significant prostate cancer (csPCa) and investigate its clinical efficacy to reduce unnecessary prostate biopsies. METHODS A total of 847 patients from institute 1 were included in cohort 1 for model development. Cohort 2 included a total of 208 patients from institute 2 for external validation of the model. The data obtained were used for retrospective analysis. The results of magnetic resonance imaging were obtained using Prostate Imaging Reporting and Data System version 2.1 (PI-RADS v2.1). Univariate and multivariate analyses were performed to determine significant predictors of csPCa. The diagnostic performances were compared using the receiver operating characteristic (ROC) curve and decision curve analyses. RESULTS Age, prostate-specific antigen density (PSAD), and PI-RADS v2.1 scores were used as predictors of the model. In the development cohort, the areas under the ROC curve (AUC) for csPCa about age, PSAD, PI-RADS v2.1 scores, and the model were 0.675, 0.823, 0.875, and 0.938, respectively. In the external validation cohort, the AUC values predicted by the four were 0.619, 0.811, 0.863, and 0.914, respectively. Decision curve analysis revealed that the clear net benefit of the model was higher than PI-RADS v2.1 scores and PSAD. The model significantly reduced unnecessary prostate biopsies within the risk threshold of > 10%. CONCLUSIONS In both internal and external validation, the model constructed by combining age, PSAD, and PI-RADS v2.1 scores exhibited excellent clinical efficacy and can be utilized to reduce unnecessary prostate biopsies.
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Affiliation(s)
- Zengni Ma
- Department of Urology, The Fifth People's Hospital of Datong, 037000, Datong, China
| | - Xinchao Wang
- School of Public Health , Shanxi Medical University, Taiyuan, 030000, China
| | - Wanchun Zhang
- Department of Nuclear Medicine, Shanxi Bethune Hospital, Taiyuan, 030000, China
| | - Kaisheng Gao
- Department of Urology, First Hospital of Shanxi Medical University, Taiyuan, 030000, China
| | - Le Wang
- Department of Radiology, First Hospital of Shanxi Medical University, Taiyuan, 030000, China
| | - Lixia Qian
- Department of Radiology, Shanxi Bethune Hospital, Taiyuan, 030000, China
| | - Jingjun Mu
- Department of Urology, Shanxi Cancer Hospital, Taiyuan, 030000, China
| | - Zhongyi Zheng
- Department of Urology, First Hospital of Shanxi Medical University, Taiyuan, 030000, China
| | - Xiaoming Cao
- Department of Urology, First Hospital of Shanxi Medical University, Taiyuan, 030000, China.
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Chung JH, Park BK, Song W, Kang M, Sung HH, Jeon HG, Jeong BC, Seo SI, Jeon SS, Lee HM. TRUS-Guided Target Biopsy for a PI-RADS 3–5 Index Lesion to Reduce Gleason Score Underestimation: A Propensity Score Matching Analysis. Front Oncol 2022; 11:824204. [PMID: 35141158 PMCID: PMC8818749 DOI: 10.3389/fonc.2021.824204] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/29/2021] [Accepted: 12/30/2021] [Indexed: 11/26/2022] Open
Abstract
Background Magnetic resonance imaging (MRI) and transrectal ultrasound (TRUS)-guided cognitive or image fusion biopsy is performed to target a prostate imaging reporting and data system (PI-RADS) 3–5 lesion. Biopsy Gleason score (GS) is frequently underestimated compared to prostatectomy GS. However, it is still unclear about how many cores on target are necessary to reduce undergrading and if additional cores around the target may improve grade prediction on surgical specimen. Purpose To determine the number of target cores and targeting strategy to reduce GS underestimation. Materials and Methods Between May 2017 and April 2020, a total of 385 patients undergoing target cognitive or image fusion biopsy of PI-RADS 3–5 index lesions and radical prostatectomies (RP) were 2:1 matched with propensity score using multiple variables and divided into the 1–4 core (n = 242) and 5–6 core (n = 143) groups, which were obtained with multiple logistic regression with restricted cubic spline curve. Target cores of 1–3 and 4–6 were sampled from central and peripheral areas, respectively. Pathologic outcomes and target cores were retrospectively assessed to analyze the GS difference or changes between biopsy and RP with Wilcoxon signed-rank test. Results The median of target cores was 3 and 6 in the 1–4 core and 5–6 core groups, respectively (p < 0.001). Restricted cubic spline curve showed that GS upgrade was significantly reduced from the 5th core and there was no difference between 5th and 6th cores. Among the matched patients, 35.4% (136/385; 95% confidence interval, 0.305–0.403) had a GS upgrade after RP. The GS upgrades in the 1–4 core and 5–6 core groups were observed in 40.6% (98/242, 0.343–0.470) and 26.6% (38/143, 0.195–0.346), respectively (p = 0.023). Although there was no statistical difference between the matched groups in terms of RP GS (p = 0.092), the 5–6 core group had significantly higher biopsy GS (p = 0.006) and lower GS change from biopsy to RP (p = 0.027). Conclusion Five or more target cores sampling from both periphery and center of an index tumor contribute to reduce GS upgrade.
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Affiliation(s)
- Jae Hoon Chung
- Department of Urology, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, South Korea
| | - Byung Kwan Park
- Department of Radiology, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, South Korea
- *Correspondence: Byung Kwan Park, ;
| | - Wan Song
- Department of Urology, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, South Korea
| | - Minyong Kang
- Department of Urology, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, South Korea
| | - Hyun Hwan Sung
- Department of Urology, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, South Korea
| | - Hwang Gyun Jeon
- Department of Urology, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, South Korea
| | - Byong Chang Jeong
- Department of Urology, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, South Korea
| | - Seong Il Seo
- Department of Urology, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, South Korea
| | - Seong Soo Jeon
- Department of Urology, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, South Korea
| | - Hyun Moo Lee
- Department of Urology, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, South Korea
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