Evaluation of initial prostate cancer biopsies utilizing 3D open‐top light‐sheet microscopy for detection of early disease

Abstract

AbstractBackgroundOpen‐top light‐sheet (OTLS) microscopy is a technique that allows for high‐resolution 3D imaging of tissue specimens and can therefore provide a more detailed assessment of tissue architecture. Given that Gleason grading is based on tissue architecture, we hypothesized that OTLS microscopy would enable us to survey a larger amount of tissue and detect occult prostate cancers in men who had prostate core biopsy specimens initially classified as being benign‐appearing who later developed clinically significant prostate cancers.MethodsBenign appearing tissue (based on routine pathologic evaluation) from 20 patients who subsequently developed a clinically significant prostate cancer (experimental group) was evaluated with OTLS microscopy and compared to tissue from 20 patients who underwent prostate biopsy and never developed a clinically significant prostate cancer (control group). We compared the incidence of detectable prostate cancer between groups.ResultsBaseline clinical characteristics were similar between the experimental and control groups. Three patients (15%) in the control group and one (5%) in the experimental group had suspicious findings on low‐resolution OTLS microscopy. Higher resolution OTLS imaging revealed two patients (10%) in the control group had an occult prostate cancer, while no occult cancers were found in the experimental group.ConclusionIn spite of a high pretest probability for the presence of an occult prostate cancer, we did not identify cancer in our experimental group. This may be due to under‐sampling at the time of prostate needle biopsy.