title: Real-time cancer diagnosis during prostate biopsy: ex vivo evaluation of full-field optical coherence tomography (FFOCT) imaging on biopsy cores.
abstract: OBJECTIVE
  To evaluate the diagnostic accuracy (Acc) of full-field optical coherence tomography (FFOCT) for cancer detection on prostate biopsy.
  
  
  METHODS
  Thirty-eight consecutive patients with elevated PSA and/or suspicious digital rectal examination were prospectively included. For each patient, 1-10 cores were randomly selected and imaged with FFOCT immediately after sampling. The images obtained were de-identified and analyzed by three pathologists blinded to the results of pathological evaluation. The overall average Acc was measured, as well as sensitivity (Se), specificity (Sp), positive and negative predictive values (PPV and NPV). The Acc learning curve was assessed by multivariate logistic regression, and inter-reader concordance was assessed by Kappa index.
  
  
  RESULTS
  One hundred and nineteen cores were imaged. Of them, 40 (33.6%) were involved with cancer. The overall average Acc of FFOCT for cancer detection was of 70.6%. Se, Sp, PPV, and NPV were of 63, 74, 55.5, and 80%, respectively. A substantial agreement was observed among pathologists (κ = 0.6, p < 0.001). On multivariate analysis, Acc was associated with the number of previously interpreted cases, with a predicted Acc of 82% at the end of learning curve. The overall average accuracy for high Gleason score (>3 + 3) determination was of 72%, although results were limited by the small amount of cases.
  
  
  CONCLUSIONS
  FFOCT of prostate biopsy cores may provide a diagnostic accuracy greater than 80%, with a good reliability and a high NPV.
  
  
  CONCLUSIONS
  "Full-field optical coherence tomography is a novel imaging modality that could have a potential value in real-time diagnosis of prostate cancer during prostate biopsy procedures."
authors.affiliation: Service d'Urologie, Hôpital Cochin, Paris Descartes University, 27 rue du Faubourg Saint Jacques, 75014, Paris, France.
authors.forename: Jonathan
authors.initials: J
authors.lastname: Lopater
authors.affiliation: Department of Pathology, Cochin Hospital, Paris Descartes University, Paris, France.
authors.forename: Pierre
authors.initials: P
authors.lastname: Colin
authors.affiliation: Department of Pathology, Cochin Hospital, Paris Descartes University, Paris, France.
authors.forename: Frédéric
authors.initials: F
authors.lastname: Beuvon
authors.affiliation: Department of Pathology, Cochin Hospital, Paris Descartes University, Paris, France.
authors.forename: Mathilde
authors.initials: M
authors.lastname: Sibony
authors.affiliation: LLTech SAS, Paris, France.
authors.forename: Eugénie
authors.initials: E
authors.lastname: Dalimier
authors.affiliation: Department of Radiology, Cochin Hospital, Paris Descartes University, Paris, France.
authors.forename: François
authors.initials: F
authors.lastname: Cornud
authors.affiliation: Service d'Urologie, Hôpital Cochin, Paris Descartes University, 27 rue du Faubourg Saint Jacques, 75014, Paris, France. nicolasbdl@hotmail.com.
authors.forename: Nicolas Barry
authors.initials: NB
authors.lastname: Delongchamps
mesh_terms: D000368:Aged; D006801:Humans; D061705:Image-Guided Biopsy / Q000379:methods*; D008297:Male; D008875:Middle Aged; D011446:Prospective Studies; D011467:Prostate / Q000473:pathology*; D011471:Prostatic Neoplasms / Q000175:diagnosis*; D013997:Time Factors; D041623:Tomography, Optical Coherence / Q000379:methods*
keywords: Biopsy; Diagnostic; Full-field optical coherence tomography; Prostate cancer