Detecting positive surgical margins: utilisation of light-reflectance spectroscopy on ex vivo prostate specimens.
OBJECTIVE
To assess the efficacy of light-reflectance spectroscopy (LRS) to detect positive surgical margins (PSMs) on ex vivo radical prostatectomy (RP) specimens.


METHODS
A prospective evaluation of ex vivo RP specimens using LRS was performed at a single institution from June 2013 to September 2014. LRS measurements were performed on selected sites on the prostate capsule, marked with ink, and correlated with pathological analysis. Significant features on LRS curves differentiating malignant tissue from benign tissue were determined using a forward sequential selection algorithm. A logistic regression model was built and randomised cross-validation was performed. The sensitivity, specificity, accuracy, negative predictive value (NPV), positive predictive value (PPV), and area under the receiver operating characteristic curve (AUC) for LRS predicting PSM were calculated.


RESULTS
In all, 50 RP specimens were evaluated using LRS. The LRS sensitivity for Gleason score ≥7 PSMs was 91.3%, specificity 92.8%, accuracy 92.5%, PPV 73.2%, NPV 99.4%, and the AUC was 0.960. The LRS sensitivity for Gleason score ≥6 PSMs was 65.5%, specificity 88.1%, accuracy 83.3%, PPV 66.2%, NPV 90.7%, and the AUC was 0.858.


CONCLUSIONS
LRS can reliably detect PSMs for Gleason score ≥7 prostate cancer in ex vivo RP specimens.
Department of Urology, University of Texas Southwestern Medical Center, Dallas, TX, USA.
Aaron H
AH
Lay
Department of Bioengineering, University of Texas at Arlington, Arlington, TX, USA.
Xinlong
X
Wang
Department of Urology, University of Texas Southwestern Medical Center, Dallas, TX, USA.
Monica S C
MS
Morgan
Department of Pathology, University of Texas Southwestern Medical Center, Dallas, TX, USA.
Payal
P
Kapur
Department of Bioengineering, University of Texas at Arlington, Arlington, TX, USA.
Hanli
H
Liu
Department of Urology, University of Texas Southwestern Medical Center, Dallas, TX, USA.
Claus G
CG
Roehrborn
Department of Urology, University of Texas Southwestern Medical Center, Dallas, TX, USA.
Jeffrey A
JA
Cadeddu
D000328:Adult; D000368:Aged; D006801:Humans; D008297:Male; D000072662:Margins of Excision; D008875:Middle Aged; D011446:Prospective Studies; D011471:Prostatic Neoplasms / Q000473:pathology* / Q000601:surgery*; D013057:Spectrum Analysis
positive surgical margins; prostate cancer; prostatectomy; spectroscopy