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Nonlinear microscopy for detection of prostate cancer: analysis of sensitivity and specificity in radical prostatectomies
Intraoperative evaluation of specimens during radical prostatectomy using frozen sections can be time and labor intensive. Nonlinear microscopy (NLM) is a fluorescence microscopy technique that can rapidly generate images that closely resemble H&E histology in freshly excised tissue, without req...
Autores principales: | , , , , , , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
2019
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Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7195230/ https://www.ncbi.nlm.nih.gov/pubmed/31745288 http://dx.doi.org/10.1038/s41379-019-0408-4 |
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author | Cahill, Lucas C. Wu, Yubo Yoshitake, Tadayuki Ponchiardi, Cecilia Giacomelli, Michael G. Wagner, Andrew A. Rosen, Seymour Fujimoto, James G. |
author_facet | Cahill, Lucas C. Wu, Yubo Yoshitake, Tadayuki Ponchiardi, Cecilia Giacomelli, Michael G. Wagner, Andrew A. Rosen, Seymour Fujimoto, James G. |
author_sort | Cahill, Lucas C. |
collection | PubMed |
description | Intraoperative evaluation of specimens during radical prostatectomy using frozen sections can be time and labor intensive. Nonlinear microscopy (NLM) is a fluorescence microscopy technique that can rapidly generate images that closely resemble H&E histology in freshly excised tissue, without requiring freezing or microtome sectioning. Specimens are stained with nuclear and cytoplasmic/stromal fluorophores, and nonlinear microscopy evaluation can begin within 3 minutes of grossing. Fluorescence signals can be displayed using an H&E color scale, facilitating pathologist interpretation. This study evaluates the accuracy of prostate cancer detection in blinded reading of nonlinear microscopy images compared to the gold-standard of formalin fixed, paraffin embedded H&E histology. A total of 122 freshly excised prostate specimens were obtained from 40 patients undergoing radical prostatectomy. The prostates were grossed, dissected into specimens of ~10×10 mm with 1–4 mm thickness, stained for 2 minutes for nuclear and cytoplasmic/stromal contrast, and then rinsed with saline for 30 seconds. Nonlinear microscopy images were acquired and multiple images were stitched together to generate large field of view, centimeter-scale digital images suitable for reading. Specimens were then processed for standard paraffin H&E. The study protocol consisted of training, pre-testing, and blinded reading phases. After a washout period, pathologists read corresponding paraffin H&E slides. Three pathologists achieved a 95% or greater sensitivity with 100% specificity for detecting cancer on nonlinear microscopy compared to paraffin H&E. Pooled sensitivity and specificity was 97.3% (93.7%−99.1%; 95% confidence interval) and 100.0% (97%−100%), respectively. Interobserver agreement for nonlinear microscopy reading had a Fleiss κ=0.95. The high cancer detection accuracy and rapid specimen preparation suggest that nonlinear microscopy may be useful for intraoperative evaluation in radical prostatectomy. |
format | Online Article Text |
id | pubmed-7195230 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2019 |
record_format | MEDLINE/PubMed |
spelling | pubmed-71952302020-05-19 Nonlinear microscopy for detection of prostate cancer: analysis of sensitivity and specificity in radical prostatectomies Cahill, Lucas C. Wu, Yubo Yoshitake, Tadayuki Ponchiardi, Cecilia Giacomelli, Michael G. Wagner, Andrew A. Rosen, Seymour Fujimoto, James G. Mod Pathol Article Intraoperative evaluation of specimens during radical prostatectomy using frozen sections can be time and labor intensive. Nonlinear microscopy (NLM) is a fluorescence microscopy technique that can rapidly generate images that closely resemble H&E histology in freshly excised tissue, without requiring freezing or microtome sectioning. Specimens are stained with nuclear and cytoplasmic/stromal fluorophores, and nonlinear microscopy evaluation can begin within 3 minutes of grossing. Fluorescence signals can be displayed using an H&E color scale, facilitating pathologist interpretation. This study evaluates the accuracy of prostate cancer detection in blinded reading of nonlinear microscopy images compared to the gold-standard of formalin fixed, paraffin embedded H&E histology. A total of 122 freshly excised prostate specimens were obtained from 40 patients undergoing radical prostatectomy. The prostates were grossed, dissected into specimens of ~10×10 mm with 1–4 mm thickness, stained for 2 minutes for nuclear and cytoplasmic/stromal contrast, and then rinsed with saline for 30 seconds. Nonlinear microscopy images were acquired and multiple images were stitched together to generate large field of view, centimeter-scale digital images suitable for reading. Specimens were then processed for standard paraffin H&E. The study protocol consisted of training, pre-testing, and blinded reading phases. After a washout period, pathologists read corresponding paraffin H&E slides. Three pathologists achieved a 95% or greater sensitivity with 100% specificity for detecting cancer on nonlinear microscopy compared to paraffin H&E. Pooled sensitivity and specificity was 97.3% (93.7%−99.1%; 95% confidence interval) and 100.0% (97%−100%), respectively. Interobserver agreement for nonlinear microscopy reading had a Fleiss κ=0.95. The high cancer detection accuracy and rapid specimen preparation suggest that nonlinear microscopy may be useful for intraoperative evaluation in radical prostatectomy. 2019-11-19 2020-05 /pmc/articles/PMC7195230/ /pubmed/31745288 http://dx.doi.org/10.1038/s41379-019-0408-4 Text en Users may view, print, copy, and download text and data-mine the content in such documents, for the purposes of academic research, subject always to the full Conditions of use:http://www.nature.com/authors/editorial_policies/license.html#terms |
spellingShingle | Article Cahill, Lucas C. Wu, Yubo Yoshitake, Tadayuki Ponchiardi, Cecilia Giacomelli, Michael G. Wagner, Andrew A. Rosen, Seymour Fujimoto, James G. Nonlinear microscopy for detection of prostate cancer: analysis of sensitivity and specificity in radical prostatectomies |
title | Nonlinear microscopy for detection of prostate cancer: analysis of sensitivity and specificity in radical prostatectomies |
title_full | Nonlinear microscopy for detection of prostate cancer: analysis of sensitivity and specificity in radical prostatectomies |
title_fullStr | Nonlinear microscopy for detection of prostate cancer: analysis of sensitivity and specificity in radical prostatectomies |
title_full_unstemmed | Nonlinear microscopy for detection of prostate cancer: analysis of sensitivity and specificity in radical prostatectomies |
title_short | Nonlinear microscopy for detection of prostate cancer: analysis of sensitivity and specificity in radical prostatectomies |
title_sort | nonlinear microscopy for detection of prostate cancer: analysis of sensitivity and specificity in radical prostatectomies |
topic | Article |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7195230/ https://www.ncbi.nlm.nih.gov/pubmed/31745288 http://dx.doi.org/10.1038/s41379-019-0408-4 |
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