1 Department of Urology, Institut Montsouris and Descartes University , Paris, France .
J Endourol. 2014 Mar;28(3):371-6. doi: 10.1089/end.2013.0419. Epub 2013 Dec 26.
To assess the accuracy of prostate histoscanning (PHS) for spatial detection and localization of prostate cancer (PCa).
Prospective, single center study from January to September 2012 was conducted. Inclusion criterion was biopsy confirmed PCa in patients scheduled for radical prostatectomy. In total, 98 patients were included in the study. Results of PHS were compared against whole-mount step sectioning by the Stanford technique. A lower limit of 0.1 cm(3) was used for PHS. A dedicated 12-sector form was used for spatial correlation. The urologist and pathologist were blinded for each other's results. Sensitivity, specificity, and receiver operating characteristic curves were calculated with a logistic regression model for covariates.
PHS performance for detection of PCa lesions ≥0.1 cm(3) had sensitivity of 60%, specificity of 66%, and area under the curve (AUC) of 0.63. Posterior and anterior sectors achieved sensitivity of 77%, specificity of 39%, and 28% and 84%, respectively. The model containing PHS positivity within a given sector reached sensitivity of 73.4%, specificity of 65.7%, and AUC of 0.75. In a ogistic regression model, the performance of PHS was affected by sector location, rectal distance, index, and total cancer volume (all P<0.0001) and bladder fullness (P=0.02). The best PHS accuracy was present in midposterior sectors.
PHS has a potential for clinical practice, especially if PHS positivity within given sectors is taken into account. A trained operator is important. More studies are necessary to test different detection limits in various clinical settings, such as targeted biopsies and image guided focal therapy.
评估前列腺组织扫描（PHS）在前列腺癌（PCa）的空间检测和定位中的准确性。
这是一项 2012 年 1 月至 9 月进行的前瞻性、单中心研究。纳入标准为计划接受根治性前列腺切除术的患者活检证实为 PCa。共有 98 例患者纳入本研究。将 PHS 的结果与斯坦福技术的全距切片进行比较。PHS 的下限为 0.1cm³。使用专用的 12 扇区形式进行空间相关性。泌尿科医生和病理学家对彼此的结果均不知情。使用逻辑回归模型计算协变量的敏感性、特异性和接收者操作特征曲线。
对于检测≥0.1cm³的 PCa 病变，PHS 的性能具有 60%的敏感性、66%的特异性和 0.63 的曲线下面积（AUC）。后和前扇区的敏感性分别为 77%、39%、28%和 84%，特异性分别为 39%、84%。在给定扇区中包含 PHS 阳性的模型达到了 73.4%的敏感性、65.7%的特异性和 0.75 的 AUC。在逻辑回归模型中，PHS 的性能受扇区位置、直肠距离、指数和总癌症体积（均 P<0.0001）和膀胱充盈度（P=0.02）的影响。在中后扇区，PHS 的准确性最高。
PHS 具有临床应用的潜力，特别是如果考虑到给定扇区中的 PHS 阳性，则尤其如此。训练有素的操作员很重要。需要进行更多的研究来测试不同的检测限在不同的临床环境中的效果，例如靶向活检和图像引导的聚焦治疗。
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