Histopathologic examination of the pathologic specimens using hematoxylin & eosin stains represents the backbone of the modern pathology. It is time-consuming; thus, "real-time" assessment of prostatic and periprostatic tissue has gained special interest in the diagnosis and management of prostate cancer. The current study focuses on the review of the different available techniques for "real-time" evaluation of surgical margins during radical prostatectomy (RP). We performed a comprehensive search of the Medline database to identify all the articles discussing "real-time" or intraoperative assessment of surgical margins during RP. Several filters were applied to the search to include only English articles performed on human subjects and published between January 2000 and March 2019. The search revealed several options for pathologic assessment of surgical margins including intraoperative frozen sections, confocal laser endomicroscopy, optical spectroscopy, photodynamic diagnosis, optical coherence tomography, multiphoton microscopy, structured illumination microscopy, 3D augmented reality, and ex vivo fluorescence confocal microscope. Frozen section represents the gold standard technique for real-time pathologic examinations of surgical margins during RP; however, several other options showed promising results in the initial clinical trials, and considering the rapid development in the field of molecular and cellular imaging, some of these options may serve as an alternative to frozen section.
Keywords: Confocal microscopy; Extra-prostatic extension; Frozen section; Pathologic examination; Prostate cancer.
Copyright © 2019. Published by Elsevier Inc.
Atlas of Ex Vivo Prostate Tissue and Cancer Images Using Confocal Laser Endomicroscopy: A Project for Intraoperative Positive Surgical Margin Detection During Radical ProstatectomyD Panarello et al. Eur Urol Focus. PMID 30683530.Each CLE image was correlated with the corresponding haematoxylin/eosin/saffron definitive pathology image, allowing building of an atlas as a necessary tool to assess th …
Intraoperative Optical Biopsy During Robotic Assisted Radical Prostatectomy Using Confocal EndomicroscopyA Lopez et al. J Urol 195 (4 Pt 1), 1110-1117. PMID 26626214.We report the initial feasibility of optical biopsy of prostatic and periprostatic tissue during robotic assisted radical prostatectomy. Image guidance and tissue interro …
Confocal Laser Endomicroscopy and Optical Coherence Tomography for the Diagnosis of Prostate Cancer: A Needle-Based, In Vivo Feasibility Study Protocol (IDEAL Phase 2A)A Swaan et al. JMIR Res Protoc 7 (5), e132. PMID 29784633.Confocal laser endomicroscopy and optical coherence tomography are promising optical imaging techniques that can visualize and analyze tissue structure, possible tumor gr …
Positive Surgical Margins After Radical Prostatectomy: A Systematic Review and Contemporary UpdateO Yossepowitch et al. Eur Urol 65 (2), 303-13. PMID 23932439. - ReviewAlthough positive margins in prostate cancer are considered an adverse oncologic outcome, their long-term impact on survival is highly variable and largely influenced by …
Role of In Vivo Reflectance Confocal Microscopy in the Analysis of Melanocytic LesionsED Serban et al. Acta Dermatovenerol Croat 26 (1), 64-67. PMID 29782304. - ReviewWorldwide melanoma incidence and mortality are increasing (1). Despite the ongoing research, advanced melanoma is still incurable; therefore, the most appropriate solutio …