Does Prostate HistoScanning™ accurately identify prostate cancer, measure tumour volume and assess pathological stage prior to radical prostatectomy?. (November 2013)

• Record Type: Journal Article
• Authors: Javed, Saqib; Chadwick, Eliot; Beveridge, Sabeena; Bott, Simon; Eden, Christopher; Langley, Stephen
• Is Part Of: Journal of clinical urology. Volume 6:Number 6(2013)
• Page Start: 395
• Page End: 402
• Publication Date: 2013-11
• Subjects: Prostate cancer -- transrectal ultrasound -- Prostate HistoScanning™ -- tumour volume -- radical prostatectomy; Genitourinary organs -- Surgery -- Periodicals; Genitourinary organs -- Diseases -- Periodicals; Urology -- Periodicals; 616.6005
• DOI: 10.1177/2051415813489682
• Languages: English
• ISSNs: 2051-4158

Abstract

Objective: The objective of this paper is to assess the ability of Prostate HistoScanning™ (PHS) to accurately identify tumour volume, index lesion characteristics and pathological stage. PHS is a novel technology employing transrectal ultrasound scanning and software analysis of radiofrequency data to produce signatures for benign and cancerous tissues. Recent reports have suggested PHS is capable of characterising the index cancer lesion and disease multifocality and detecting extraprostatic extension (EPE). Materials and methods: The index test was preoperative PHS on patients undergoing radical prostatectomy (RP). The reference test was the whole-mount pathological analysis of the RP specimen. PHS analysis estimated total tumour volumes, tumour volumes by prostate sextant, the locations and volumes of index lesions, and the presence and location of EPE. Results: There was no correlation between PHS and histology total tumour volume estimates (Pearson coefficient –0.099), despite accounting for specimen fixation shrinkage (Pearson coefficient –0.070), nor among 144 prostate sextants in 24 patients (Pearson coefficient 0.14). Sensitivity and specificity of PHS in detecting foci > 0.2 ml were 63% and 53%, respectively; and 37% and 71%, respectively, for foci > 0.5 ml. Pearson correlation coefficient for index lesion volumes identified at pathology vs PHS was 0.065. PHS failed to locate accurately index lesion and pathological EPE. Conclusions: PHS fails to identify total tumour volumes, tumour volumes prostate sextant, index lesion volumes and locations, and presence and location of EPE compared to RP pathology. PHS appears unsuitable for routine diagnostic clinical use in prostate cancer.