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    Needle-based optical coherence tomography for the detection of prostate cancer: A visual and quantitative analysis in 20 patients
    (Spie-Soc Photo-Optical Instrumentation Engineers, 2018) Muller, Berrend G.; van Kollenburg, Rob A. A.; Swaan, Abel; Zwartkruis, Evita C. H.; Brandt, Martin J.; Wilk, Leah S.; Almasian, Mitra; Schreurs, A. Wim; Faber, Dirk J.; Rozendaal, L. Rence; Vis, Andre N.; Nieuwenhuijzen, Jakko A.; van Moorselaar, Jeroen R. J. A.; de la Rosette, Jean J. M. C. H.; de Bruin, Daniel Martijn; van Leeuwen, Ton G.
    Diagnostic accuracy of needle-based optical coherence tomography (OCT) for prostate cancer detection by visual and quantitative analysis is defined. 106 three-dimensional (3-D)-OCT data sets were acquired in 20 prostates after radical prostatectomy and precisely matched with pathology. OCT images were grouped per histological category. Two reviewers performed blind assessments of the OCT images. Sensitivity and specificity for malignancy detection were calculated. Quantitative analyses by automated optical attenuation coefficient calculation were performed. OCT can reliably differentiate between fat, cystic, and regular atrophy and benign glands. The overall sensitivity and specificity for malignancy detection was 79% and 88% for reviewer 1 and 88% and 81% for reviewer 2. Quantitative analysis for differentiation between stroma and malignancy showed a significant difference (4.6mm(-1) versus 5.0mm(-1) Mann-Whitney U-test p <0.0001). A Kruskal-Wallis test showed a significant difference in median attenuation coefficient between stroma, inflammation, Gleason 3, and Gleason 4 (4.6, 4.1, 5.9, and 5.0mm(-1), respectively). However, attenuation coefficient varied per patient and a related-samples Wilcoxon signed-rank test showed no significant difference per patient (p = 0.17). This study confirmed the one to one correlation of histopathology and OCT. Precise matching showed that most histological tissues categories in the prostate could be distinguished by their unique pattern in OCT images. In addition, the optical attenuation coefficient can play a role in the differentiation between stroma and malignancy; however, a per patient analysis of the optical attenuation coefficient did not show a significant difference. (C) The Authors. Published by SPIE under a Creative Commons Attribution 3.0 Unported License.
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    Standardized nomenclature and surveillance methodologies after focal therapy and partial gland ablation for localized prostate cancer: An international multidisciplinary consensus
    (Elsevier, 2020) Lebastchi, Amir H.; George, Arvin Koruthu; Polascik, Thomas J.; Coleman, Jonathan; de la Rosette, Jean J. M. C. H.; Türkbey, Barış; Wood, Bradford J.; Gorin, Michael A.; Sidana, Abhinav; Ghai, Sangeet; Tay, Kae Jack; Ward, John; Sanchez-Salas, Rafael; Muller, Berrend G.; Malavaud, Bernard; Mozer, Pierre; Crouzet, Sebastien; Choyke, Peter L.; Ukimura, Osamu; Rastinehad, Ardeshir R.; Pinto, Peter A.
    Background: Focal therapy (FT) and partial gland ablation (PGA) are quickly adopted by urologists and radiologists as an option for the management of localized prostate cancer.Objective: To find consensus on a standardized nomenclature and to define a follow-up guideline after FT and PGA for localized prostate cancer in clinical practice.Design, setting, and participants: A review of the literature identified controversial topics in the field of FT. Online questionnaires were distributed to experts during three rounds, with the goal to achieve consensus on debated topics. The consensus project was concluded with a face-to-face meeting in which final conclusions were formulated. Outcome measurements and statistical analysis: Controlled feedback of responses of previous rounds were summarized and returned to the participants allowing them to re-evaluate their decisions. The level of agreement to achieve consensus on a topic was set at 80%.Results and limitations: Sixty-five experts participated in this interdisciplinary consensus study (72% urologists; 28% radiologists). The experts propose the use of the herein standardized nomenclature for ablative procedures. After FT/PGA, the following tests should be performed to assess treatment outcomes: prostate-specific antigen (PSA), imaging, biopsies, and functional outcome assessment. Although not a reliable marker for treatment failure, PSA should be measured every 3 mo in the 1st year and every 6 mo thereafter. Magnetic resonance imaging is the preferred image modality and should be performed at 6 and 18 mo after treatment. A systematic 12-core transrectal ultrasoundguided biopsy combined with a targeted biopsy of the treated area should be performed 6-12 mo after treatment. Functional outcomes should be obtained 3-6 mo after treatment for the first time and until stability is attained.Conclusions: The panel recommends the use of the proposed nomenclature and follow-up protocols to generate reliable data supporting a broader implementation of FT as a standard of care for select patients with localized prostate cancer. Patient summary: In this report, we present expert opinion on the use of a standardized nomenclature, and surveillance methodologies after focal therapy and partial gland ablation for localized prostate cancer.