BERKELEY, CA (UroToday.com) - Full-field optical coherence tomography (FFOCT) may be a potential additional tool in the strategy of prostate cancer detection. If the technique can be performed safely during transrectal ultrasound (TRUS) biopsy, and without adding significant time to the procedure, the information provided by FFOCT imaging during biopsy would increase the performance level of cancer detection. FFOCT imaging would allow immediate additional sampling in an area suspicious of cancer involvement, thus optimizing its characterization. In cases where there’s an absence of suspicious FFOCT image results in other areas, sampling could be limited to one core, thus decreasing the total number of cores performed, and potentially decreasing procedure-related morbidity.
Also, FFOCT could be an additional tool for confirming the specificity of a suspicious image detected on multiparametric prostate MRI (MP-MRI) and targeted during TRUS biopsy. This additional tool could also confirm that the biopsy has been truly targeted on the suspicious MP-MRI-detected image. Targeting, with TRUS, a lesion that is visible only on MP-MRI, is indeed challenging, even with the use of an MRI-ultrasound image fusion system.
Finally, with the use of such technology, perspectives also include the development of ultra-focal therapy. Currently proposed protocols of focal therapy are, in fact hemi-ablations, performed after the pathological examination of prostate biopsies. If FFOCT imaging demonstrates high sensitivity and specificity, a potential perspective would be to propose focal laser ablation of the suspicious lesion during the biopsy procedure. The ablated lesion would then be confirmed as cancer, by standard pathology, performed in the next few days.
Written by:
Nicolas Barry Delongchamps, MD as part of Beyond the Abstract on UroToday.com. This initiative offers a method of publishing for the professional urology community. Authors are given an opportunity to expand on the circumstances, limitations etc... of their research by referencing the published abstract.
Service d'urologie, hôpital Cochin, université Paris Descartes, 27, rue du Faubourg-Saint-Jacques, 75014 Paris, France
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