Full Field Optical Coherence Tomography (FFOCT) to analyze prostate biopsy core in-office: a new step to real-time cancer diagnosis

BACKGROUND Focal therapy for prostate cancer is rising. One of the actual challenge is the management of the margins. A real-time cancer diagnosis device could be a useful tool to control margins during focal therapy. Full Field Optical Coherence Tomography (FFOCT) is a recent technique to analyze tissue in real time. The aim of our study was to assess the accuracy of FFOCT in prostate cancer diagnosis on biopsy cores by urologists. METHODS 91 patients undergoing prostatic biopsies were included. Among these patients, we randomly selected 991 biopsy cores for the FFOCT analysis. FFOCT images were analyzed by two urologists and two urology residents, blinded for the results of the standard histological analysis (gold standard). The FFOCT analysis included the presence of prostate cancer, and clinically significant prostate cancer (ISUP≥2). Results were compared to the histological analysis. RESULTS All the 991 cores were analyzed. Among them, 236 cores (23,7%) were positive for prostate cancer and 37 cores (3,7%)for clinically significant prostate cancer (csPCa). Global accuracy was 86,9% for csPCa. Global negative predictive value (NPV) was 97,5% for csPCa. Reproducibility between readers was K= 0,46 (IC95%[0,37 – 0,48]). CONCLUSIONS Our results confirmed that FFOCT is feasible and accurate to eliminate prostate cancer on biopsy cores (NPV=97,5%). Further studies should evaluate FFOCT for framing biopsies during focal therapy procedures.