Spectroscopy technique enables more accurate surgical removal of prostate cancer

Light reflectance spectroscopy allowed researchers to distinguish malignant from benign prostate tissue with 86% accuracy.

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Researchers at the University of Texas Southwestern Medical Center (Dallas, TX) used light reflectance spectroscopy to differentiate between malignant and benign prostate tissue with 86% accuracy, which could lead to real-time tissue analysis during prostate cancer surgery. The technique could allow highly accurate surgical removal of all cancerous tissue and the ability to spare more healthy tissue, minimizing the likelihood of cancer recurrence or additional treatment.

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Light reflectance spectroscopy measures light intensity reflected or backscattered from tissues. In patients with prostate cancer, physicians will perform radical prostatectomy, a procedure in which the prostate gland and some of the surrounding tissue is surgically removed. Because of the amount of time involved with traditional techniques such as prostatectomy and the lack of proven clinical usefulness, analysis to determine removal of all cancer surrounding the visible tumor's edges is not routinely performed during surgery. As such, undetectable cancer cells can be left behind and are termed "positive surgical margins."

Patients with intermediate- to high-risk disease requiring radical prostatectomy were enrolled in the research team's study. Immediately after the prostate gland was removed, light reflectance spectroscopy was performed on suspected malignant and benign prostate margins. Each sample was analyzed and correlated with pathological samples, which were analyzed post-surgery. Light reflectance spectroscopy analysis was performed on 17 prostate gland specimens, on which a total of 11 histologically positive and 22 negative surgical margins were measured. The optical probe predicted positive surgical margins with 85% sensitivity, 86% specificity, and 86% accuracy.

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Jeffrey Cadeddu of the University of Texas Southwestern Medical Center, who led the work using light reflectance spectroscopy to better detect prostate cancer. (Photo credit: UT Southwestern Medical Center)

"This study highlights one of a growing number of technology platforms that aim to improve the outcomes of cancer surgery," explains Dr. Jeffrey Cadeddu, Professor of Urology and Radiology at the University of Texas Southwestern Medical Center and lead author of the study, who holds the Ralph C. Smith, M.D., Distinguished Chair in Minimally Invasive Urologic Surgery. "Further study is required to determine whether such analysis may be used in real time to improve surgical decision-making and decrease the amount of tissue surgeons need to remove," he adds.

Full details of the work appear in the Journal of Urology; for more information, please visit http://dx.doi.org/10.1016/j.juro.2016.02.005.

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