PD41-12: From biopsy to diagnosis in 30 min: Remote instant prostate pathology based on artificial intelligence enhanced ultrasound (AI-US)

Hamza Aljabali, Jakob Heidborn, Turkan Hajili, Kristina Greimelmaier, Jeremias Wohlschläger, Flensburg, Germany, Stephan Kruck, Pforzheim, Germany, Gerd Reis, Kaiserslautern, Germany, Tillmann Loch, Flensburg, Germany

Introduction: Early diagnosis of prostate cancer (PC) based on rapid histopathological evaluation is an essential step on the way to personalized medicine. For the first time we utilized the combination of AI-US and remote telepathological Fluorescent Confocal Microscopy (FCM) within 30 minutes to identify malignancy and discuss consequences instantly.

Methods: After informed consent 73 patients (median-age: 73, PSA-range: 1.2 - 1173ng/ml) were scheduled for AI-US targeted prostate biopsy (1-6 cores) between 2020-2021. Cores were stained for FCM analysis and digital images were sent for “real-time” pathology review followed by routine pathological procedure.

Results: Overall PC detection was 34% (25/73 cases). Clinically significant PC (csPC: Gleason =7) was found in 56% (14/25 cases). Median time from biopsy to FCM diagnosis was 30 min. FCM diagnosis was confirmed by standard pathology analysis in 88% (64/73) to differentiate between malignant and benign tissue. All csPC were diagnosed by instant FCM, detection rate of insignificant cancer (=Gleason 6) was 60% (6/10cases). All high-risk patients according to AI-US classification were diagnosed with only 2 targeted cores by FCM analysis.

Conclusions: Combination of AI-enhanced US targeted biopsy and instant FCM is a new tool to personalize the diagnostic approach. Reduction of core number and real-time confirmation of csPC allows reduction of diagnosis-related stress for patients, costs and time.

Source of Funding: none