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In a single-centre prospective observational study, men undergoing MRI-targeted transperineal prostate biopsy had targeted cores imaged ex vivo after rapid acridine orange immersion. Two blinded genitourinary pathologists classified cancer and clinically significant cancer (ISUP GG ≥ 2), while workflow component times for same-day feasibility were quantified. Results showed high diagnostic performance, strong accuracy, and interobserver agreement within clinically feasible timeframes.",{"@graph":69,"@context":122},[70,84,105],{"@type":71,"itemListElement":72},"BreadcrumbList",[73,77,79,82],{"item":74,"name":75,"@type":76,"position":8},"https://docshare.wps.com","Home","ListItem",{"item":78,"name":9,"@type":76,"position":14},"https://docshare.wps.com/document/",{"item":80,"name":35,"@type":76,"position":81},"https://docshare.wps.com/document/healthcare/",3,{"item":83,"name":65,"@type":76,"position":19},"https://docshare.wps.com/document/same-day-fluorescence-confocal-microscopy-of-mri-targeted-prostate-biopsies-a-feasibility-study/351892/",{"url":83,"name":65,"@type":85,"image":86,"author":91,"headline":65,"publisher":94,"fileFormat":97,"inLanguage":63,"description":67,"dateModified":98,"datePublished":99,"encodingFormat":97,"isAccessibleForFree":100,"interactionStatistic":101},"DigitalDocument",{"url":87,"@type":88,"width":89,"height":90},"https://docshare.wps.com/thumbnails/same-day-fluorescence-confocal-microscopy-of-mri-targeted-prostate-biopsies-a-feasibility-study/351892.png","ImageObject",300,407,{"name":92,"@type":93},"Kurz","Person",{"url":74,"name":95,"@type":96},"DocShare","Organization","application/pdf","2026-09-23","2026-09-22",true,{"@type":102,"interactionType":103,"userInteractionCount":8},"InteractionCounter",{"@type":104},"ViewAction",{"@type":106,"mainEntity":107},"FAQPage",[108,114,118],{"name":109,"@type":110,"acceptedAnswer":111},"What was the main objective of the study?","Question",{"text":112,"@type":113},"The study aimed to determine the diagnostic performance of ex vivo fluorescence confocal microscopy for prostate cancer detection in MRI-targeted biopsy specimens and to quantify workflow times relevant to same-day implementation.","Answer",{"name":115,"@type":110,"acceptedAnswer":116},"How were biopsy specimens processed and evaluated?",{"text":117,"@type":113},"MRI-targeted transperineal biopsy cores were imaged ex vivo using an FCM scanner after rapid acridine orange immersion, then assessed by two blinded board-certified genitourinary pathologists against final histopathology.",{"name":119,"@type":110,"acceptedAnswer":120},"What did the study find about diagnostic performance and speed?",{"text":121,"@type":113},"Reader 1 and Reader 2 achieved high sensitivity and accuracy, with interobserver agreement of 88% for cancer detection and 86% for clinically significant cancer. Specimen preparation and interpretation took about 2 minutes each, with scanning time around 50 seconds, allowing complete assessment in under 5 minutes.","https://schema.org",{"og:url":83,"og:type":124,"og:title":65,"og:site_name":95,"og:description":67},"article",{"robots":126,"canonical":83},"index,follow",{"doc_id":128,"site_id":62},351892,1790138396,{"code":4,"msg":5,"data":131},{"doc_id":128,"user_id":132,"nickname":92,"user_avatar":133,"doc_module":4,"category_id":34,"category_name":35,"doc_title":65,"doc_description":67,"doc_content":134,"file_id":135,"file_url":136,"file_type":137,"file_size":138,"view_count":8,"is_deleted":4,"is_public":8,"is_downloadable":8,"audit_status":8,"page_count":44,"language":139,"language_code":63,"site_id":62,"html_lang":63,"table_of_contents":140,"faqs":141,"seo_title":142,"seo_description":67,"update_tm":143,"read_time":144},2336478945635,"https://ap-avatar.wpscdn.com/davatar_6f874abed73319feea01a86fa6f0fab8","BJU Int 2026; 138: Supplement 1: S112–S120 doi:10.1111/bju.70263  \nOriginal Article  \nSame-day fluorescence confocal microscopy of MRItargeted prostate biopsies: A feasibility study  \nSalim K. Younis1 , Mohamad Watfa1 , Lin Wang1, Karim Daher1 , Nicolas A. Soputro1, Abdulrahman Al-Bayati 1 , Samarpit Rai1, Rui M. Bernardino 1, Ruben Olivares1, Riccardo Autorino1 , Christopher J. Weight 1, Jihad Kaouk1, Jane K. Nguyen1,2 and Zeyad R. Schwen1  \n1Glickman Urological Institute, and 2Diagnostics Institute, Anatomical Pathology, Cleveland Clinic, Cleveland, OH, USA  \nS. K.Y. and M.W. contributed equally to this work and share first authorship.  \nPublished as part of the themed issue on Fluorescent confocal microscopy in urological surgery. [https://bjui.pub/FCMicro](https://bjui.pub/FCMicro)  \nObjectives  \nTo determine the diagnostic performance of ex vivo fluorescence confocal microscopy (FCM) for prostate cancer detection in magnetic resonance imaging (MRI)-targeted biopsy specimens using final histopathology as the reference standard, and to quantify workflow component times relevant to same-day implementation.  \nPatients and Methods  \nIn this single-centre prospective observational study, men undergoing MRI-targeted transperineal prostate biopsy were enrolled. Targeted biopsy cores were imaged ex vivo using a Histolog􀀁 FCM scanner (SamanTree Medical SA, Lausanne, Switzerland) after rapid acridine orange immersion and prior to routine histopathological processing. Two board-certified genitourinary pathologists independently reviewed FCM images in a blinded fashion and classified each specimen as positive or negative for prostate cancer and clinically significant cancer (CSC), defined as International Society of Urological Pathology Grade Group (GG) ≥2 . Diagnostic performance was calculated against final histopathology. Workflow feasibility was assessed by measuring specimen preparation, scanning, and interpretation times. Interobserver agreement and exploratory discordance analyses were performed.  \nResults  \nA total of 50 MRI-targeted biopsy specimens from 44 patients were analysed, of which 33 (66%) contained prostate cancer and 17 (52%) met criteria for CSC. For cancer detection, Reader 1 achieved 87.9% sensitivity and 94.1% specificity, and Reader 2 achieved 97.0% sensitivity and 76.5% specificity, with overall accuracy of 90% for both readers. Interobserver agreement for cancer detection was 88%(j = 0.74), and for CSC was 86%(j = 0.61) . Mean specimen preparation and interpretation times were ~2 min each, with standardised scanning time of 50 s, enabling complete FCM assessment in \u003C5 min per target. Discordance was concentrated in GG 2 disease and Prostate Imaging-Reporting and Data System (PIRADS) 3 targets, while higher-grade cancers and PI-RADS 5 lesions were uniformly concordant.  \nConclusion  \nEx vivo FCM provides rapid, accurate, and reproducible assessment of MRI-targeted prostate biopsy specimens for cancer detection within clinically feasible timeframes. These findings support FCM as a same-day diagnostic adjunct and justify prospective trials evaluating real-time implementation during targeted biopsy.  \nKeywords  \nfluorescence confocal microscopy, digital pathology, prostate cancer, MRI-targeted biopsy, transperineal biopsy, same-day diagnosis, interobserver agreement, diagnostic accuracy  \nIntroduction  \nProstate biopsy remains the cornerstone for the diagnosis and risk stratification of prostate cancer [1] . Despite advances in multiparametric MRI and MRI-targeted biopsy techniques,  \nstandard histopathological results are not available at the point of care and are typically reported days after biopsy [1,2] . This delay prolongs patient uncertainty and limits opportunities to accelerate diagnostic decision-making after biopsy.  \n􀀃 2026 The Author(s) .  \n[wileyonlinelibrary.com](wileyonlinelibrary.com) BJU International published by John Wiley & Sons Ltd on behalf of BJU [International. www.bjui.org](International. www.bjui.org)","cbCaiirJxAfWkrLa","https://ap.wps.com/l/cbCaiirJxAfWkrLa","pdf",4611941,"English","# Objectives\n# Patients and Methods\n# Results\n# Conclusion\n# Keywords\n# Introduction","[{\"question\":\"What was the main objective of the study?\",\"answer\":\"The study aimed to determine the diagnostic performance of ex vivo fluorescence confocal microscopy for prostate cancer detection in MRI-targeted biopsy specimens and to quantify workflow times relevant to same-day implementation.\"},{\"question\":\"How were biopsy specimens processed and evaluated?\",\"answer\":\"MRI-targeted transperineal biopsy cores were imaged ex vivo using an FCM scanner after rapid acridine orange immersion, then assessed by two blinded board-certified genitourinary pathologists against final histopathology.\"},{\"question\":\"What did the study find about diagnostic performance and speed?\",\"answer\":\"Reader 1 and Reader 2 achieved high sensitivity and accuracy, with interobserver agreement of 88% for cancer detection and 86% for clinically significant cancer. Specimen preparation and interpretation took about 2 minutes each, with scanning time around 50 seconds, allowing complete assessment in under 5 minutes.\"}]","Same-day fluorescence confocal microscopy of MRI-targeted prostate biopsies - A feasibility study | PDF",1790096412,23]