Pub Date : 2026-04-01Epub Date: 2026-01-08DOI: 10.1111/bju.70137
Arighno Das, David Jarrard
{"title":"Response to comment by Semwal et al.","authors":"Arighno Das, David Jarrard","doi":"10.1111/bju.70137","DOIUrl":"10.1111/bju.70137","url":null,"abstract":"","PeriodicalId":8985,"journal":{"name":"BJU International","volume":" ","pages":"736-737"},"PeriodicalIF":4.4,"publicationDate":"2026-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145916683","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2026-04-01Epub Date: 2026-01-20DOI: 10.1111/bju.70151
Carlo Silvani, Alfonso Santangelo, Jack Considine, Anna Tylecki, Alex Stephens, Adam Mssika, Benjamin Robinson, Sebastiano Nazzani, Alberto Briganti, Andrea Salonia, Francesco Montorsi, Akshay Sood, Nicola Nicolai, Emanuele Montanari, Craig Rogers, Firas Abdollah
Objectives: To evaluate whether neighbourhood socioeconomic deprivation, measured by the Area Deprivation Index (ADI), is associated with cancer-specific mortality (CSM) in patients with non-muscle-invasive bladder cancer (NMIBC).
Patients and methods: We retrospectively reviewed patients with NMIBC (T stage <2, node-negative, non-metastatic) from Michigan Cancer Surveillance Program (2004-2019). ADI national percentiles were assigned based on residential census block groups and stratified into quartiles, with the fourth quartile (ADI 75-100) being the most deprived. Cumulative incidence functions compared CSM between quartiles, and competing-risk regression analysis assessed the association between ADI and CSM after adjusting for covariates.
Results: Among 19 722 patients (92.2% non-Hispanic White; median [interquartile range] age 72 [64-80] years; 76.7% male), most resided in metropolitan areas (81%) and 61% were married. Overall, 8.5%, 26.4%, 34.9%, and 30.2% of patients were in the first, second, third, and fourth ADI quartile, respectively. At 10 years, the cumulative incidence of CSM was 7.3%, 7.9%, 8.7%, and 9.7% across the first-fourth quartiles, respectively (P = 0.002). At the competing risk analysis, each 25-point increase in ADI was associated with a 6% higher hazard of CSM (95% confidence interval 1.01-1.12; P = 0.032). Older age, higher T stage, unmarried status, and Medicaid insurance were independently associated with greater CSM.
Conclusions: Higher ADI was associated with increased CSM in our cohort. Evaluating socioeconomic context in NMIBC care may inform follow-up and therapy and, potentially, influence progression and mortality.
{"title":"Area deprivation and cancer-specific mortality in non-muscle-invasive bladder cancer: a statewide analysis.","authors":"Carlo Silvani, Alfonso Santangelo, Jack Considine, Anna Tylecki, Alex Stephens, Adam Mssika, Benjamin Robinson, Sebastiano Nazzani, Alberto Briganti, Andrea Salonia, Francesco Montorsi, Akshay Sood, Nicola Nicolai, Emanuele Montanari, Craig Rogers, Firas Abdollah","doi":"10.1111/bju.70151","DOIUrl":"10.1111/bju.70151","url":null,"abstract":"<p><strong>Objectives: </strong>To evaluate whether neighbourhood socioeconomic deprivation, measured by the Area Deprivation Index (ADI), is associated with cancer-specific mortality (CSM) in patients with non-muscle-invasive bladder cancer (NMIBC).</p><p><strong>Patients and methods: </strong>We retrospectively reviewed patients with NMIBC (T stage <2, node-negative, non-metastatic) from Michigan Cancer Surveillance Program (2004-2019). ADI national percentiles were assigned based on residential census block groups and stratified into quartiles, with the fourth quartile (ADI 75-100) being the most deprived. Cumulative incidence functions compared CSM between quartiles, and competing-risk regression analysis assessed the association between ADI and CSM after adjusting for covariates.</p><p><strong>Results: </strong>Among 19 722 patients (92.2% non-Hispanic White; median [interquartile range] age 72 [64-80] years; 76.7% male), most resided in metropolitan areas (81%) and 61% were married. Overall, 8.5%, 26.4%, 34.9%, and 30.2% of patients were in the first, second, third, and fourth ADI quartile, respectively. At 10 years, the cumulative incidence of CSM was 7.3%, 7.9%, 8.7%, and 9.7% across the first-fourth quartiles, respectively (P = 0.002). At the competing risk analysis, each 25-point increase in ADI was associated with a 6% higher hazard of CSM (95% confidence interval 1.01-1.12; P = 0.032). Older age, higher T stage, unmarried status, and Medicaid insurance were independently associated with greater CSM.</p><p><strong>Conclusions: </strong>Higher ADI was associated with increased CSM in our cohort. Evaluating socioeconomic context in NMIBC care may inform follow-up and therapy and, potentially, influence progression and mortality.</p>","PeriodicalId":8985,"journal":{"name":"BJU International","volume":" ","pages":"677-683"},"PeriodicalIF":4.4,"publicationDate":"2026-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146003063","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Muhammed Arif Ibis, Maria Satchi, Nicholas Raison, Hakan Bahadır Haberal, Araz Musaev, Tet Yap, Angelo Territo, Cagri Akpinar, Giuseppe Fallara, Dean Y. Huang, Murat Gul, Asif Muneer, Antonio Ruffo, Omer Onur Cakir, Fabio Castiglione
Objective To conduct a systematic review and meta‐analysis to indirectly compare the diagnostic performance of contrast‐enhanced ultrasonography (CEUS) and magnetic resonance imaging (MRI) in the evaluation of indeterminate testicular lesions and to explore their potential roles in guiding clinical decision‐making. Methods PubMed, Web of Science, and Scopus were searched in August 2025. Eligible studies were prospective or retrospective cohorts evaluating CEUS or MRI in small, impalpable, or incidentally detected testicular lesions, with histopathology or clinical/radiological follow‐up as reference standard. Two reviewers independently performed selection, data extraction, and Quality Assessment of Diagnostic Accuracy Studies‐2 tool assessment. Random‐effects meta‐analyses and meta‐regression were conducted in R (R: A language and environment for statistical computing. R Foundation for Statistical Computing, Vienna, Austria). This review was registered in the Prospective Register of Systematic Reviews (CRD420251113920). Results A total of 12 studies including 912 patients with 920 lesions (279 malignant, 641 benign) were analysed. CEUS showed a sensitivity of 90% (95% confidence interval [CI] 80–95%) and specificity of 74% (95% CI 47–91%), while MRI achieved a sensitivity of 94% (95% CI 88–97%) and specificity of 84% (95% CI 72–91%). CEUS provided a higher negative predictive value (NPV; 96% vs 88%), whereas MRI demonstrated superior positive predictive value (PPV; 83% vs 65%) and accuracy (91% vs 80%). Differences in PPV and accuracy significantly favoured MRI ( P = 0.025 and P = 0.031). Limitations included protocol heterogeneity, operator dependence, and small sample sizes. Conclusion Both CEUS and MRI demonstrated a high sensitivity and NPV, supporting their role in excluding malignancy. CEUS, with accessibility, low cost, and particularly high NPV, may serve as the first‐line adjunct, while MRI is best reserved for equivocal or higher‐risk cases. No funding was received for this study.
目的通过系统回顾和荟萃分析，间接比较超声造影（CEUS）和磁共振成像（MRI）对不确定睾丸病变的诊断效果，探讨其在指导临床决策中的潜在作用。方法于2025年8月检索PubMed、Web of Science、Scopus。符合条件的研究是前瞻性或回顾性队列，以组织病理学或临床/放射学随访为参考标准，评估超声造影或MRI对小的、难以察觉的或偶然发现的睾丸病变的影响。两名审稿人独立进行选择、数据提取和诊断准确性研究质量评估- 2工具评估。随机效应meta分析和meta回归在R （R：一种用于统计计算的语言和环境）中进行。R基金会统计计算，维也纳，奥地利)。该综述已在系统评价前瞻性注册（CRD420251113920）中注册。结果共分析12篇文献912例920个病变，其中恶性279例，良性641例。CEUS的灵敏度为90%(95%置信区间[CI] 80-95%)，特异性为74% (95% CI 47-91%)，而MRI的灵敏度为94% (95% CI 88-97%)，特异性为84% （95% CI 72-91%）。CEUS提供了更高的阴性预测值（NPV； 96%对88%），而MRI显示了更高的阳性预测值（PPV； 83%对65%）和准确性（91%对80%）。PPV和准确性的差异显著有利于MRI （P = 0.025和P = 0.031）。限制包括协议异质性、操作者依赖性和小样本量。结论超声造影和MRI均具有较高的敏感性和NPV值，支持其对恶性肿瘤的排除作用。超声造影具有可及性、低成本和特别高的净现值，可作为一线辅助手段，而MRI则最好用于模棱两可或高风险的病例。本研究未收到任何资金。
{"title":"Contrast‐enhanced ultrasonography vs MRI for indeterminate testicular lesions: a systematic review and meta‐analysis","authors":"Muhammed Arif Ibis, Maria Satchi, Nicholas Raison, Hakan Bahadır Haberal, Araz Musaev, Tet Yap, Angelo Territo, Cagri Akpinar, Giuseppe Fallara, Dean Y. Huang, Murat Gul, Asif Muneer, Antonio Ruffo, Omer Onur Cakir, Fabio Castiglione","doi":"10.1111/bju.70256","DOIUrl":"https://doi.org/10.1111/bju.70256","url":null,"abstract":"Objective To conduct a systematic review and meta‐analysis to indirectly compare the diagnostic performance of contrast‐enhanced ultrasonography (CEUS) and magnetic resonance imaging (MRI) in the evaluation of indeterminate testicular lesions and to explore their potential roles in guiding clinical decision‐making. Methods PubMed, Web of Science, and Scopus were searched in August 2025. Eligible studies were prospective or retrospective cohorts evaluating CEUS or MRI in small, impalpable, or incidentally detected testicular lesions, with histopathology or clinical/radiological follow‐up as reference standard. Two reviewers independently performed selection, data extraction, and Quality Assessment of Diagnostic Accuracy Studies‐2 tool assessment. Random‐effects meta‐analyses and meta‐regression were conducted in R (R: A language and environment for statistical computing. R Foundation for Statistical Computing, Vienna, Austria). This review was registered in the Prospective Register of Systematic Reviews (CRD420251113920). Results A total of 12 studies including 912 patients with 920 lesions (279 malignant, 641 benign) were analysed. CEUS showed a sensitivity of 90% (95% confidence interval [CI] 80–95%) and specificity of 74% (95% CI 47–91%), while MRI achieved a sensitivity of 94% (95% CI 88–97%) and specificity of 84% (95% CI 72–91%). CEUS provided a higher negative predictive value (NPV; 96% vs 88%), whereas MRI demonstrated superior positive predictive value (PPV; 83% vs 65%) and accuracy (91% vs 80%). Differences in PPV and accuracy significantly favoured MRI ( <jats:italic>P</jats:italic> = 0.025 and <jats:italic>P</jats:italic> = 0.031). Limitations included protocol heterogeneity, operator dependence, and small sample sizes. Conclusion Both CEUS and MRI demonstrated a high sensitivity and NPV, supporting their role in excluding malignancy. CEUS, with accessibility, low cost, and particularly high NPV, may serve as the first‐line adjunct, while MRI is best reserved for equivocal or higher‐risk cases. No funding was received for this study.","PeriodicalId":8985,"journal":{"name":"BJU International","volume":"14 1","pages":""},"PeriodicalIF":4.5,"publicationDate":"2026-03-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147506767","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Mario de Angelis, Edoardo Beatrici, Natali Rodriguez Penaranda, Nicola Frego, Stefano Resca, Enrico Vecchio, Attilio Barretta, Marco Ticonosco, Claudio Brancelli, Vincenzo Cavarra, Alessio Guidotti, Francesco Pepillo, Francesco Prata, Nicolas Carl, Francesco Barletta, Francesco Cei, Geert De Naeyer, Edward Lambert, Kris Van Der Steen, Ruben De Groote, Alexandre Mottrie
Objective To evaluate the feasibility of adopting fluorescence confocal microscopy (FCM) for intraoperative assessment of positive surgical margins (PSMs) during robot‐assisted radical prostatectomy (RARP) in a real‐world clinical setting. Patients and Methods We conducted a prospective observational study including consecutive patients undergoing RARP between October 2023 and November 2024 in whom intraoperative margin assessment was performed using FCM (Histolog® Scanner; SamanTree Medical SA, Lausanne, Switzerland). After exclusion of initial learning‐curve cases and non‐interpretable scans, a per‐patient analysis was performed. Prostate specimens were scanned ex vivo intraoperatively, and digital images were reviewed remotely and in real time by an experienced uropathologist blinded to final pathology. Final histopathological evaluation served as the reference standard. Diagnostic performance metrics included sensitivity, specificity, positive predictive value (PPV), negative PV (NPV), and overall accuracy, assessed both for any PSM and for clinically significant PSMs (≥3 mm). Results A total of 101 patients were included in the final analysis. The median (interquartile range) overall time from prostate extraction to intraoperative report was 13 (6–16) min. At final pathology, 17 patients (17%) had PSMs. For detection of any PSM, FCM demonstrated a sensitivity of 88.2%, specificity of 91.7%, PPV of 68.2%, and NPV of 97.5%, with an overall diagnostic accuracy of 91.1%. When restricting the analysis to clinically significant PSMs (≥3 mm), diagnostic performance improved, with sensitivity, specificity, PPV, and NPV of 93.8%, 91.8%, 68.2%, and 98.7%, respectively, and an overall accuracy of 92.1%. Conclusions Intraoperative surgical margin assessment using FCM is feasible and demonstrates good diagnostic accuracy compared with final histopathology, with rapid turnaround times compatible with routine surgical workflows. Diagnostic performance improves when clinically relevant PSM length thresholds are applied. Larger multicentre studies and randomised trials are warranted to determine whether FCM‐guided intraoperative decision‐making can improve oncological and functional outcomes after RARP.
目的探讨在机器人辅助根治性前列腺切除术（RARP）中应用荧光共聚焦显微镜（FCM）术中评估阳性手术切缘（psm）的可行性。患者和方法我们进行了一项前瞻性观察研究，包括2023年10月至2024年11月期间连续接受RARP的患者，其中术中切缘评估使用FCM （Histolog®扫描仪；SamanTree Medical SA，洛桑，瑞士）。在排除了初始学习曲线病例和不可解释的扫描后，对每个患者进行分析。术中对前列腺标本进行离体扫描，并由经验丰富的泌尿病理学家对最终病理进行远程和实时的数字图像检查。最终组织病理学评价作为参考标准。诊断性能指标包括敏感性、特异性、阳性预测值（PPV）、阴性PV （NPV）和总体准确性，对任何PSM和临床显著PSM（≥3mm）进行评估。结果101例患者纳入最终分析。从前列腺摘除到术中报告的中位（四分位数范围）总时间为13（6-16）分钟。最终病理时，17例患者（17%）患有psm。对于任何PSM的检测，FCM的敏感性为88.2%，特异性为91.7%，PPV为68.2%，NPV为97.5%，总体诊断准确率为91.1%。当将分析限制在临床显著的psm（≥3 mm）时，诊断性能得到提高，敏感性、特异性、PPV和NPV分别为93.8%、91.8%、68.2%和98.7%，总体准确性为92.1%。结论术中应用FCM进行手术切缘评估是可行的，与最终的组织病理学相比，FCM的诊断准确性较高，周转时间短，符合常规手术流程。应用临床相关的PSM长度阈值可提高诊断性能。更大规模的多中心研究和随机试验是有必要的，以确定FCM引导的术中决策是否可以改善RARP术后的肿瘤和功能结局。
{"title":"Intraoperative margin assessment using fluorescence confocal microscopy during robot‐assisted radical prostatectomy: a first experience","authors":"Mario de Angelis, Edoardo Beatrici, Natali Rodriguez Penaranda, Nicola Frego, Stefano Resca, Enrico Vecchio, Attilio Barretta, Marco Ticonosco, Claudio Brancelli, Vincenzo Cavarra, Alessio Guidotti, Francesco Pepillo, Francesco Prata, Nicolas Carl, Francesco Barletta, Francesco Cei, Geert De Naeyer, Edward Lambert, Kris Van Der Steen, Ruben De Groote, Alexandre Mottrie","doi":"10.1111/bju.70262","DOIUrl":"https://doi.org/10.1111/bju.70262","url":null,"abstract":"Objective To evaluate the feasibility of adopting fluorescence confocal microscopy (FCM) for intraoperative assessment of positive surgical margins (PSMs) during robot‐assisted radical prostatectomy (RARP) in a real‐world clinical setting. Patients and Methods We conducted a prospective observational study including consecutive patients undergoing RARP between October 2023 and November 2024 in whom intraoperative margin assessment was performed using FCM (Histolog® Scanner; SamanTree Medical SA, Lausanne, Switzerland). After exclusion of initial learning‐curve cases and non‐interpretable scans, a per‐patient analysis was performed. Prostate specimens were scanned <jats:italic>ex vivo</jats:italic> intraoperatively, and digital images were reviewed remotely and in real time by an experienced uropathologist blinded to final pathology. Final histopathological evaluation served as the reference standard. Diagnostic performance metrics included sensitivity, specificity, positive predictive value (PPV), negative PV (NPV), and overall accuracy, assessed both for any PSM and for clinically significant PSMs (≥3 mm). Results A total of 101 patients were included in the final analysis. The median (interquartile range) overall time from prostate extraction to intraoperative report was 13 (6–16) min. At final pathology, 17 patients (17%) had PSMs. For detection of any PSM, FCM demonstrated a sensitivity of 88.2%, specificity of 91.7%, PPV of 68.2%, and NPV of 97.5%, with an overall diagnostic accuracy of 91.1%. When restricting the analysis to clinically significant PSMs (≥3 mm), diagnostic performance improved, with sensitivity, specificity, PPV, and NPV of 93.8%, 91.8%, 68.2%, and 98.7%, respectively, and an overall accuracy of 92.1%. Conclusions Intraoperative surgical margin assessment using FCM is feasible and demonstrates good diagnostic accuracy compared with final histopathology, with rapid turnaround times compatible with routine surgical workflows. Diagnostic performance improves when clinically relevant PSM length thresholds are applied. Larger multicentre studies and randomised trials are warranted to determine whether FCM‐guided intraoperative decision‐making can improve oncological and functional outcomes after RARP.","PeriodicalId":8985,"journal":{"name":"BJU International","volume":"190 1","pages":""},"PeriodicalIF":4.5,"publicationDate":"2026-03-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147506768","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Active surveillance in the elderly: Is it the right strategy to avoid overtreatment?","authors":"Christophe K Mannaerts,Diederik M Somford","doi":"10.1111/bju.70238","DOIUrl":"https://doi.org/10.1111/bju.70238","url":null,"abstract":"","PeriodicalId":8985,"journal":{"name":"BJU International","volume":"2 1","pages":""},"PeriodicalIF":4.5,"publicationDate":"2026-03-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147502513","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Response to the Li et al. comment on 'Overall survival benefit after prophylactic urethrectomy: true oncological effect or unadjusted selection bias?'","authors":"Murat Akand,Hendrik Van Poppel","doi":"10.1111/bju.70250","DOIUrl":"https://doi.org/10.1111/bju.70250","url":null,"abstract":"","PeriodicalId":8985,"journal":{"name":"BJU International","volume":"474 1","pages":""},"PeriodicalIF":4.5,"publicationDate":"2026-03-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147502511","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
OBJECTIVESTo evaluate the feasibility and diagnostic performance of ex vivo fluorescence confocal microscopy (FCM) using the Histolog® Scanner (SamanTree Medical SA, Lausanne, Switzerland) for the assessment of penile cancer (PeCa) specimens, and to compare FCM-based diagnoses with standard formalin-fixed, paraffin-embedded (FFPE) histopathology.PATIENTS AND METHODSWe conducted a single-centre study including 12 patients with clinical or radiological suspicion of PeCa who underwent diagnostic or excisional biopsy between June 2022 and November 2023. Fresh biopsy specimens were stained with a nuclear fluorescent dye and scanned ex vivo with the Histolog Scanner. Digital images were retrospectively reviewed by two uropathologists and compared with conventional haematoxylin and eosin-stained FFPE sections. The primary endpoint was diagnostic concordance between FCM and histopathology in detecting invasive squamous cell carcinoma (SCC); secondary endpoints included sensitivity, specificity, and overall feasibility of image acquisition.RESULTSA total of 29 FCM scans were obtained. Diagnostic image quality was achieved in 28/29 scans (96.6%). FFPE analysis confirmed invasive SCC in eight patients, differentiated penile intraepithelial neoplasia in three, and an atypical squamous proliferative lesion (ASPL) in one. FCM correctly identified tumour category in 11/12 patients, yielding an overall accuracy of 91.7% (95% confidence interval [CI] 61.5-99.8%). Sensitivity for invasive SCC detection was 87.5% (7/8; 95% CI 47.3-99.7%), and specificity was 100% (4/4; 95% CI 39.8-100%). One SCC was misclassified as ASPL on FCM. Median workflow time was ~5 min/specimen.CONCLUSIONSEx vivo FCM is a feasible, rapid imaging technique that enables high concordance with histopathology for the diagnosis of PeCa. This pilot study represents the first assessment of ex vivo FCM in penile malignancies and provides preliminary evidence supporting its potential role in intraoperative margin assessment. Larger prospective studies are required to confirm its diagnostic accuracy and clinical utility.
目的评价利用Histolog®扫描仪（SamanTree Medical SA, Lausanne, Switzerland）进行离体荧光共聚焦显微镜（FCM）诊断阴茎癌（PeCa）标本的可行性和诊断性能，并将FCM诊断与标准的福尔马林固定石蜡包埋（FFPE）组织病理学进行比较。患者和方法我们进行了一项单中心研究，包括12名临床或放射学怀疑为PeCa的患者，这些患者在2022年6月至2023年11月期间接受了诊断或切除活检。新鲜的活检标本用核荧光染料染色，并用组织学扫描仪进行离体扫描。两位泌尿病理学家回顾了数字图像，并将其与传统的苏木精和伊红染色的FFPE切片进行了比较。主要终点是FCM与组织病理学诊断浸润性鳞状细胞癌（SCC）的一致性；次要终点包括敏感性、特异性和图像采集的总体可行性。结果共获得29张FCM扫描片。28/29次扫描达到诊断图像质量（96.6%）。FFPE分析证实8例患者为浸润性鳞状细胞癌，3例为分化性阴茎上皮内瘤变，1例为非典型鳞状增生性病变（ASPL）。FCM正确识别了11/12例患者的肿瘤类别，总体准确率为91.7%（95%置信区间[CI] 61.5-99.8%）。浸润性SCC检测的敏感性为87.5% (7/8;95% CI 47.3-99.7%)，特异性为100% （4/4;95% CI 39.8-100%）。一个SCC在FCM上被错误地分类为ASPL。平均工作时间为~5分钟/个标本。结论体内FCM是一种可行的快速成像技术，与组织病理学高度一致。这项初步研究首次评估了体外FCM在阴茎恶性肿瘤中的应用，并提供了初步证据支持其在术中边缘评估中的潜在作用。需要更大规模的前瞻性研究来证实其诊断准确性和临床实用性。
{"title":"Diagnosis of penile cancer with ex vivo fluorescence confocal microscopy using the Histolog® Scanner.","authors":"Xiaohu Zhang,Ricardo Almeida-Magana,Larissa Sena Teixeira Mendes,Daniela Fleck Lavergne,Hussain Alnajjar,Greg Shaw,Alex Freeman,Asif Muneer,Aiman Haider","doi":"10.1111/bju.70239","DOIUrl":"https://doi.org/10.1111/bju.70239","url":null,"abstract":"OBJECTIVESTo evaluate the feasibility and diagnostic performance of ex vivo fluorescence confocal microscopy (FCM) using the Histolog® Scanner (SamanTree Medical SA, Lausanne, Switzerland) for the assessment of penile cancer (PeCa) specimens, and to compare FCM-based diagnoses with standard formalin-fixed, paraffin-embedded (FFPE) histopathology.PATIENTS AND METHODSWe conducted a single-centre study including 12 patients with clinical or radiological suspicion of PeCa who underwent diagnostic or excisional biopsy between June 2022 and November 2023. Fresh biopsy specimens were stained with a nuclear fluorescent dye and scanned ex vivo with the Histolog Scanner. Digital images were retrospectively reviewed by two uropathologists and compared with conventional haematoxylin and eosin-stained FFPE sections. The primary endpoint was diagnostic concordance between FCM and histopathology in detecting invasive squamous cell carcinoma (SCC); secondary endpoints included sensitivity, specificity, and overall feasibility of image acquisition.RESULTSA total of 29 FCM scans were obtained. Diagnostic image quality was achieved in 28/29 scans (96.6%). FFPE analysis confirmed invasive SCC in eight patients, differentiated penile intraepithelial neoplasia in three, and an atypical squamous proliferative lesion (ASPL) in one. FCM correctly identified tumour category in 11/12 patients, yielding an overall accuracy of 91.7% (95% confidence interval [CI] 61.5-99.8%). Sensitivity for invasive SCC detection was 87.5% (7/8; 95% CI 47.3-99.7%), and specificity was 100% (4/4; 95% CI 39.8-100%). One SCC was misclassified as ASPL on FCM. Median workflow time was ~5 min/specimen.CONCLUSIONSEx vivo FCM is a feasible, rapid imaging technique that enables high concordance with histopathology for the diagnosis of PeCa. This pilot study represents the first assessment of ex vivo FCM in penile malignancies and provides preliminary evidence supporting its potential role in intraoperative margin assessment. Larger prospective studies are required to confirm its diagnostic accuracy and clinical utility.","PeriodicalId":8985,"journal":{"name":"BJU International","volume":"15 1","pages":""},"PeriodicalIF":4.5,"publicationDate":"2026-03-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147495195","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Tian Ye,Benjamin Tura,Ben Abbotts,Maurice P Zeegers,K K Cheng,Nicholas D James,Richard T Bryan
{"title":"Clinical outcomes of BCG-treated patients with high-risk non-muscle-invasive bladder cancer according to pre- and post-2021 European Association of Urology risk classifications.","authors":"Tian Ye,Benjamin Tura,Ben Abbotts,Maurice P Zeegers,K K Cheng,Nicholas D James,Richard T Bryan","doi":"10.1111/bju.70247","DOIUrl":"https://doi.org/10.1111/bju.70247","url":null,"abstract":"","PeriodicalId":8985,"journal":{"name":"BJU International","volume":"16 1","pages":""},"PeriodicalIF":4.5,"publicationDate":"2026-03-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147495194","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
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