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A systematic review and meta-analysis of Histoscanning™ in prostate cancer diagnostics
Andrey Morozov1, Vasiliy Kozlov2, Juan Gomez Rivas3
1Institute for Urology and Reproductive Health, Sechenov University, Bolshaya Pirogovskaya str. 2 bld. 1, Moscow, 119991, Russia.
Insights
Histoscanning (HS) shows low accuracy for prostate cancer screening and detection, with limited value compared to conventional methods. While slightly better for predicting extracapsular extension, its practical effectiveness remains unproven.
Area of Science:
- Urology
- Medical Imaging
- Oncology
Background:
- Histoscanning (HS) has been utilized in clinical practice for over a decade for prostate cancer (PCa) imaging, yet its diagnostic value remains a subject of debate.
- The study addresses the ongoing discussion surrounding the efficacy of HS in PCa diagnostics.
Purpose of the Study:
- To systematically review and synthesize existing data on Histoscanning from various prostate cancer diagnostic viewpoints.
- To evaluate the potential and clinical utility of HS in the management of prostate cancer.
Main Methods:
- A systematic literature search was conducted using Medline and Scopus databases with the keyword "Histoscan*".
- Primary endpoint focused on the accuracy of HS, with secondary endpoints including correlation of lesion volume with histology and prediction of extracapsular extension or seminal vesicle invasion.
Main Results:
- Histoscanning demonstrated improved cancer detection rates per core and per patient, but overall pooled accuracy (sensitivity: 0.2, specificity: 0.12, AUC: 0.12) was markedly low.
- Most studies (8/10) indicated no additional value of HS over conventional methods. Post-radical prostatectomy (RP) accuracy was slightly better (sensitivity: 0.56, specificity: 0.23, AUC: 0.4), yet still low, with 9/12 studies finding no benefit.
Conclusions:
- This meta-analysis found no incremental value of Histoscanning compared to conventional transrectal ultrasound (TRUS) for prostate cancer screening and targeted biopsy.
- While HS showed slight improvement in predicting extracapsular extension post-RP, its practical effectiveness is not established due to insufficient data.
- Current evidence suggests Histoscanning has low accuracy for screening and detecting prostate cancer.
Context:
The value of Histoscanning™ (HS) in prostate cancer (PCa) imaging is much debated, although it has been used in clinical practice for more than 10 years now.
Objective:
To summarize the data on HS from various PCa diagnostic perspectives to determine its potential.
Materials And Methods:
We performed a systematic search using 2 databases (Medline and Scopus) on the query "Histoscan*". The primary endpoint was HS accuracy. The secondary endpoints were: correlation of lesion volume by HS and histology, ability of HS to predict extracapsular extension or seminal vesicle invasion.
Results:
HS improved cancer detection rate "per core", OR = 16.37 (95% CI 13.2; 20.3), p < 0.0001, I2 = 98% and "per patient", OR = 1.83 (95% CI 1.51; 2.21), p < 0.0001, I2 = 95%. The pooled accuracy was markedly low: sensitivity - 0.2 (95% CI 0.19-0.21), specificity - 0.12 (0.11-0.13), AUC 0.12. 8 of 10 studiers showed no additional value for HS. The pooled accuracy with histology after RP was relatively better, yet still very low: sensitivity - 0.56 (95% CI 0.5-0.63), specificity - 0.23 (0.18-0.28), AUC 0.4. 9 of 12 studies did not show any benefit of HS.
Conclusion:
This meta-analysis does not see the incremental value in comparing prostate Histoscanning with conventional TRUS in prostate cancer screening and targeted biopsy. HS proved to be slightly more accurate in predicting extracapsular extension on RP, but the available data does not allow us to draw any conclusions on its effectiveness in practice. Histoscanning is a modification of ultrasound for prostate cancer visualization. The available data suggest its low accuracy in screening and detecting of prostate cancer.
