Evaluating Conventional Light Microscopy for Primary Diagnosis of Prostate Lesions: A Validation Study on Small Biopsy Specimens

Prostate biopsies are crucial for diagnosing prostate lesions, including cancer. The procedure typically involves obtaining tissue samples using a needle. While the severity of complications is generally low, common adverse effects include mild bleeding, infection, and discomfort. Severe complications are rare. The incidence of clinically significant prostate cancer detection through core biopsies is significant, making it an indispensable diagnostic tool. The biopsies are traditionally viewed on glass slides by Conventional Light Microscopy (C.L.M.). Whole Slide Imaging (WSI): Whole Slide Imaging (WSI) involves scanning entire glass slides to produce high-resolution digital images. These images can be viewed, analysed, and shared electronically, enabling remote consultation and diagnosis. Aim: To assess the diagnostic accuracy of WSI compared to CLM. Material and methods: This single-center, cross-sectional study assessed diagnostic concordance in prostate lesion biopsies using Conventional Light Microscopy (CLM), with evaluations by two pathologists. It included core, tru-cut, and sextant biopsies, focusing on CLM accuracy. Inclusion criteria covered all available prostate biopsy specimens, while exclusion criteria included inadequate samples or those unsuitable for analysis. Selective sampling ensured a representative distribution of various prostate lesions. Results: The table shows diagnostic concordance and discrepancies between two pathologists using Conventional Light Microscopy (CLM) for prostate biopsies. While there was strong agreement in benign cases like BPH, differences were noted in adenocarcinoma grading, Gleason scores (G.S.), and perineural invasion (PNI). Some cases showed variations in Gleason pattern interpretation, affecting final diagnoses. These findings highlight inter-observer variability, suggesting the need for further analysis, possibly incorporating Whole Slide Imaging (WSI) to improve diagnostic consistency. Conclusion: This study aim