Clinical factors influencing diffuse reflection spectroscopy for prostate tissue discrimination

Positive surgical margins (PSMs) after radical prostatectomy increase biochemical recurrence and secondary treatment, highlighting the need for reliable margin assessment. This study aimed to evaluate how tissue heterogeneity, glandular origin, and malignancy grade affect the performance of diffuse reflectance spectroscopy (DRS) in distinguishing prostate tissue types. In an ex vivo study of 104 patients, spectra were acquired and matched to histology for classification. Performance differed by anatomical region, with tumor–healthy discrimination varying across zones. Grade effects were inconclusive due to limited data. Heterogeneous tissues yielded about 72% sensitivity and specificity.