3D Tumor Mapping and Grade Heterogeneity Metrics in Radical Prostatectomy: A Joint Pathology–Computation Feasibility Protocol for Spatially-Informed Reporting

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Büyükgök M.

22nd EUROPEAN CONGRESS ON DIGITAL PATHOLOGY, Graz, Avusturya, 18 - 20 Haziran 2026, ss.292, (Özet Bildiri)

  • Yayın Türü: Bildiri / Özet Bildiri
  • Basıldığı Şehir: Graz
  • Basıldığı Ülke: Avusturya
  • Sayfa Sayıları: ss.292
  • Dokuz Eylül Üniversitesi Adresli: Evet

Özet

Introduction: Prostate adenocarcinoma is routinely graded on 2D histologic sections (Gleason/ISUP) despite multifocality and spatial heterogeneity (1). Spatially explicit reporting may better capture dominant and highest-grade foci and support multidisciplinary decisions(2,3).

Materials and Methods: We propose a feasibility and methods study co-designed by pathologists and computational scientists to build a reproducible 3D tumor-mapping pipeline for radical prostatectomy using whole-slide imaging (WSI). Serial sections will be digitized; tumor foci annotated using predefined rules. Per focus we will record ISUP grade, extent (percent/length), laterality and multifocality. Annotations will be aggregated into a 3D map to derive spatial metrics (dominant focus, highest-grade focus, estimated tumor volume, and grade heterogeneity descriptors such as grade distribution across foci and spatial dispersion of highest-grade areas). Where whole-mount is not available, reconstruction from digitized tissue fragments will be explored(4).  A sector-based spatial summary will be generated as a report-ready artifact for tumor boards. Unlike imaging-centric validation studies, the primary deliverable is a pathology-first, report-ready spatial output that explicitly encodes grade heterogeneity. If available, mpMRI and/or PSMA PET will be explored for anatomical concordance, and registration uncertainty will be characterized(5,6).

Results: Primary endpoints will be feasibility (annotation time, reconstruction success rate, report generation) and reproducibility (interobserver agreement for key spatial metrics). We expect an implementable workflow that makes intraprostatic heterogeneity explicit and generates hypotheses for correlation with extraprostatic extension (EPE), margin status, seminal vesicle invasion (SVI) and biochemical recurrence.

Conclusions: 3D tumor mapping from routine WSI is feasible and provides a standardized framework for spatial heterogeneity metrics, enabling outcome-driven validation.

Keywords : digital pathology; prostate cancer; 3D mapping; spatial pathology; grade heterogeneity; structured reporting