Abstract：
Intraoperative frozen section (IFS) is used with the intention to improve functional and oncological outcomes for patients undergoing radical prostatectomy (RP). High resource requirements of IFS techniques such as NeuroSAFE may preclude widespread adoption, even if there are benefits to patients. Recent advances in fresh-tissue microscopic digital imaging technologies may offer an attractive alternative, and there is a growing body of evidence regarding these technologies. In this narrative review, we discuss some of the familiar limitations of IFS and compare these to the attractive counterpoints of modern digital imaging technologies such as the speed and ease of image generation, the locality of equipment within (or near) the operating room, the ability to maintain tissue integrity, and digital transfer of images. Confocal laser microscopy (CLM) is the modality most frequently reported in the literature for margin assessment during RP. We discuss several imitations and obstacles to widespread dissemination of digital imaging technologies. Among these, we consider how the \'en-face\' margin perspective will challenge urologists and pathologists to understand afresh the meaning of positive margin significance. As a part of this, discussions on how to describe, categorize, react to, and evaluate these technologies are needed to improve patient outcomes. Limitations of this review include its narrative structure and that the evidence base in this field is relatively immature but developing at pace.
摘要：
术中冷冻切片（IFS）旨在改善接受根治性前列腺切除术（RP）的患者的功能和肿瘤预后。IFS技术的高资源需求，如NeuroSAFE可能会阻碍广泛采用，即使对患者有好处。新鲜组织显微数字成像技术的最新进展可能会提供一个有吸引力的替代方案，关于这些技术的证据越来越多。在这篇叙述性评论中，我们讨论了IFS的一些熟悉的局限性，并将这些局限性与现代数字成像技术的有吸引力的对立面进行比较，例如图像生成的速度和便利性，手术室内（或附近）设备的位置，保持组织完整性的能力，和图像的数字传输。共聚焦激光显微镜（CLM）是文献中最常见的用于RP期间边缘评估的方式。我们讨论了数字成像技术广泛传播的几种模仿和障碍。其中,我们考虑“正面边缘”观点将如何挑战泌尿科医师和病理学家重新理解正面边缘意义的含义。作为其中的一部分,讨论如何描述，归类,反应,并评估这些技术需要改善患者预后。这篇评论的局限性包括其叙事结构，以及该领域的证据基础相对不成熟但发展迅速。
