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1. The Transatlantic Recommendations for Prostate Gland Evaluation with Magnetic Resonance Imaging After Focal Therapy (TARGET): A Systematic Review and International Consensus Recommendations

Author

Light, Alexander, Mayor, Nikhil, Cullen, Emma, Kirkham, Alex, Padhani, Anwar R., Arya, Manit, Bomers, J.G.R., Ahmed, Hashim U., Shah, Taimur T., Light, Alexander, Mayor, Nikhil, Cullen, Emma, Kirkham, Alex, Padhani, Anwar R., Arya, Manit, Bomers, J.G.R., Ahmed, Hashim U., and Shah, Taimur T.

Abstract

Contains fulltext : 306978.pdf (Publisher’s version ) (Open Access)

Published
2024

2. The Transatlantic Recommendations for Prostate Gland Evaluation with Magnetic Resonance Imaging After Focal Therapy (TARGET):A Systematic Review and International Consensus Recommendations

Author

Light, Alexander, Mayor, Nikhil, Cullen, Emma, Kirkham, Alex, Padhani, Anwar R., Arya, Manit, Bomers, Joyce G.R., Dudderidge, Tim, Ehdaie, Behfar, Freeman, Alex, Guillaumier, Stephanie, Hindley, Richard, Lakhani, Amish, Pendse, Douglas, Punwani, Shonit, Rastinehad, Ardeshir R., Rouvière, Olivier, Sanchez-Salas, Rafael, Schoots, Ivo G., Sokhi, Heminder K., Tam, Henry, Tempany, Clare M., Valerio, Massimo, Verma, Sadhna, Villeirs, Geert, van der Meulen, Jan, Ahmed, Hashim U., Shah, Taimur T., Light, Alexander, Mayor, Nikhil, Cullen, Emma, Kirkham, Alex, Padhani, Anwar R., Arya, Manit, Bomers, Joyce G.R., Dudderidge, Tim, Ehdaie, Behfar, Freeman, Alex, Guillaumier, Stephanie, Hindley, Richard, Lakhani, Amish, Pendse, Douglas, Punwani, Shonit, Rastinehad, Ardeshir R., Rouvière, Olivier, Sanchez-Salas, Rafael, Schoots, Ivo G., Sokhi, Heminder K., Tam, Henry, Tempany, Clare M., Valerio, Massimo, Verma, Sadhna, Villeirs, Geert, van der Meulen, Jan, Ahmed, Hashim U., and Shah, Taimur T.

Abstract

Background and objective: Magnetic resonance imaging (MRI) can detect recurrences after focal therapy for prostate cancer but there is no robust guidance regarding its use. Our objective was to produce consensus recommendations on MRI acquisition, interpretation, and reporting after focal therapy. Methods:A systematic review was performed in July 2022 to develop consensus statements. A two-round consensus exercise was then performed, with a consensus meeting in January 2023, during which 329 statements were scored by 23 panellists from Europe and North America spanning urology, radiology, and pathology with experience across eight focal therapy modalities. Using RAND Corporation/University of California-Los Angeles methodology, the Transatlantic Recommendations for Prostate Gland Evaluation with MRI after Focal Therapy (TARGET) were based on consensus for statements scored with agreement or disagreement. Key findings and limitations: In total, 73 studies were included in the review. All 20 studies (100%) reporting suspicious imaging features cited focal contrast enhancement as suspicious for cancer recurrence. Of 31 studies reporting MRI assessment criteria, the Prostate Imaging-Reporting and Data System (PI-RADS) score was the scheme used most often (20 studies; 65%), followed by a 5-point Likert score (six studies; 19%). For the consensus exercise, consensus for statements scored with agreement or disagreement increased from 227 of 295 statements (76.9%) in round one to 270 of 329 statements (82.1%) in round two. Key recommendations include performing routine MRI at 12 mo using a multiparametric protocol compliant with PI-RADS version 2.1 standards. PI-RADS category scores for assessing recurrence within the ablation zone should be avoided. An alternative 5-point scoring system is presented that includes a major dynamic contrast enhancement (DCE) sequence and joint minor diffusion-weighted imaging and T2-w

Published
2024

3. External validation of a risk model predicting failure of salvage focal ablation for prostate cancer

Author

MS Radiotherapie, Light, Alexander, Peters, Max, Reddy, Deepika, Kanthabalan, Abi, Otieno, Marjorie, Pavlou, Menelaos, Omar, Rumana, Adeleke, Sola, Giganti, Francesco, Brew-Graves, Chris, Williams, Norman R, Emara, Amr, Haroon, Athar, Latifoltojar, Arash, Sidhu, Harbir, Freeman, Alex, Orczyk, Clement, Nikapota, Ashok, Dudderidge, Tim, Hindley, Richard G, Virdi, Jaspal, Arya, Manit, Payne, Heather, Mitra, Anita V, Bomanji, Jamshed, Winkler, Mathias, Horan, Gail, Moore, Caroline, Emberton, Mark, Punwani, Shonit, Ahmed, Hashim U, Shah, Taimur T, MS Radiotherapie, Light, Alexander, Peters, Max, Reddy, Deepika, Kanthabalan, Abi, Otieno, Marjorie, Pavlou, Menelaos, Omar, Rumana, Adeleke, Sola, Giganti, Francesco, Brew-Graves, Chris, Williams, Norman R, Emara, Amr, Haroon, Athar, Latifoltojar, Arash, Sidhu, Harbir, Freeman, Alex, Orczyk, Clement, Nikapota, Ashok, Dudderidge, Tim, Hindley, Richard G, Virdi, Jaspal, Arya, Manit, Payne, Heather, Mitra, Anita V, Bomanji, Jamshed, Winkler, Mathias, Horan, Gail, Moore, Caroline, Emberton, Mark, Punwani, Shonit, Ahmed, Hashim U, and Shah, Taimur T

Published
2023

4. Evaluation of Outcomes Following Focal Ablative Therapy for Treatment of Localized Clinically Significant Prostate Cancer in Patients >70 Years: A Multi-institute, Multi-energy 15-Year Experience

Author

MS Radiotherapie, Onderzoek Radiotherapie, Cancer, Habashy, David, Reddy, Deepika, Peters, Max, Shah, Taimur T, van Son, Marieke, van Rossum, Peter, Tanaka, Mariana Bertoncelli, Cullen, Emma, Engle, Ryan, McCracken, Stuart, Greene, Damian, Hindley, Richard G, Emara, Amr, Nigam, Raj, Orczyk, Clement, Shergill, Iqbal, Persad, Raj, Virdi, Jaspal, Moore, Caroline M, Arya, Manit, Winkler, Mathias, Emberton, Mark, Ahmed, Hashim U, Dudderidge, Tim, MS Radiotherapie, Onderzoek Radiotherapie, Cancer, Habashy, David, Reddy, Deepika, Peters, Max, Shah, Taimur T, van Son, Marieke, van Rossum, Peter, Tanaka, Mariana Bertoncelli, Cullen, Emma, Engle, Ryan, McCracken, Stuart, Greene, Damian, Hindley, Richard G, Emara, Amr, Nigam, Raj, Orczyk, Clement, Shergill, Iqbal, Persad, Raj, Virdi, Jaspal, Moore, Caroline M, Arya, Manit, Winkler, Mathias, Emberton, Mark, Ahmed, Hashim U, and Dudderidge, Tim

Published
2023

6. Diagnostic accuracy of magnetic resonance imaging targeted biopsy techniques compared to transrectal ultrasound guided biopsy of the prostate: a systematic review and meta-analysis

Author

Bass, Edward J., Bass, Edward J., Pantović, Ana, Connor, Martin J., Loeb, Stacy, Rastinehad, Ardeshir R., Winkler, Mathias H., Gabe, Rhian, Ahmed, Hashim U., Bass, Edward J., Bass, Edward J., Pantović, Ana, Connor, Martin J., Loeb, Stacy, Rastinehad, Ardeshir R., Winkler, Mathias H., Gabe, Rhian, and Ahmed, Hashim U.

Abstract

Background: Multiparametric MRI localizes cancer in the prostate, allowing for MRI guided biopsy (MRI-GB) 43 alongside transrectal ultrasound-guided systematic biopsy (TRUS-GB). Three MRI-GB approaches exist; visual estimation (COG-TB); fusion software-assisted (FUS-TB) and MRI ‘in-bore’ biopsy (IB-TB). It is unknown whether any of these are superior. We conducted a systematic review and meta-analysis to address three questions. First, whether MRI-GB is superior to TRUS-GB at detecting clinically significant PCa (csPCa). Second, whether MRI-GB is superior to TRUS-GB at avoiding detection of insignificant PCa. Third, whether any MRI-GB strategy is superior at detecting csPCa. Methods: A systematic literature review from 2015 to 2019 was performed in accordance with the START recommendations. Studies reporting PCa detection rates, employing MRI-GB and TRUS-GB were included and evaluated using the QUADAS-2 checklist. 1553 studies were found, of which 43 were included in the meta-analysis. Results: For csPCa, MRI-GB was superior in detection to TRUS-GB (0.83 vs. 0.63 [p = 0.02]). MRI-GB was superior in detection to TRUS-GB at avoiding detection of insignificant PCa. No MRI-GB technique was superior at detecting csPCa (IB-TB 0.87; COG TB 0.81; FUS-TB 0.81, [p = 0.55]). There was significant heterogeneity observed between the included studies. Conclusions: In patients with suspected PCa on MRI, MRI-GB offers superior rates of csPCa detection and reduces detection of insignificant PCa compared to TRUS-GB. No individual MRI-GB technique was found to be better in csPCa detection. Prospective adequately powered randomized controlled trials are required.

Published
2022

7. Diagnostic accuracy of magnetic resonance imaging targeted biopsy techniques compared to transrectal ultrasound guided biopsy of the prostate: a systematic review and meta-analysis

Author

Bass, Edward J., Bass, Edward J., Pantović, Ana, Connor, Martin J., Loeb, Stacy, Rastinehad, Ardeshir R., Winkler, Mathias H., Gabe, Rhian, Ahmed, Hashim U., Bass, Edward J., Bass, Edward J., Pantović, Ana, Connor, Martin J., Loeb, Stacy, Rastinehad, Ardeshir R., Winkler, Mathias H., Gabe, Rhian, and Ahmed, Hashim U.

Abstract

Background: Multiparametric MRI localizes cancer in the prostate, allowing for MRI guided biopsy (MRI-GB) 43 alongside transrectal ultrasound-guided systematic biopsy (TRUS-GB). Three MRI-GB approaches exist; visual estimation (COG-TB); fusion software-assisted (FUS-TB) and MRI ‘in-bore’ biopsy (IB-TB). It is unknown whether any of these are superior. We conducted a systematic review and meta-analysis to address three questions. First, whether MRI-GB is superior to TRUS-GB at detecting clinically significant PCa (csPCa). Second, whether MRI-GB is superior to TRUS-GB at avoiding detection of insignificant PCa. Third, whether any MRI-GB strategy is superior at detecting csPCa. Methods: A systematic literature review from 2015 to 2019 was performed in accordance with the START recommendations. Studies reporting PCa detection rates, employing MRI-GB and TRUS-GB were included and evaluated using the QUADAS-2 checklist. 1553 studies were found, of which 43 were included in the meta-analysis. Results: For csPCa, MRI-GB was superior in detection to TRUS-GB (0.83 vs. 0.63 [p = 0.02]). MRI-GB was superior in detection to TRUS-GB at avoiding detection of insignificant PCa. No MRI-GB technique was superior at detecting csPCa (IB-TB 0.87; COG TB 0.81; FUS-TB 0.81, [p = 0.55]). There was significant heterogeneity observed between the included studies. Conclusions: In patients with suspected PCa on MRI, MRI-GB offers superior rates of csPCa detection and reduces detection of insignificant PCa compared to TRUS-GB. No individual MRI-GB technique was found to be better in csPCa detection. Prospective adequately powered randomized controlled trials are required.

Published
2022

8. Cancer Control Outcomes Following Focal Therapy Using High-intensity Focused Ultrasound in 1379 Men with Nonmetastatic Prostate Cancer: A Multi-institute 15-year Experience

Author

Arts-assistenten Radiotherapie, Onderzoek Radiotherapie, Reddy, Deepika, Peters, Max, Shah, Taimur T, van Son, Marieke, Tanaka, Mariana Bertoncelli, Huber, Philipp M, Lomas, Derek, Rakauskas, Arnas, Miah, Saiful, Eldred-Evans, David, Guillaumier, Stephanie, Hosking-Jervis, Feargus, Engle, Ryan, Dudderidge, Tim, Hindley, Richard G, Emara, Amr, Nigam, Raj, McCartan, Neil, Valerio, Massimo, Afzal, Naveed, Lewi, Henry, Orczyk, Clement, Ogden, Chris, Shergill, Iqbal, Persad, Raj, Virdi, Jaspal, Moore, Caroline M, Arya, Manit, Winkler, Mathias, Emberton, Mark, Ahmed, Hashim U, Arts-assistenten Radiotherapie, Onderzoek Radiotherapie, Reddy, Deepika, Peters, Max, Shah, Taimur T, van Son, Marieke, Tanaka, Mariana Bertoncelli, Huber, Philipp M, Lomas, Derek, Rakauskas, Arnas, Miah, Saiful, Eldred-Evans, David, Guillaumier, Stephanie, Hosking-Jervis, Feargus, Engle, Ryan, Dudderidge, Tim, Hindley, Richard G, Emara, Amr, Nigam, Raj, McCartan, Neil, Valerio, Massimo, Afzal, Naveed, Lewi, Henry, Orczyk, Clement, Ogden, Chris, Shergill, Iqbal, Persad, Raj, Virdi, Jaspal, Moore, Caroline M, Arya, Manit, Winkler, Mathias, Emberton, Mark, and Ahmed, Hashim U

Published
2022

9. Predicting the Need for Biopsy to Detect Clinically Significant Prostate Cancer in Patients with a Magnetic Resonance Imaging-detected Prostate Imaging Reporting and Data System/Likert ≥3 Lesion: Development and Multinational External Validation of the Imperial Rapid Access to Prostate Imaging and Diagnosis Risk Score

Author

Arts-assistenten Radiotherapie, MS Radiotherapie, Cancer, Peters, Max, Eldred-Evans, David, Kurver, Piet, Falagario, Ugo Giovanni, Connor, Martin J, Shah, Taimur T, Verhoeff, Joost J C, Taimen, Pekka, Aronen, Hannu J, Knaapila, Juha, Montoya Perez, Ileana, Ettala, Otto, Stabile, Armando, Gandaglia, Giorgio, Fossati, Nicola, Martini, Alberto, Cucchiara, Vito, Briganti, Alberto, Lantz, Anna, Picker, Wolfgang, Haug, Erik Skaaheim, Nordström, Tobias, Tanaka, Mariana Bertoncelli, Reddy, Deepika, Bass, Edward, van Rossum, Peter S N, Wong, Kathie, Tam, Henry, Winkler, Mathias, Gordon, Stephen, Qazi, Hasan, Boström, Peter J, Jambor, Ivan, Ahmed, Hashim U, Arts-assistenten Radiotherapie, MS Radiotherapie, Cancer, Peters, Max, Eldred-Evans, David, Kurver, Piet, Falagario, Ugo Giovanni, Connor, Martin J, Shah, Taimur T, Verhoeff, Joost J C, Taimen, Pekka, Aronen, Hannu J, Knaapila, Juha, Montoya Perez, Ileana, Ettala, Otto, Stabile, Armando, Gandaglia, Giorgio, Fossati, Nicola, Martini, Alberto, Cucchiara, Vito, Briganti, Alberto, Lantz, Anna, Picker, Wolfgang, Haug, Erik Skaaheim, Nordström, Tobias, Tanaka, Mariana Bertoncelli, Reddy, Deepika, Bass, Edward, van Rossum, Peter S N, Wong, Kathie, Tam, Henry, Winkler, Mathias, Gordon, Stephen, Qazi, Hasan, Boström, Peter J, Jambor, Ivan, and Ahmed, Hashim U

Published
2022

11. The ReIMAGINE Multimodal Warehouse: Using Artificial Intelligence for Accurate Risk Stratification of Prostate Cancer

Author

Santaolalla, Aida, Hulsen, Tim, Davis, Jenson, Ahmed, Hashim U., Moore, Caroline M., Punwani, Shonit, Coolen, A.C.C., Hemelrijck, Mieke Van, Santaolalla, Aida, Hulsen, Tim, Davis, Jenson, Ahmed, Hashim U., Moore, Caroline M., Punwani, Shonit, Coolen, A.C.C., and Hemelrijck, Mieke Van

Abstract

Contains fulltext : 247229.pdf (Publisher’s version ) (Open Access)

Published
2021

12. Conventional radical versus focal treatment for localised prostate cancer: a propensity score weighted comparison of 6-year tumour control

Author

Cancer, Onderzoek Radiotherapie, Arts-assistenten Radiotherapie, Onderzoek Beeld, Klinische Fysica RT, MS Radiotherapie, van Son, Marieke J., Peters, Max, Reddy, Deepika, Shah, Taimur T., Hosking-Jervis, Feargus, Robinson, Stephen, Lagendijk, Jan J.W., Mangar, Stephen, Dudderidge, Tim, McCracken, Stuart, Hindley, Richard G., Emara, Amr, Nigam, Raj, Persad, Raj, Virdi, Jaspal, Lewi, Henry, Moore, Caroline, Orczyk, Clement, Emberton, Mark, Arya, Manit, Ahmed, Hashim U., van der Voort van Zyp, Jochem R.N., Winkler, Matt, Falconer, Alison, Cancer, Onderzoek Radiotherapie, Arts-assistenten Radiotherapie, Onderzoek Beeld, Klinische Fysica RT, MS Radiotherapie, van Son, Marieke J., Peters, Max, Reddy, Deepika, Shah, Taimur T., Hosking-Jervis, Feargus, Robinson, Stephen, Lagendijk, Jan J.W., Mangar, Stephen, Dudderidge, Tim, McCracken, Stuart, Hindley, Richard G., Emara, Amr, Nigam, Raj, Persad, Raj, Virdi, Jaspal, Lewi, Henry, Moore, Caroline, Orczyk, Clement, Emberton, Mark, Arya, Manit, Ahmed, Hashim U., van der Voort van Zyp, Jochem R.N., Winkler, Matt, and Falconer, Alison

Published
2021

13. Focal therapy compared to radical prostatectomy for non-metastatic prostate cancer: a propensity score-matched study

Author

Arts-assistenten Radiotherapie, Cancer, Onderzoek Radiotherapie, Shah, Taimur T, Reddy, Deepika, Peters, Max, Ball, Daniel, Kim, Na Hyun, Gomez, Enrique Gomez, Miah, Saiful, Evans, David Eldred, Guillaumier, Stephanie, van Rossum, Peter S N, Van Son, Marieke J, Hosking-Jervis, Feargus, Dudderidge, Tim, Hindley, Richard, Emara, Amr, McCracken, Stuart, Greene, Damian, Nigam, Raj, McCartan, Neil, Valerio, Massimo, Minhas, Suks, Afzal, Naveed, Lewi, Henry, Ogden, Chris, Persad, Raj, Virdi, Jaspal, Moore, Caroline M, Arya, Manit, Emberton, Mark, Ahmed, Hashim U, Winkler, Mathias, Arts-assistenten Radiotherapie, Cancer, Onderzoek Radiotherapie, Shah, Taimur T, Reddy, Deepika, Peters, Max, Ball, Daniel, Kim, Na Hyun, Gomez, Enrique Gomez, Miah, Saiful, Evans, David Eldred, Guillaumier, Stephanie, van Rossum, Peter S N, Van Son, Marieke J, Hosking-Jervis, Feargus, Dudderidge, Tim, Hindley, Richard, Emara, Amr, McCracken, Stuart, Greene, Damian, Nigam, Raj, McCartan, Neil, Valerio, Massimo, Minhas, Suks, Afzal, Naveed, Lewi, Henry, Ogden, Chris, Persad, Raj, Virdi, Jaspal, Moore, Caroline M, Arya, Manit, Emberton, Mark, Ahmed, Hashim U, and Winkler, Mathias

Published
2021

14. A Comparison of Prostate Cancer Detection Between Visual-Estimation (Cognitive Registration) and Image-Fusion (Software Registration) Targeted Transperineal Prostate Biopsy

Author

Arts-assistenten Radiotherapie, Onderzoek Radiotherapie, Cancer, Khoo, Christopher C, Eldred-Evans, David, Peters, Max, van Son, Marieke, van Rossum, Peter, Connor, Martin J, Hosking-Jervis, Feargus, Tanaka, Mariana Bertoncelli, Reddy, Deepika, Bass, Edward, Powell, Laura, Ahmad, Shahzad, Pegers, Elizabeth, Joshi, Suchita, Sri, Denosshan, Wong, Kathie, Tam, Henry, Hrouda, David, Qazi, Hasan, Gordon, Stephen, McCracken, Stuart, Winkler, Mathias, Ahmed, Hashim U, Arts-assistenten Radiotherapie, Onderzoek Radiotherapie, Cancer, Khoo, Christopher C, Eldred-Evans, David, Peters, Max, van Son, Marieke, van Rossum, Peter, Connor, Martin J, Hosking-Jervis, Feargus, Tanaka, Mariana Bertoncelli, Reddy, Deepika, Bass, Edward, Powell, Laura, Ahmad, Shahzad, Pegers, Elizabeth, Joshi, Suchita, Sri, Denosshan, Wong, Kathie, Tam, Henry, Hrouda, David, Qazi, Hasan, Gordon, Stephen, McCracken, Stuart, Winkler, Mathias, and Ahmed, Hashim U

Published
2021

15. ESUR/ESUI consensus statements on multi-parametric MRI for the detection of clinically significant prostate cancer:quality requirements for image acquisition, interpretation and radiologists’ training

Author

de Rooij, Maarten, Israël, Bas, Tummers, Marcia, Ahmed, Hashim U., Barrett, Tristan, Giganti, Francesco, Hamm, Bernd, Løgager, Vibeke, Padhani, Anwar, Panebianco, Valeria, Puech, Philippe, Richenberg, Jonathan, Rouvière, Olivier, Salomon, Georg, Schoots, Ivo, Veltman, Jeroen, Villeirs, Geert, Walz, Jochen, Barentsz, Jelle O., de Rooij, Maarten, Israël, Bas, Tummers, Marcia, Ahmed, Hashim U., Barrett, Tristan, Giganti, Francesco, Hamm, Bernd, Løgager, Vibeke, Padhani, Anwar, Panebianco, Valeria, Puech, Philippe, Richenberg, Jonathan, Rouvière, Olivier, Salomon, Georg, Schoots, Ivo, Veltman, Jeroen, Villeirs, Geert, Walz, Jochen, and Barentsz, Jelle O.

Abstract

Objectives: This study aims to define consensus-based criteria for acquiring and reporting prostate MRI and establishing prerequisites for image quality. Methods: A total of 44 leading urologists and urogenital radiologists who are experts in prostate cancer imaging from the European Society of Urogenital Radiology (ESUR) and EAU Section of Urologic Imaging (ESUI) participated in a Delphi consensus process. Panellists completed two rounds of questionnaires with 55 items under three headings: image quality assessment, interpretation and reporting, and radiologists’ experience plus training centres. Of 55 questions, 31 were rated for agreement on a 9-point scale, and 24 were multiple-choice or open. For agreement items, there was consensus agreement with an agreement ≥ 70% (score 7–9) and disagreement of ≤ 15% of the panellists. For the other questions, a consensus was considered with ≥ 50% of votes. Results: Twenty-four out of 31 of agreement items and 11/16 of other questions reached consensus. Agreement statements were (1) reporting of image quality should be performed and implemented into clinical practice; (2) for interpretation performance, radiologists should use self-performance tests with histopathology feedback, compare their interpretation with expert-reading and use external performance assessments; and (3) radiologists must attend theoretical and hands-on courses before interpreting prostate MRI. Limitations are that the results are expert opinions and not based on systematic reviews or meta-analyses. There was no consensus on outcomes statements of prostate MRI assessment as quality marker. Conclusions: An ESUR and ESUI expert panel showed high agreement (74%) on issues improving prostate MRI quality. Checking and reporting of image quality are mandatory. Prostate radiologists should attend theoretical and hands-on courses, followed by supervised education, and must perform regular performance assessments. Key Points: • Multi-parametric MRI in the dia

Published
2020

16. ESUR/ESUI consensus statements on multi-parametric MRI for the detection of clinically significant prostate cancer:quality requirements for image acquisition, interpretation and radiologists’ training

Author

de Rooij, Maarten, Israël, Bas, Tummers, Marcia, Ahmed, Hashim U., Barrett, Tristan, Giganti, Francesco, Hamm, Bernd, Løgager, Vibeke, Padhani, Anwar, Panebianco, Valeria, Puech, Philippe, Richenberg, Jonathan, Rouvière, Olivier, Salomon, Georg, Schoots, Ivo, Veltman, Jeroen, Villeirs, Geert, Walz, Jochen, Barentsz, Jelle O., de Rooij, Maarten, Israël, Bas, Tummers, Marcia, Ahmed, Hashim U., Barrett, Tristan, Giganti, Francesco, Hamm, Bernd, Løgager, Vibeke, Padhani, Anwar, Panebianco, Valeria, Puech, Philippe, Richenberg, Jonathan, Rouvière, Olivier, Salomon, Georg, Schoots, Ivo, Veltman, Jeroen, Villeirs, Geert, Walz, Jochen, and Barentsz, Jelle O.

Abstract

Objectives: This study aims to define consensus-based criteria for acquiring and reporting prostate MRI and establishing prerequisites for image quality. Methods: A total of 44 leading urologists and urogenital radiologists who are experts in prostate cancer imaging from the European Society of Urogenital Radiology (ESUR) and EAU Section of Urologic Imaging (ESUI) participated in a Delphi consensus process. Panellists completed two rounds of questionnaires with 55 items under three headings: image quality assessment, interpretation and reporting, and radiologists’ experience plus training centres. Of 55 questions, 31 were rated for agreement on a 9-point scale, and 24 were multiple-choice or open. For agreement items, there was consensus agreement with an agreement ≥ 70% (score 7–9) and disagreement of ≤ 15% of the panellists. For the other questions, a consensus was considered with ≥ 50% of votes. Results: Twenty-four out of 31 of agreement items and 11/16 of other questions reached consensus. Agreement statements were (1) reporting of image quality should be performed and implemented into clinical practice; (2) for interpretation performance, radiologists should use self-performance tests with histopathology feedback, compare their interpretation with expert-reading and use external performance assessments; and (3) radiologists must attend theoretical and hands-on courses before interpreting prostate MRI. Limitations are that the results are expert opinions and not based on systematic reviews or meta-analyses. There was no consensus on outcomes statements of prostate MRI assessment as quality marker. Conclusions: An ESUR and ESUI expert panel showed high agreement (74%) on issues improving prostate MRI quality. Checking and reporting of image quality are mandatory. Prostate radiologists should attend theoretical and hands-on courses, followed by supervised education, and must perform regular performance assessments. Key Points: • Multi-parametric MRI in the dia

Published
2020

17. MRI-Guided Ultrafocal Salvage High-Dose-Rate Brachytherapy for Localized Radiorecurrent Prostate Cancer: Updated Results of 50 Patients

Author

Unit D (laboranten RT), Onderzoek Radiotherapie, Cancer, Arts-assistenten Radiotherapie, Klinische Fysica RT, Fysica Radiotherapie Research, MS Radiotherapie, van Son, Marieke Juliet, Peters, Max, Moerland, Marinus A., Lagendijk, Jan J.W., Eppinga, Wietse S.C., Shah, Taimur T., Ahmed, Hashim U., van der Voort van Zyp, Jochem R.N., Unit D (laboranten RT), Onderzoek Radiotherapie, Cancer, Arts-assistenten Radiotherapie, Klinische Fysica RT, Fysica Radiotherapie Research, MS Radiotherapie, van Son, Marieke Juliet, Peters, Max, Moerland, Marinus A., Lagendijk, Jan J.W., Eppinga, Wietse S.C., Shah, Taimur T., Ahmed, Hashim U., and van der Voort van Zyp, Jochem R.N.

Published
2020

18. MRI-Guided Ultrafocal HDR Brachytherapy for Localized Prostate Cancer: Median 4-Year Results of a feasibility study

Author

Peters, Max, van Son, Marieke J., Moerland, Marinus A., Kerkmeijer, Linda G. W., Eppinga, Wietse S. C., Meijer, Richard P., Lagendijk, Jan J. W., Shah, Taimur T., Ahmed, Hashim U., van Zijp, Jochem R. N. van der Voort, Peters, Max, van Son, Marieke J., Moerland, Marinus A., Kerkmeijer, Linda G. W., Eppinga, Wietse S. C., Meijer, Richard P., Lagendijk, Jan J. W., Shah, Taimur T., Ahmed, Hashim U., and van Zijp, Jochem R. N. van der Voort

Published
2019

19. MRI-Guided Ultrafocal HDR Brachytherapy for Localized Prostate Cancer: Median 4-Year Results of a feasibility study

Author

Peters, Max, van Son, Marieke J., Moerland, Marinus A., Kerkmeijer, Linda G. W., Eppinga, Wietse S. C., Meijer, Richard P., Lagendijk, Jan J. W., Shah, Taimur T., Ahmed, Hashim U., van Zijp, Jochem R. N. van der Voort, Peters, Max, van Son, Marieke J., Moerland, Marinus A., Kerkmeijer, Linda G. W., Eppinga, Wietse S. C., Meijer, Richard P., Lagendijk, Jan J. W., Shah, Taimur T., Ahmed, Hashim U., and van Zijp, Jochem R. N. van der Voort

Published
2019

20. MRI-Guided Ultrafocal HDR Brachytherapy for Localized Prostate Cancer: Median 4-Year Results of a feasibility study

Author

Peters, Max, van Son, Marieke J., Moerland, Marinus A., Kerkmeijer, Linda G. W., Eppinga, Wietse S. C., Meijer, Richard P., Lagendijk, Jan J. W., Shah, Taimur T., Ahmed, Hashim U., van Zijp, Jochem R. N. van der Voort, Peters, Max, van Son, Marieke J., Moerland, Marinus A., Kerkmeijer, Linda G. W., Eppinga, Wietse S. C., Meijer, Richard P., Lagendijk, Jan J. W., Shah, Taimur T., Ahmed, Hashim U., and van Zijp, Jochem R. N. van der Voort

Published
2019

21. MRI-Guided Ultrafocal HDR Brachytherapy for Localized Prostate Cancer: Median 4-Year Results of a feasibility study

Author

Arts-assistenten Radiotherapie, Onderzoek Radiotherapie, Klinische Fysica RT, Cancer, MS Radiotherapie, MS Urologische Oncologie, Urologie Medisch volwassenen, Fysica Radiotherapie Research, Peters, Max, van Son, Marieke J., Moerland, Marinus A., Kerkmeijer, Linda G. W., Eppinga, Wietse S. C., Meijer, Richard P., Lagendijk, Jan J. W., Shah, Taimur T., Ahmed, Hashim U., van Zijp, Jochem R. N. van der Voort, Arts-assistenten Radiotherapie, Onderzoek Radiotherapie, Klinische Fysica RT, Cancer, MS Radiotherapie, MS Urologische Oncologie, Urologie Medisch volwassenen, Fysica Radiotherapie Research, Peters, Max, van Son, Marieke J., Moerland, Marinus A., Kerkmeijer, Linda G. W., Eppinga, Wietse S. C., Meijer, Richard P., Lagendijk, Jan J. W., Shah, Taimur T., Ahmed, Hashim U., and van Zijp, Jochem R. N. van der Voort

Published
2019

22. Development and internal validation of prediction models for biochemical failure and composite failure after focal salvage high intensity focused ultrasound for local radiorecurrent prostate cancer : Presentation of risk scores for individual patient prognoses

Author

Peters, Max, Kanthabalan, Abi, Shah, Taimur T, McCartan, Neil, Moore, Caroline M., Arya, Manit, van der Voort van Zyp, Jochem R., Moerland, Marinus A., Hindley, Richard G., Emberton, Mark, Ahmed, Hashim U, Peters, Max, Kanthabalan, Abi, Shah, Taimur T, McCartan, Neil, Moore, Caroline M., Arya, Manit, van der Voort van Zyp, Jochem R., Moerland, Marinus A., Hindley, Richard G., Emberton, Mark, and Ahmed, Hashim U

Published
2018

23. Development and internal validation of prediction models for biochemical failure and composite failure after focal salvage high intensity focused ultrasound for local radiorecurrent prostate cancer : Presentation of risk scores for individual patient prognoses

Author

Peters, Max, Kanthabalan, Abi, Shah, Taimur T, McCartan, Neil, Moore, Caroline M., Arya, Manit, van der Voort van Zyp, Jochem R., Moerland, Marinus A., Hindley, Richard G., Emberton, Mark, Ahmed, Hashim U, Peters, Max, Kanthabalan, Abi, Shah, Taimur T, McCartan, Neil, Moore, Caroline M., Arya, Manit, van der Voort van Zyp, Jochem R., Moerland, Marinus A., Hindley, Richard G., Emberton, Mark, and Ahmed, Hashim U

Published
2018

24. Development and internal validation of prediction models for biochemical failure and composite failure after focal salvage high intensity focused ultrasound for local radiorecurrent prostate cancer : Presentation of risk scores for individual patient prognoses

Author

Peters, Max, Kanthabalan, Abi, Shah, Taimur T, McCartan, Neil, Moore, Caroline M., Arya, Manit, van der Voort van Zyp, Jochem R., Moerland, Marinus A., Hindley, Richard G., Emberton, Mark, Ahmed, Hashim U, Peters, Max, Kanthabalan, Abi, Shah, Taimur T, McCartan, Neil, Moore, Caroline M., Arya, Manit, van der Voort van Zyp, Jochem R., Moerland, Marinus A., Hindley, Richard G., Emberton, Mark, and Ahmed, Hashim U

Published
2018

25. Development and internal validation of prediction models for biochemical failure and composite failure after focal salvage high intensity focused ultrasound for local radiorecurrent prostate cancer: Presentation of risk scores for individual patient prognoses

Author

Arts-assistenten Radiotherapie, Cancer, Klinische Fysica RT, Peters, Max, Kanthabalan, Abi, Shah, Taimur T, McCartan, Neil, Moore, Caroline M., Arya, Manit, van der Voort van Zyp, Jochem R., Moerland, Marinus A., Hindley, Richard G., Emberton, Mark, Ahmed, Hashim U, Arts-assistenten Radiotherapie, Cancer, Klinische Fysica RT, Peters, Max, Kanthabalan, Abi, Shah, Taimur T, McCartan, Neil, Moore, Caroline M., Arya, Manit, van der Voort van Zyp, Jochem R., Moerland, Marinus A., Hindley, Richard G., Emberton, Mark, and Ahmed, Hashim U

Published
2018

26. UK medical students’ perceptions, attitudes, and interest toward medical leadership and clinician managers

Author

Rouhani,Maral J, Burleigh,Eleanor J, Hobbis,Chloe, Dunford,Charlotte, Osman,Nadir I, Gan,Christine, Gibbons,Norma B, Ahmed,Hashim U, Miah,Saiful, Rouhani,Maral J, Burleigh,Eleanor J, Hobbis,Chloe, Dunford,Charlotte, Osman,Nadir I, Gan,Christine, Gibbons,Norma B, Ahmed,Hashim U, and Miah,Saiful

Abstract

Maral J Rouhani,1 Eleanor J Burleigh,2 Chloe Hobbis,2 Charlotte Dunford,1 Nadir I Osman,3 Christine Gan,1 Norma B Gibbons,1 Hashim U Ahmed,1,4 Saiful Miah1,5 1Department of Urology, Imperial College Healthcare NHS Trust, Charing Cross Hospital, London, UK; 2Medical School, University of Sheffield, Sheffield, UK; 3Department of Urology, Royal Hallamshire Hospital, Sheffield, UK; 4Division of Surgery, Department of Surgery and Cancer, Imperial College London, London, UK; 5Division of Surgery and Interventional Science, University College London, London, UK Background: We aimed to determine UK medical students’ perceptions and attitudes and interest toward medical leadership and clinician managers. Methods: A cross-sectional study was conducted during the academic year 2015–2016. An online questionnaire was distributed to 2,349 final-year students from 10 UK medical schools. Participants were asked to complete a 5-point Likert scale on their current perceptions, attitudes, and interest toward medical leadership and clinician managers. They were also asked to self-rate their leadership competences set by the Medical Leadership Competency Framework and to rate the quality of management and leadership training they received from their medical school. Results: In total, we received 114 complete responses. Only 7.9% of respondents were in agreement (strongly agree or agree) when asked whether they felt they were well informed about what a managerial position in medicine entails. When asked whether clinicians should influence managerial decisions within a clinical setting, 94.7% of respondents were in agreement with the statement. About 85% of respondents were in agreement that it is important for clinicians to have managerial or leadership responsibilities, with 63.2% of students in agreement that they would have liked more management or leadership training during medical school. Over half the respondents rated their management and leadership t

Published
2018

27. Intratumoural evolutionary landscape of high-risk prostate cancer: The PROGENY study of genomic and immune parameters

Author

Linch, M., Goh, G., Hiley, C., Shanmugabavan, Y., McGranahan, N., Rowan, A., Wong, Y. N.S., King, H., Furness, A., Freeman, A., Linares, J., Akarca, A., Herrero, J., Rosenthal, R., Harder, N., Schmidt, G., Wilson, G. A., Birkbak, N. J., Mitter, R., Dentro, S., Cathcart, P., Arya, M., Johnston, E., Scott, R., Hung, M., Emberton, M., Attard, G., Szallasi, Z., Punwani, S., Quezada, S. A., Marafioti, T., Gerlinger, M., Ahmed, Hashim U., Swanton, Charles, Linch, M., Goh, G., Hiley, C., Shanmugabavan, Y., McGranahan, N., Rowan, A., Wong, Y. N.S., King, H., Furness, A., Freeman, A., Linares, J., Akarca, A., Herrero, J., Rosenthal, R., Harder, N., Schmidt, G., Wilson, G. A., Birkbak, N. J., Mitter, R., Dentro, S., Cathcart, P., Arya, M., Johnston, E., Scott, R., Hung, M., Emberton, M., Attard, G., Szallasi, Z., Punwani, S., Quezada, S. A., Marafioti, T., Gerlinger, M., Ahmed, Hashim U., and Swanton, Charles

Abstract

Background: Intratumoural heterogeneity (ITH) is well recognised in prostate cancer (PC), but its role in high-risk disease is uncertain. A prospective, single-arm, translational study using targeted multiregion prostate biopsies was carried out to study genomic and T-cell ITH in clinically high-risk PC aiming to identify drivers and potential therapeutic strategies. Patients and methods: Forty-nine men with elevated prostate-specific antigen and multiparametric-magnetic resonance imaging detected PC underwent image-guided multiregion transperineal biopsy. Seventy-nine tumour regions from 25 patients with PC underwent sequencing, analysis of mutations, copy number and neoepitopes combined with tumour infiltrating T-cell subset quantification. Results: We demonstrated extensive somatic nucleotide variation and somatic copy number alteration heterogeneity in high-risk PC. Overall, the mutational burden was low (0.93/Megabase), but two patients had hypermutation, with loss of mismatch repair (MMR) proteins, MSH2 and MSH6. Somatic copy number alteration burden was higher in patients with metastatic hormone-naive PC (mHNPC) than in those with high-risk localised PC (hrlPC), independent of Gleason grade. Mutations were rarely ubiquitous and mutational frequencies were similar for mHNPC and hrlPC patients. Enrichment of focal 3q26.2 and 3q21.3, regions containing putative metastasis drivers, was seen in mHNPC patients. We found evidence of parallel evolution with three separate clones containing activating mutations of β-catenin in a single patient. We demonstrated extensive intratumoural and intertumoural T-cell heterogeneity and high inflammatory infiltrate in the MMR-deficient (MMRD) patients and the patient with parallel evolution of β-catenin. Analysis of all patients with activating Wnt/β-catenin mutations demonstrated a low CD8+/FOXP3+ ratio, a potential surrogate marker of immune evasion. Conclusions: The PROGENY (PROstate cancer GENomic heterogeneitY) study pro

Published
2017

28. Intraoperative Organ Motion Models with an Ensemble of Conditional Generative Adversarial Networks

Author

Hu, Yipeng, Gibson, Eli, Vercauteren, Tom, Ahmed, Hashim U., Emberton, Mark, Moore, Caroline M., Noble, J. Alison, Barratt, Dean C., Hu, Yipeng, Gibson, Eli, Vercauteren, Tom, Ahmed, Hashim U., Emberton, Mark, Moore, Caroline M., Noble, J. Alison, and Barratt, Dean C.

Abstract

In this paper, we describe how a patient-specific, ultrasound-probe-induced prostate motion model can be directly generated from a single preoperative MR image. Our motion model allows for sampling from the conditional distribution of dense displacement fields, is encoded by a generative neural network conditioned on a medical image, and accepts random noise as additional input. The generative network is trained by a minimax optimisation with a second discriminative neural network, tasked to distinguish generated samples from training motion data. In this work, we propose that 1) jointly optimising a third conditioning neural network that pre-processes the input image, can effectively extract patient-specific features for conditioning; and 2) combining multiple generative models trained separately with heuristically pre-disjointed training data sets can adequately mitigate the problem of mode collapse. Trained with diagnostic T2-weighted MR images from 143 real patients and 73,216 3D dense displacement fields from finite element simulations of intraoperative prostate motion due to transrectal ultrasound probe pressure, the proposed models produced physically-plausible patient-specific motion of prostate glands. The ability to capture biomechanically simulated motion was evaluated using two errors representing generalisability and specificity of the model. The median values, calculated from a 10-fold cross-validation, were 2.8+/-0.3 mm and 1.7+/-0.1 mm, respectively. We conclude that the introduced approach demonstrates the feasibility of applying state-of-the-art machine learning algorithms to generate organ motion models from patient images, and shows significant promise for future research., Comment: Accepted to MICCAI 2017

Published
2017
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29. The death of ink: the value of typing skills as an addition to the medical school curriculum

Author

Miah,Saiful, Ahmed,Hashim U, Miah,Saiful, and Ahmed,Hashim U

Abstract

Saiful Miah,1 Hashim U Ahmed21Department of Urology, Imperial College Healthcare NHS Trust, Charing Cross Hospital, 2Imperial College London, London, UKWe read with great interest the article by Malik on the importance of writing skills, which has been highlighted as one of the four  competencies that all medical students should possess as future doctors.1 Malik’s article also stated that “first and foremost”writing in a legible manner is imperative for good clinical practice.1While we wholeheartedly agree with these statements, one potentially overlooked skill that we predict will overtake the requirement of legible writing skills within a generation of doctors is typing proficiency. Decades of investment and development of electronic health records (EHRs) have resulted in a greater implementation of this tool globally.2 EHRs have been shown through use of reminders, electronic order sets and other means to improve reliability of performance of many basic tasks in acute, preventive and chronic medical care.2View the original paper by Malik.&nbsp

Published
2017

30. Multivariable model development and internal validation for prostate cancer specific survival and overall survival after whole-gland salvage Iodine-125 prostate brachytherapy

Author

Peters, Max, van der Voort van Zyp, Jochem R N, Moerland, Marinus A, Hoekstra, Carel J, van de Pol, Sandrine, Westendorp, Hendrik, Maenhout, Metha, Kattevilder, Rob, Verkooijen, Helena M, van Rossum, Peter S N, Ahmed, Hashim U, Shah, Taimur T, Emberton, Mark, van Vulpen, Marco, Peters, Max, van der Voort van Zyp, Jochem R N, Moerland, Marinus A, Hoekstra, Carel J, van de Pol, Sandrine, Westendorp, Hendrik, Maenhout, Metha, Kattevilder, Rob, Verkooijen, Helena M, van Rossum, Peter S N, Ahmed, Hashim U, Shah, Taimur T, Emberton, Mark, and van Vulpen, Marco

Published
2016

31. Multivariable model development and internal validation for prostate cancer specific survival and overall survival after whole-gland salvage Iodine-125 prostate brachytherapy

Author

Peters, Max, van der Voort van Zyp, Jochem R N, Moerland, Marinus A, Hoekstra, Carel J, van de Pol, Sandrine, Westendorp, Hendrik, Maenhout, Metha, Kattevilder, Rob, Verkooijen, Helena M, van Rossum, Peter S N, Ahmed, Hashim U, Shah, Taimur T, Emberton, Mark, van Vulpen, Marco, Peters, Max, van der Voort van Zyp, Jochem R N, Moerland, Marinus A, Hoekstra, Carel J, van de Pol, Sandrine, Westendorp, Hendrik, Maenhout, Metha, Kattevilder, Rob, Verkooijen, Helena M, van Rossum, Peter S N, Ahmed, Hashim U, Shah, Taimur T, Emberton, Mark, and van Vulpen, Marco

Published
2016

32. Multivariable model development and internal validation for prostate cancer specific survival and overall survival after whole-gland salvage Iodine-125 prostate brachytherapy

Author

Peters, Max, van der Voort van Zyp, Jochem R N, Moerland, Marinus A, Hoekstra, Carel J, van de Pol, Sandrine, Westendorp, Hendrik, Maenhout, Metha, Kattevilder, Rob, Verkooijen, Helena M, van Rossum, Peter S N, Ahmed, Hashim U, Shah, Taimur T, Emberton, Mark, van Vulpen, Marco, Peters, Max, van der Voort van Zyp, Jochem R N, Moerland, Marinus A, Hoekstra, Carel J, van de Pol, Sandrine, Westendorp, Hendrik, Maenhout, Metha, Kattevilder, Rob, Verkooijen, Helena M, van Rossum, Peter S N, Ahmed, Hashim U, Shah, Taimur T, Emberton, Mark, and van Vulpen, Marco

Published
2016

33. Multivariable model development and internal validation for prostate cancer specific survival and overall survival after whole-gland salvage Iodine-125 prostate brachytherapy

Author

Onderzoek Radiotherapie, Cancer, MS Radiotherapie, Klinische Fysica RT, Arts-assistenten Radiotherapie, Trialbureau Beeld, Circulatory Health, Epi Kanker Team A, JC onderzoeksprogramma Kanker, Fysica Radiotherapie Research, Radiotherapie, Peters, Max, van der Voort van Zyp, Jochem R N, Moerland, Marinus A, Hoekstra, Carel J, van de Pol, Sandrine, Westendorp, Hendrik, Maenhout, Metha, Kattevilder, Rob, Verkooijen, Helena M, van Rossum, Peter S N, Ahmed, Hashim U, Shah, Taimur T, Emberton, Mark, van Vulpen, Marco, Onderzoek Radiotherapie, Cancer, MS Radiotherapie, Klinische Fysica RT, Arts-assistenten Radiotherapie, Trialbureau Beeld, Circulatory Health, Epi Kanker Team A, JC onderzoeksprogramma Kanker, Fysica Radiotherapie Research, Radiotherapie, Peters, Max, van der Voort van Zyp, Jochem R N, Moerland, Marinus A, Hoekstra, Carel J, van de Pol, Sandrine, Westendorp, Hendrik, Maenhout, Metha, Kattevilder, Rob, Verkooijen, Helena M, van Rossum, Peter S N, Ahmed, Hashim U, Shah, Taimur T, Emberton, Mark, and van Vulpen, Marco

Published
2016

34. Novel tools to improve patient selection and monitoring on active surveillance for low-risk prostate cancer: a systematic review.

Author

van den Bergh, Roderick CN, van den Bergh, Roderick CN, Ahmed, Hashim U, Bangma, Chris H, Cooperberg, Matthew R, Villers, Arnauld, Parker, Christopher C, van den Bergh, Roderick CN, van den Bergh, Roderick CN, Ahmed, Hashim U, Bangma, Chris H, Cooperberg, Matthew R, Villers, Arnauld, and Parker, Christopher C

Abstract

ContextActive surveillance (AS) is an alternative to initial radical treatment of low-risk prostate cancer (PCa). Current criteria for selection and follow-up incorrectly exclude some patients eligible for AS and misclassify some who actually harbour significant disease. Better prediction of cancer behaviour at diagnosis would allow less strict monitoring and may improve acceptance of AS.ObjectiveTo review and critically analyse the literature on the value of novel clinical tools for patient selection and monitoring on AS.Evidence acquisitionA comprehensive search of the PubMed database until July 10, 2013, was performed according to Preferred Reporting Items for Systematic Reviews and Meta-analysis statement guidelines. Studies assessing novel markers and diagnostics for patient selection for AS and follow-up during AS were included. Studies analysing only classic clinical parameters used in current protocols (prostate-specific antigen, prostate volume, number of (positive) prostate biopsies, percentage malignant tissue, Gleason score) were excluded. This review focuses only on the AS setting and not on predicting insignificant disease in general.Evidence synthesisOf 787 studies on AS, 30 were included in this review: 14 on magnetic resonance imaging (MRI), 5 on serum markers, 5 on urinary markers, 4 on histopathology markers, and 2 on germline genetic markers. Several of these markers improve the prediction of tumour volume, tumour grade, or time to active treatment. MRI has a high specificity for low-risk PCa; new serum markers are associated with unfavourable disease. In none of the studies was the new marker used as the primary decision tool. Long-term outcome measures such as mortality were not assessed. The definition of indolent PCa is disputable.ConclusionsImaging and serum markers may improve future patient selection for AS and follow-up during AS. Prospective studies should aim to further evaluate the clinical utility of these new markers with respect to

Published
2014

35. Novel tools to improve patient selection and monitoring on active surveillance for low-risk prostate cancer: a systematic review.

Author

van den Bergh, Roderick CN, van den Bergh, Roderick CN, Ahmed, Hashim U, Bangma, Chris H, Cooperberg, Matthew R, Villers, Arnauld, Parker, Christopher C, van den Bergh, Roderick CN, van den Bergh, Roderick CN, Ahmed, Hashim U, Bangma, Chris H, Cooperberg, Matthew R, Villers, Arnauld, and Parker, Christopher C

Abstract

ContextActive surveillance (AS) is an alternative to initial radical treatment of low-risk prostate cancer (PCa). Current criteria for selection and follow-up incorrectly exclude some patients eligible for AS and misclassify some who actually harbour significant disease. Better prediction of cancer behaviour at diagnosis would allow less strict monitoring and may improve acceptance of AS.ObjectiveTo review and critically analyse the literature on the value of novel clinical tools for patient selection and monitoring on AS.Evidence acquisitionA comprehensive search of the PubMed database until July 10, 2013, was performed according to Preferred Reporting Items for Systematic Reviews and Meta-analysis statement guidelines. Studies assessing novel markers and diagnostics for patient selection for AS and follow-up during AS were included. Studies analysing only classic clinical parameters used in current protocols (prostate-specific antigen, prostate volume, number of (positive) prostate biopsies, percentage malignant tissue, Gleason score) were excluded. This review focuses only on the AS setting and not on predicting insignificant disease in general.Evidence synthesisOf 787 studies on AS, 30 were included in this review: 14 on magnetic resonance imaging (MRI), 5 on serum markers, 5 on urinary markers, 4 on histopathology markers, and 2 on germline genetic markers. Several of these markers improve the prediction of tumour volume, tumour grade, or time to active treatment. MRI has a high specificity for low-risk PCa; new serum markers are associated with unfavourable disease. In none of the studies was the new marker used as the primary decision tool. Long-term outcome measures such as mortality were not assessed. The definition of indolent PCa is disputable.ConclusionsImaging and serum markers may improve future patient selection for AS and follow-up during AS. Prospective studies should aim to further evaluate the clinical utility of these new markers with respect to

Published
2014

36. Scoring systems used for the interpretation and reporting of multiparametric MRI for prostate cancer detection, localization, and characterization: could standardization lead to improved utilization of imaging within the diagnostic pathway?

Author

UCL - (SLuc) Service d'urologie, UCL - SSS/IREC/CHEX - Pôle de chirgurgie expérimentale et transplantation, Dickinson, Louise, Ahmed, Hashim U, Allen, Clare, Barentsz, Jelle O, Carey, Brendan, Futterer, Jurgen J, Heijmink, Stijn W, Hoskin, Peter, Kirkham, Alex P, Padhani, Anwar R, Persad, Raj, Puech, Philippe, Punwani, Shonit, Sohaib, Aslam, Tombal, Bertrand, Villers, Arnauld, Emberton, Mark, UCL - (SLuc) Service d'urologie, UCL - SSS/IREC/CHEX - Pôle de chirgurgie expérimentale et transplantation, Dickinson, Louise, Ahmed, Hashim U, Allen, Clare, Barentsz, Jelle O, Carey, Brendan, Futterer, Jurgen J, Heijmink, Stijn W, Hoskin, Peter, Kirkham, Alex P, Padhani, Anwar R, Persad, Raj, Puech, Philippe, Punwani, Shonit, Sohaib, Aslam, Tombal, Bertrand, Villers, Arnauld, and Emberton, Mark

Abstract

Multiparametric magnetic resonance imaging (mpMRI) is increasingly being used earlier in the prostate cancer diagnostic pathway in order to detect and localize disease. Its results can be used to help decide on the indication, type, and localization of a prostate biopsy for cancer diagnosis. In addition, mpMRI has the potential to contribute information on the characterization, or aggressiveness, of detected cancers including tumor progression over time. There is considerable variation in the way results of different MRI sequences are reported. We conducted a review of scoring systems that have been used in the detection and characterization of prostate cancer. This revealed that existing scoring and reporting systems differ in purpose, scale, and range. We evaluate these differences in this review. This first step in collating all methods of scoring and reporting mpMRI will ultimately lead to consensus approaches to develop a standardized reporting scheme that can be widely adopted and validated to ensure comparability of research outputs and optimal clinical practice. J. Magn. Reson. Imaging 2013;37:48-58.

Published
2013

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