86 results on '"Schoots, I.G."'
Search Results
2. Beyond Gleason Patterns: Radiomics for cribriform growth differentiation
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Fernandez Salamanca, M., primary, Simoes, R., additional, van der Heide, U., additional, Deregowska-Cylke, M., additional, van Leeuwen, P., additional, van der Poel, H., additional, Bekers, E., additional, Guimaraes, M.A.S., additional, and Schoots, I.G., additional
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- 2023
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3. The diagnostic value of fibroblast activation protein inhibitor positron emission tomography/computed tomography in genitourinary malignancies – a systematic review
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Hagens, M.J., primary, van Leeuwen, P.J., additional, Boellaard, T.N., additional, Schoots, I.G., additional, van der Poel, H.G., additional, and Mertens, L.S., additional
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- 2023
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4. Pre-magnetic resonance imaging (MRI) prostate-specific antigen density (PSAD) risk-stratification to avoid MRIs, biopsies and detection of low-risk prostate cancer: Results of the MR-PROPER study
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Prinsen, A.M.A., primary, Somford, D.M, additional, Van den Bergh, R.C.N., additional, and Schoots, I.G., additional
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- 2023
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5. Impact of Epithelial Histological Types, Subtypes, and Growth Patterns on Oncological Outcomes for Patients with Nonmetastatic Prostate Cancer Treated with Curative Intent: A Systematic Review.
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Marra, G., Leenders, G.J.L.H. van, Zattoni, F., Kesch, C., Rajwa, P., Cornford, P., Kwast, T. van der, Bergh, R.C.N. van den, Briers, E., Broeck, T. Van den, Meerleer, G. de, Santis, M. de, Eberli, D., Farolfi, A., Gillessen, S., Grivas, N., Grummet, J.P., Henry, A.M., Lardas, M., Lieuw, M., Linares Espinós, E., Mason, M.D., O'Hanlon, S., Oort, I.M. van, Oprea-Lager, D.E., Ploussard, G., Rouvière, O., Schoots, I.G., Stranne, J., Tilki, D., Wiegel, T., Willemse, P.M., Mottet, N., Gandaglia, G., Marra, G., Leenders, G.J.L.H. van, Zattoni, F., Kesch, C., Rajwa, P., Cornford, P., Kwast, T. van der, Bergh, R.C.N. van den, Briers, E., Broeck, T. Van den, Meerleer, G. de, Santis, M. de, Eberli, D., Farolfi, A., Gillessen, S., Grivas, N., Grummet, J.P., Henry, A.M., Lardas, M., Lieuw, M., Linares Espinós, E., Mason, M.D., O'Hanlon, S., Oort, I.M. van, Oprea-Lager, D.E., Ploussard, G., Rouvière, O., Schoots, I.G., Stranne, J., Tilki, D., Wiegel, T., Willemse, P.M., Mottet, N., and Gandaglia, G.
- Abstract
01 juli 2023, Item does not contain fulltext, CONTEXT: The optimal management for men with prostate cancer (PCa) with unconventional histology (UH) is unknown. The outcome for these cancers might be worse than for conventional PCa and so different approaches may be needed. OBJECTIVE: To compare oncological outcomes for conventional and UH PCa in men with localized disease treated with curative intent. EVIDENCE ACQUISITION: A systematic review adhering to the Referred Reporting Items for Systematic Reviews and Meta-Analyses was prospectively registered on PROSPERO (CRD42022296013) was performed in July 2021. EVIDENCE SYNTHESIS: We screened 3651 manuscripts and identified 46 eligible studies (reporting on 1 871 814 men with conventional PCa and 6929 men with 10 different PCa UHs). Extraprostatic extension and lymph node metastases, but not positive margin rates, were more common with UH PCa than with conventional tumors. PCa cases with cribriform pattern, intraductal carcinoma, or ductal adenocarcinoma had higher rates of biochemical recurrence and metastases after radical prostatectomy than for conventional PCa cases. Lower cancer-specific survival rates were observed for mixed cribriform/intraductal and cribriform PCa. By contrast, pathological findings and oncological outcomes for mucinous and prostatic intraepithelial neoplasia (PIN)-like PCa were similar to those for conventional PCa. Limitations of this review include low-quality studies, a risk of reporting bias, and a scarcity of studies that included radiotherapy. CONCLUSIONS: Intraductal, cribriform, and ductal UHs may have worse oncological outcomes than for conventional and mucinous or PIN-like PCa. Alternative treatment approaches need to be evaluated in men with these cancers. PATIENT SUMMARY: We reviewed the literature to explore whether prostate cancers with unconventional growth patterns behave differently to conventional prostate cancers. We found that some unconventional growth patterns have worse outcomes, so we need to investigate if they nee
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- 2023
6. Genetic Aspects and Molecular Testing in Prostate Cancer: A Report from a Dutch Multidisciplinary Consensus Meeting
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Mehra, N., Kloots, I., Vlaming, M., Aluwini, S., Dewulf, E., Oprea-Lager, D.E., Poel, H. van der, Stoevelaar, H., Yakar, D., Bangma, Chris H., Bekers, E., Bergh, Roderick van den, Bergman, A.M., Berkmortel, F. van den, Boudewijns, S, Dinjens, W.N., Futterer, J.J., Hulle, T. van der, Jenster, G., Kroeze, L., Kruchten, M. van, Leenders, G. van, Leeuwen, P.J. van, Leng, W.W.J. de, Moorselaar, R.J.A. van, Noordzij, W., Oldenburg, R.A., Oort, I.M. van, Oving, I., Schalken, J.A., Schoots, I.G., Schuuring, E., Smeenk, R.J., Vanneste, B.G.L., Vegt, E, Vis, Andre N., Vries, K. de, Willemse, P.M., Wondergem, M., Ausems, M., Mehra, N., Kloots, I., Vlaming, M., Aluwini, S., Dewulf, E., Oprea-Lager, D.E., Poel, H. van der, Stoevelaar, H., Yakar, D., Bangma, Chris H., Bekers, E., Bergh, Roderick van den, Bergman, A.M., Berkmortel, F. van den, Boudewijns, S, Dinjens, W.N., Futterer, J.J., Hulle, T. van der, Jenster, G., Kroeze, L., Kruchten, M. van, Leenders, G. van, Leeuwen, P.J. van, Leng, W.W.J. de, Moorselaar, R.J.A. van, Noordzij, W., Oldenburg, R.A., Oort, I.M. van, Oving, I., Schalken, J.A., Schoots, I.G., Schuuring, E., Smeenk, R.J., Vanneste, B.G.L., Vegt, E, Vis, Andre N., Vries, K. de, Willemse, P.M., Wondergem, M., and Ausems, M.
- Abstract
Item does not contain fulltext, BACKGROUND: Germline and tumour genetic testing in prostate cancer (PCa) is becoming more broadly accepted, but testing indications and clinical consequences for carriers in each disease stage are not yet well defined. OBJECTIVE: To determine the consensus of a Dutch multidisciplinary expert panel on the indication and application of germline and tumour genetic testing in PCa. DESIGN SETTING AND PARTICIPANTS: The panel consisted of 39 specialists involved in PCa management. We used a modified Delphi method consisting of two voting rounds and a virtual consensus meeting. OUTCOME MEASUREMENTS AND STATISTICAL ANALYSIS: Consensus was reached if ≥75% of the panellists chose the same option. Appropriateness was assessed by the RAND/UCLA appropriateness method. RESULTS AND LIMITATIONS: Of the multiple-choice questions, 44% reached consensus. For men without PCa having a relevant family history (familial PCa/BRCA-related hereditary cancer), follow-up by prostate-specific antigen was considered appropriate. For patients with low-risk localised PCa and a family history of PCa, active surveillance was considered appropriate, except in case of the patient being a BRCA2 germline pathogenic variant carrier. Germline and tumour genetic testing should not be done for nonmetastatic hormone-sensitive PCa in the absence of a relevant family history of cancer. Tumour genetic testing was deemed most appropriate for the identification of actionable variants, with uncertainty for germline testing. For tumour genetic testing in metastatic castration-resistant PCa, consensus was not reached for the timing and panel composition. The principal limitations are as follows: (1) a number of topics discussed lack scientific evidence, and therefore the recommendations are partly opinion based, and (2) there was a small number of experts per discipline. CONCLUSIONS: The outcomes of this Dutch consensus meeting may provide further guidance on genetic counselling and molecular testing related to PCa.
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- 2023
7. Adjuvant use of PLAsmJet device during cytoreductive surgery for advanced-stage ovarian cancer
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Nieuwenhuyzen-de Boer, G.M., Hofhuis, W., Reesink-Peters, N., Willemsen, S., Boere, I.A., Schoots, I.G., Piek, J.M.J., Hofman, L.N., Beltman, J.J., Driel, W.J. van, Werner, H.M.J., Baalbergen, A., Haaften-de Jong, A.M.L.D. van, Dorman, M., Haans, L., Nedelcu, I., Ewing-Graham, P.C., Beekhuizen, H.J. van, Obstetrie & Gynaecologie, MUMC+: MA Medische Staf Obstetrie Gynaecologie (9), RS: GROW - R2 - Basic and Translational Cancer Biology, Gynecological Oncology, Epidemiology, Medical Oncology, Radiology & Nuclear Medicine, and Pathology
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Ovarian Neoplasms ,RESECTION ,Plasma Gases ,CARCINOMA ,IMPACT ,ACHIEVING COMPLETE CYTOREDUCTION ,Cytoreduction Surgical Procedures ,Carcinoma, Ovarian Epithelial ,ENERGY ,NEOADJUVANT CHEMOTHERAPY ,Oncology ,TUMOR ,SDG 3 - Good Health and Well-being ,RESIDUAL DISEASE ,NEUTRAL ARGON PLASMA ,Quality of Life ,Humans ,Female ,Surgery ,PRIMARY DEBULKING SURGERY ,Netherlands - Abstract
Objective Standard surgical treatment of advanced-stage ovarian carcinoma with electrosurgery cannot always result in complete cytoreductive surgery (CRS), especially when many small metastases are found on the mesentery and intestinal surface. We investigated whether adjuvant use of a neutral argon plasma device can help increase the complete cytoreduction rate. Patients and Methods 327 patients with FIGO stage IIIB–IV epithelial ovarian cancer (EOC) who underwent primary or interval CRS were randomized to either surgery with neutral argon plasma (PlasmaJet) (intervention) or without PlasmaJet (control group). The primary outcome was the percentage of complete CRS. The secondary outcomes were duration of surgery, blood loss, number of bowel resections and colostomies, hospitalization, 30-day morbidity, and quality of life (QoL). Results Complete CRS was achieved in 119 patients (75.8%) in the intervention group and 115 patients (67.6%) in the control group (risk difference (RD) 8.2%, 95% confidence interval (CI) –0.021 to 0.181; P = 0.131). In a per-protocol analysis excluding patients with unresectable disease, complete CRS was obtained in 85.6% in the intervention group and 71.5% in the control group (RD 14.1%, 95% CI 0.042 to 0.235; P = 0.005). Patient-reported QoL at 6 months after surgery differed between groups in favor of PlasmaJet surgery (95% CI 0.455–8.350; P = 0.029). Other secondary outcomes did not differ significantly. Conclusions Adjuvant use of PlasmaJet during CRS for advanced-stage ovarian cancer resulted in a significantly higher proportion of complete CRS in patients with resectable disease and higher QoL at 6 months after surgery. (Funded by ZonMw, Trial Register NL62035.078.17.) Trial Registration Approved by the Medical Ethics Review Board of the Erasmus University Medical Center Rotterdam, the Netherlands, NL62035.078.17 on 20-11-2017. Recruitment started on 30-1-2018.
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- 2022
8. Clinical implementation of pre-biopsy magnetic resonance imaging pathways for the diagnosis of prostate cancer
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Israël, B., Immerzeel, J., Leest, M.M. van der, Hannink, G., Zamecnik, P., Bomers, J.G.R., Schoots, I.G., Basten, J.P. van, Debruyne, F.M., Oort, I.M. van, Sedelaar, M., Barentsz, J., Israël, B., Immerzeel, J., Leest, M.M. van der, Hannink, G., Zamecnik, P., Bomers, J.G.R., Schoots, I.G., Basten, J.P. van, Debruyne, F.M., Oort, I.M. van, Sedelaar, M., and Barentsz, J.
- Abstract
Item does not contain fulltext, OBJECTIVE: To assess the outcomes of pre-biopsy magnetic resonance imaging (MRI) pathways, as a tool in biopsy-naïve men with suspicion of prostate cancer, in routine clinical practice. Secondary outcomes included a comparison of transrectal MRI-directed biopsy (TR-MRDB) and transperineal (TP)-MRDB in men with suspicious MRI. PATIENTS AND METHODS: We retrospectively assessed a two-centre cohort of consecutive biopsy-naïve men with suspicion of prostate cancer who underwent a Prostate Imaging-Reporting and Data System version 2 (PI-RADS v2) compliant pre-biopsy MRI in a single, high-volume centre between 2015 and 2019 (Centre 1). Men with suspicious MRI scans underwent TR-MRDB in Centre 1 and TP-MRDB with additional random biopsies (RB) in Centre 2. The MRI and histopathology were assessed in the same institution (Centre 1). Outcomes included: (i) overall detection rates of Grade Group (GG) 1, GG ≥2, and GG ≥3 cancer in men with suspicious MRI; (ii) Biopsy-avoidance due to non-suspicious MRI; and (iii) Cancer detection rates and biopsy-related complications between TR- and TP-MRDB. To reduce confounding bias for MRDB comparisons, inverse probability weighting (IPW) was performed for age, digital rectal examination, prostate-specific antigen (PSA), prostate volume, PSA density, and PI-RADS category. RESULTS: Of the 2597 men included, the overall GG 1, GG ≥2, and GG ≥3 prevalence was 8% (210/2597), 27% (697/2597), and 15% (396/2597), respectively. Biopsy was avoided in 57% (1488/2597) of men. After IPW, the GG 1, GG ≥2 and GG ≥3 detection rates after TR- and TP-MRDB were comparable at 24%, 57%, and 32%; and 18%, 64%, and 38%, respectively; with mean differences of -5.7% (95% confidence interval [CI] -13% to 1.4%), 6.1% (95% CI -2.1% to 14%), and 5.7% (95% CI -1.7% to 13%). Complications were similar in TR-MRDB (0.50%) and TP-MRDB with RB (0.62%; mean difference 0.11%, 95% CI -0.87% to 1.1%). CONCLUSION: This high-volume, two-centre study shows pre-biopsy MRI as a decis
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- 2022
9. Development and External Validation of a Novel Nomogram to Predict Side-specific Extraprostatic Extension in Patients with Prostate Cancer Undergoing Radical Prostatectomy
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Soeterik, T.F.W., Melick, H.H.E. van, Dijksman, L.M., Küsters-Vandevelde, H., Stomps, S., Schoots, I.G., Biesma, D.H., Witjes, J.A., Basten, Jean-Paul A. van, Soeterik, T.F.W., Melick, H.H.E. van, Dijksman, L.M., Küsters-Vandevelde, H., Stomps, S., Schoots, I.G., Biesma, D.H., Witjes, J.A., and Basten, Jean-Paul A. van
- Abstract
Item does not contain fulltext, BACKGROUND: Prediction of side-specific extraprostatic extension (EPE) is crucial in selecting patients for nerve-sparing radical prostatectomy (RP). OBJECTIVE: To develop and externally validate nomograms including multiparametric magnetic resonance imaging (mpMRI) information to predict side-specific EPE. DESIGN, SETTING, AND PARTICIPANTS: A retrospective analysis of 1870 consecutive prostate cancer patients who underwent robot-assisted RP from 2014 to 2018 at three institutions. OUTCOME MEASUREMENTS AND STATISTICAL ANALYSIS: Four multivariable logistic regression models were established, including combinations of patient-based and side-specific variables: prostate-specific antigen (PSA) density, highest ipsilateral International Society of Urological Pathology (ISUP) biopsy grade, ipsilateral percentage of positive cores on systematic biopsy, and side-specific clinical stage assessed by both digital rectal examination and mpMRI. Discrimination (area under the curve [AUC]), calibration, and net benefit of these models were assessed in the development cohort and two external validation cohorts. RESULTS AND LIMITATIONS: On external validation, AUCs of the four models ranged from 0.80 (95% confidence interval [CI] 0.68-0.88) to 0.83 (95% CI 0.72-0.90) in cohort 1 and from 0.77 (95% CI 0.62-0.87) to 0.78 (95% CI 0.64-0.88) in cohort 2. The three models including mpMRI staging information resulted in relatively higher AUCs compared with the model without mpMRI information. No major differences between the four models regarding net benefit were established. The model based on PSA density, ISUP grade, and mpMRI T stage was superior in terms of calibration. Using this model with a cut-off of 20%, 1980/2908 (68%) prostatic lobes without EPE would be found eligible for nerve sparing, whereas non-nerve sparing would be advised in 642/832 (77%) lobes with EPE. CONCLUSIONS: Our analysis resulted in a simple and robust nomogram for the prediction of side-specific EPE, which sho
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- 2022
10. A Prospective Multicenter Comparison Study of Risk-adapted Ultrasound-directed and Magnetic Resonance Imaging-directed Diagnostic Pathways for Suspected Prostate Cancer in Biopsy-naive Men
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Wagensveld, I.M., Osses, D.F., Groenendijk, P.M., Zijta, F.M., Busstra, M.B., Rociu, E., Barentsz, J.O., Sedelaar, J.P.M., Arbeel, B., Roeleveld, T., Geenen, R., Koeter, I., Meer, S.A. van der, Cappendijk, V., Somford, R., Klaver, S., Lely, H. Van der, Wolters, T., Hellings, W., Leter, M.R., Poel, H.G. van der, Heijmink, S., Debruyne, F., Immerzeel, J., Leijte, J., Roermund, J. van, Miclea, R., Planken, E., Vis, Andre N., Jong, I. de, Tijsterman, J., Wolterbeek, D., Claessen, A., Vrijhof, E., Nederend, J., Leenders, G. van, Bangma, Chris H., Krestin, G.P., Remmers, S., Schoots, I.G., Group, M.-M.W., Wagensveld, I.M., Osses, D.F., Groenendijk, P.M., Zijta, F.M., Busstra, M.B., Rociu, E., Barentsz, J.O., Sedelaar, J.P.M., Arbeel, B., Roeleveld, T., Geenen, R., Koeter, I., Meer, S.A. van der, Cappendijk, V., Somford, R., Klaver, S., Lely, H. Van der, Wolters, T., Hellings, W., Leter, M.R., Poel, H.G. van der, Heijmink, S., Debruyne, F., Immerzeel, J., Leijte, J., Roermund, J. van, Miclea, R., Planken, E., Vis, Andre N., Jong, I. de, Tijsterman, J., Wolterbeek, D., Claessen, A., Vrijhof, E., Nederend, J., Leenders, G. van, Bangma, Chris H., Krestin, G.P., Remmers, S., Schoots, I.G., and Group, M.-M.W.
- Abstract
Contains fulltext : 283332.pdf (Publisher’s version ) (Open Access), BACKGROUND: European Association of Urology guidelines recommend a risk-adjusted biopsy strategy for early detection of prostate cancer in biopsy-naive men. It remains unclear which strategy is most effective. Therefore, we evaluated two risk assessment pathways commonly used in clinical practice. OBJECTIVE: To compare the diagnostic performance of a risk-based ultrasound (US)-directed pathway (Rotterdam Prostate Cancer Risk Calculator [RPCRC] #3; US volume assessment) and a magnetic resonance imaging (MRI)-directed pathway. DESIGN, SETTING, AND PARTICIPANTS: This was a prospective multicenter study (MR-PROPER) with 1:1 allocation among 21 centers (US arm in 11 centers, MRI arm in ten). Biopsy-naive men with suspicion of prostate cancer (age >/=50 yr, prostate-specific antigen 3.0-50 ng/ml, +/- abnormal digital rectal examination) were included. INTERVENTION: Biopsy-naive men with elevated risk of prostate cancer, determined using RPCRC#3 in the US arm and Prostate Imaging Reporting and Data System scores of 3-5 in the MRI arm, underwent systematic biopsies (US arm) or targeted biopsies (MRI arm). OUTCOME MEASUREMENTS AND STATISTICAL ANALYSIS: The primary outcome was the proportion of men with grade group (GG) >/=2 cancer. Secondary outcomes were the proportions of biopsies avoided and GG 1 cancers detected. Categorical (nonparametric) data were assessed using the Mann-Whitney U test and chi(2) tests. RESULTS AND LIMITATIONS: A total of 1965 men were included in the intention-to-treat population (US arm n = 950, MRI arm n = 1015). The US and MRI pathways detected GG >/=2 cancers equally well (235/950, 25% vs 239/1015, 24%; difference 1.2%, 95% confidence interval [CI] -2.6% to 5.0%; p = 0.5). The US pathway detected more GG 1 cancers than the MRI pathway (121/950, 13% vs 84/1015, 8.3%; difference 4.5%, 95% CI 1.8-7.2%; p < 0.01). The US pathway avoided fewer biopsies than the MRI pathway (403/950, 42% vs 559/1015, 55%; difference -13%, 95% CI -17% to -8.3%; p < 0.01
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- 2022
11. Prognostic importance of concomitant non-regional lymph node and bone metastases in men with newly diagnosed metastatic prostate cancer
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Heesterman, B.L., Poel, H.G. van der, Schoots, I.G., Mehra, N., Aben, K.K.H., Heesterman, B.L., Poel, H.G. van der, Schoots, I.G., Mehra, N., and Aben, K.K.H.
- Abstract
Item does not contain fulltext, OBJECTIVES: To evaluate the prognostic importance of concomitant non-regional lymph node (NRLN) and bone metastases in men with synchronous metastatic hormone-sensitive prostate cancer (mHSPC), and to determine whether M1b/M1c is the most appropriate M-stage and evaluate the additional importance to the distinction in low/high volume disease. PATIENTS AND METHODS: All men diagnosed with synchronous mHSPC from 2010 to 2018 in the Netherlands were identified in the Netherlands Cancer Registry. Men were categorised as having NRLN (M1a), bone (M1b), NRLN and bone (M1c), or visceral metastases (M1c). For men diagnosed since October 2015 disease volume could be determined. Analyses were performed in this cohort (>5600 men) and repeated in the 2010-2018 cohort (>14 000 men). The primary outcome measure in this observational cohort study was overall survival (OS) and Cox regression was used to calculate hazard ratios (HRs). RESULTS: Compared to men with NRLN and bone metastases (reference group), OS of men with only NRLN (HR 0.70, 95% confidence interval [CI] 0.55-0.88) was better. This was also true for men with only bone metastases in the low-volume subgroup (HR 0.75, 95% CI0.58-0.98), but not in the high-volume subgroup (HR 0.99, 95% CI 0.84-1.18). In contrast, the OS of men with visceral metastases was worse (HR 2.20, 95% CI 1.75-2.77 + 0.97/month, 95% CI 0.96-0.98). CONCLUSION: In men with low-volume synchronous mHSPC, presence of concomitant NRLN and bone metastases (currently classified as M1c), is a poor prognostic sign. However, survival of men with visceral metastases (M1c) is worse. Implying that classifying concomitant NRLN and bone metastases as M1c or M1b is not appropriate. Adding a fourth M1-category to the ninth edition of the Tumour-Node-Metastasis classification should be contemplated. Furthermore, definitions of metastatic burden need to be re-evaluated.
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- 2022
12. A Prospective Multicenter Comparison Study of Risk-adapted Ultrasound-directed and Magnetic Resonance Imaging-directed Diagnostic Pathways for Suspected Prostate Cancer in Biopsy-naïve Men
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Wagensveld, I.M., Osses, D.F., Groenendijk, P.M., Zijta, F.M., Busstra, M.B., Rociu, E., Barentsz, J.O., Sedelaar, J.P.M., Arbeel, B., Roeleveld, T., Geenen, R., Koeter, I., Meer, S.A. van der, Cappendijk, V., Somford, R., Klaver, S., Lely, H. Van der, Wolters, T., Hellings, W., Leter, M.R., Poel, H.G. van der, Heijmink, S., Debruyne, F., Immerzeel, J., Leijte, J., Roermund, J. van, Miclea, R., Planken, E., Vis, Andre N., Jong, I. de, Tijsterman, J., Wolterbeek, D., Claessen, A., Vrijhof, E., Nederend, J., Leenders, G. van, Bangma, Chris H., Krestin, G.P., Remmers, S., Schoots, I.G., Group, M.-M.W., Urology, CCA - Imaging and biomarkers, MUMC+: MA Urologie (9), MUMC+: MA AIOS Urologie (9), MUMC+: DA BV Medisch Specialisten Radiologie (9), RS: FHML non-thematic output, and Radiology & Nuclear Medicine
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Image-Guided Biopsy ,Male ,SDG 3 - Good Health and Well-being ,Urological cancers Radboud Institute for Health Sciences [Radboudumc 15] ,Urology ,Urological cancers Radboud Institute for Molecular Life Sciences [Radboudumc 15] ,Prostate ,Humans ,Prostatic Neoplasms ,Prospective Studies ,Magnetic Resonance Imaging - Abstract
Contains fulltext : 283332.pdf (Publisher’s version ) (Open Access) BACKGROUND: European Association of Urology guidelines recommend a risk-adjusted biopsy strategy for early detection of prostate cancer in biopsy-naive men. It remains unclear which strategy is most effective. Therefore, we evaluated two risk assessment pathways commonly used in clinical practice. OBJECTIVE: To compare the diagnostic performance of a risk-based ultrasound (US)-directed pathway (Rotterdam Prostate Cancer Risk Calculator [RPCRC] #3; US volume assessment) and a magnetic resonance imaging (MRI)-directed pathway. DESIGN, SETTING, AND PARTICIPANTS: This was a prospective multicenter study (MR-PROPER) with 1:1 allocation among 21 centers (US arm in 11 centers, MRI arm in ten). Biopsy-naive men with suspicion of prostate cancer (age >/=50 yr, prostate-specific antigen 3.0-50 ng/ml, +/- abnormal digital rectal examination) were included. INTERVENTION: Biopsy-naive men with elevated risk of prostate cancer, determined using RPCRC#3 in the US arm and Prostate Imaging Reporting and Data System scores of 3-5 in the MRI arm, underwent systematic biopsies (US arm) or targeted biopsies (MRI arm). OUTCOME MEASUREMENTS AND STATISTICAL ANALYSIS: The primary outcome was the proportion of men with grade group (GG) >/=2 cancer. Secondary outcomes were the proportions of biopsies avoided and GG 1 cancers detected. Categorical (nonparametric) data were assessed using the Mann-Whitney U test and chi(2) tests. RESULTS AND LIMITATIONS: A total of 1965 men were included in the intention-to-treat population (US arm n = 950, MRI arm n = 1015). The US and MRI pathways detected GG >/=2 cancers equally well (235/950, 25% vs 239/1015, 24%; difference 1.2%, 95% confidence interval [CI] -2.6% to 5.0%; p = 0.5). The US pathway detected more GG 1 cancers than the MRI pathway (121/950, 13% vs 84/1015, 8.3%; difference 4.5%, 95% CI 1.8-7.2%; p < 0.01). The US pathway avoided fewer biopsies than the MRI pathway (403/950, 42% vs 559/1015, 55%; difference -13%, 95% CI -17% to -8.3%; p < 0.01). Among men with elevated risk, more GG >/=2 cancers were detected in the MRI group than in the US group (52% vs 43%; difference 9.2%, 95% CI 3.0-15%; p < 0.01). CONCLUSIONS: Risk-adapted US-directed and MRI-directed pathways detected GG >/=2 cancers equally well. The risk-adapted US-directed pathway performs well for prostate cancer diagnosis if prostate MRI capacity and expertise are not available. If prostate MRI availability is sufficient, risk assessment should preferably be performed using MRI, as this avoids more biopsies and detects fewer cases of GG 1 cancer. PATIENT SUMMARY: Among men with suspected prostate cancer, relevant cancers were equally well detected by risk-based pathways using either ultrasound or magnetic resonance imaging (MRI) to guide biopsy of the prostate. If prostate MRI availability is sufficient, risk assessment should be performed with MRI to reduce unnecessary biopsies and detect fewer irrelevant cancers.
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- 2021
13. O1 - External validation and addition of PSMA-PET to the most frequently used nomograms for the prediction of pelvic lymph-node metastases: An international multicenter study
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Meijer, D., Van Leeuwen, P.J., Roberts, M.J., Siriwardana, A.R., Morton, A., Yaxley, J.W., Samaratunga, H., Emmett, L., Van De Ven, P.M., Van Der Poel, H.G., Donswijk, M.L., Boellaard, T.N., Schoots, I.G., Oprea-Lager, D.E., Coughlin, G.D., and Vis, A.N.
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- 2021
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14. External validation and addition of PSMA-PET to the most frequently used nomograms for the prediction of pelvic lymph-node metastases: An international multicenter study
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Meijer, D., primary, Van Leeuwen, P.J., additional, Roberts, M.J., additional, Siriwardana, A.R., additional, Morton, A., additional, Yaxley, J.W., additional, Samaratunga, H., additional, Emmett, L., additional, Van De Ven, P.M., additional, Van Der Poel, H.G., additional, Donswijk, M.L., additional, Boellaard, T.N., additional, Schoots, I.G., additional, Oprea-Lager, D.E., additional, Coughlin, G.D., additional, and Vis, A.N., additional
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- 2021
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15. Extended - targeted-plus-regional - MRI-directed biopsy approach in prostate cancer diagnosis – a systematic review and meta-analysis
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Hagens, M.J., primary, Fernandez Salamanca, M., additional, Phadhani, A.R., additional, Van Leeuwen, P.J., additional, Van Der Poel, H.G., additional, and Schoots, I.G., additional
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- 2021
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16. P080 - Beyond Gleason Patterns: Radiomics for cribriform growth differentiation
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Fernandez Salamanca, M., Simoes, R., van der Heide, U., Deregowska-Cylke, M., van Leeuwen, P., van der Poel, H., Bekers, E., Guimaraes, M.A.S., and Schoots, I.G.
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- 2023
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17. P010 - Prostate-specific antigen density (PSAD) in post-magnetic resonance imaging (MRI) risk-stratification to avoid biopsies and detection of low-risk prostate cancer: Results of the MR-PROPER study
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Prinsen, A.M.A., Somford, D.M., Van den Bergh, R.C.N., and Schoots, I.G.
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- 2023
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18. O06 - The diagnostic value of fibroblast activation protein inhibitor positron emission tomography/computed tomography in genitourinary malignancies – a systematic review
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Hagens, M.J., van Leeuwen, P.J., Boellaard, T.N., Schoots, I.G., van der Poel, H.G., and Mertens, L.S.
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- 2023
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19. O05 - Pre-magnetic resonance imaging (MRI) prostate-specific antigen density (PSAD) risk-stratification to avoid MRIs, biopsies and detection of low-risk prostate cancer: Results of the MR-PROPER study
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Prinsen, A.M.A., Somford, D.M, Van den Bergh, R.C.N., and Schoots, I.G.
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- 2023
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20. Prostate Magnetic Resonance Imaging for Local Recurrence Reporting (PI-RR): International Consensus -based Guidelines on Multiparametric Magnetic Resonance Imaging for Prostate Cancer Recurrence after Radiation Therapy and Radical Prostatectomy
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Panebianco, V, Villeirs, G., Weinreb, J.C., Turkbey, B.I., Margolis, D.J., Richenberg, J., Schoots, I.G., Moore, C.M., Futterer, J.J., Macura, K.J., Oto, A., Bittencourt, L.K., Haider, M.A., Salomon, G., Tempany, C.M., Padhani, A.R., Barentsz, J.O., Panebianco, V, Villeirs, G., Weinreb, J.C., Turkbey, B.I., Margolis, D.J., Richenberg, J., Schoots, I.G., Moore, C.M., Futterer, J.J., Macura, K.J., Oto, A., Bittencourt, L.K., Haider, M.A., Salomon, G., Tempany, C.M., Padhani, A.R., and Barentsz, J.O.
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Item does not contain fulltext, BACKGROUND: Imaging techniques are used to identify local recurrence of prostate cancer (PCa) for salvage therapy and to exclude metastases that should be addressed with systemic therapy. For magnetic resonance imaging (MRI), a reduction in the variability of acquisition, interpretation, and reporting is required to detect local PCa recurrence in men with biochemical relapse after local treatment with curative intent. OBJECTIVE: To propose a standardised method for image acquisition and assessment of PCa local recurrence using MRI after radiation therapy (RP) and radical prostatectomy (RT). EVIDENCE ACQUISITION: Prostate Imaging for Recurrence Reporting (PI-RR) was formulated using the existing literature. An international panel of experts conducted a nonsystematic review of the literature. The PI-RR system was created via consensus through a combination of face-to-face and online discussions. EVIDENCE SYNTHESIS: Similar to with PI-RADS, based on the best available evidence and expert opinion, the minimum acceptable MRI parameters for detection of recurrence after radiation therapy and radical prostatectomy are set. Also, a simplified and standardised terminology and content of the reports that use five assessment categories to summarise the suspicion of local recurrence (PI-RR) are designed. PI-RR scores of 1 and 2 are assigned to lesions with a very low and low likelihood of recurrence, respectively. PI-RR 3 is assigned if the presence of recurrence is uncertain. PI-RR 4 and 5 are assigned for a high and very high likelihood of recurrence, respectively. PI-RR is intended to be used in routine clinical practice and to facilitate data collection and outcome monitoring for research. CONCLUSIONS: This paper provides a structured reporting system (PI-RR) for MRI evaluation of local recurrence of PCa after RT and RP. PATIENT SUMMARY: A new method called PI-RR was developed to promote standardisation and reduce variations in the acquisition, interpretation, and reporting
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- 2021
21. ESUR/ESUI position paper: developing artificial intelligence for precision diagnosis of prostate cancer using magnetic resonance imaging
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Penzkofer, T., Padhani, A.R., Turkbey, B., Haider, M.A., Huisman, H.J., Walz, J., Salomon, G., Schoots, I.G., Richenberg, J., Villeirs, G., Panebianco, V, Rouviere, O., Logager, V.B., Barentsz, J.O., Penzkofer, T., Padhani, A.R., Turkbey, B., Haider, M.A., Huisman, H.J., Walz, J., Salomon, G., Schoots, I.G., Richenberg, J., Villeirs, G., Panebianco, V, Rouviere, O., Logager, V.B., and Barentsz, J.O.
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Contains fulltext : 245173.pdf (Publisher’s version ) (Open Access), Artificial intelligence developments are essential to the successful deployment of community-wide, MRI-driven prostate cancer diagnosis. AI systems should ensure that the main benefits of biopsy avoidance are delivered while maintaining consistent high specificities, at a range of disease prevalences. Since all current artificial intelligence / computer-aided detection systems for prostate cancer detection are experimental, multiple developmental efforts are still needed to bring the vision to fruition. Initial work needs to focus on developing systems as diagnostic supporting aids so their results can be integrated into the radiologists' workflow including gland and target outlining tasks for fusion biopsies. Developing AI systems as clinical decision-making tools will require greater efforts. The latter encompass larger multicentric, multivendor datasets where the different needs of patients stratified by diagnostic settings, disease prevalence, patient preference, and clinical setting are considered. AI-based, robust, standard operating procedures will increase the confidence of patients and payers, thus enabling the wider adoption of the MRI-directed approach for prostate cancer diagnosis. KEY POINTS: * AI systems need to ensure that the benefits of biopsy avoidance are delivered with consistent high specificities, at a range of disease prevalence. * Initial work has focused on developing systems as diagnostic supporting aids for outlining tasks, so they can be integrated into the radiologists' workflow to support MRI-directed biopsies. * Decision support tools require a larger body of work including multicentric, multivendor studies where the clinical needs, disease prevalence, patient preferences, and clinical setting are additionally defined.
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- 2021
22. Fast Magnetic Resonance Imaging as a Viable Method for Directing the Prostate Cancer Diagnostic Pathway
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Padhani, A.R., Schoots, I.G., Barentsz, J.O., Padhani, A.R., Schoots, I.G., and Barentsz, J.O.
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Item does not contain fulltext
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- 2021
23. PI-RADS Committee Position on MRI Without Contrast Medium in Biopsy-Naive Men With Suspected Prostate Cancer: Narrative Review
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Schoots, I.G., Barentsz, J.O., Bittencourt, L.K., Haider, M.A., Macura, K.J., Margolis, D.J., Moore, C.M., Oto, A., Panebianco, V, Siddiqui, M.M., Tempany, C., Turkbey, B., Villeirs, G.M., Weinreb, J.C., Padhani, A.R., Schoots, I.G., Barentsz, J.O., Bittencourt, L.K., Haider, M.A., Macura, K.J., Margolis, D.J., Moore, C.M., Oto, A., Panebianco, V, Siddiqui, M.M., Tempany, C., Turkbey, B., Villeirs, G.M., Weinreb, J.C., and Padhani, A.R.
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Item does not contain fulltext, The steadily increasing demand for diagnostic prostate MRI has led to concerns regarding the lack of access to and the availability of qualified MRI scanners and sufficiently experienced radiologists, radiographers, and technologists to meet the demand. Solutions must enhance operational benefits without compromising diagnostic performance, quality, and delivery of service. Solutions should also mitigate risks such as decreased reader confidence and referrer engagement. One approach may be the implementation of MRI without the use gadolinium-based contrast medium (bipara-metric MRI), but only if certain prerequisites such as high-quality imaging, expert interpretation quality, and availability of patient recall or on-table monitoring are mandated. Alternatively, or in combination, a clinical risk-based approach could be used for protocol selection, specifically, which biopsy-naive men need MRI with contrast medium (multiparametric MRI). There is a need for prospective studies in which biopsy decisions are made according to MRI without contrast enhancement. Such studies must define clinical and operational benefits and identify which patient groups can be scanned successfully without contrast enhancement. These higher-quality data are needed before the Prostate Imaging Reporting and Data System (PI-RADS) Committee can make evidence-based recommendations about MRI without contrast enhancement as an initial diagnostic approach for prostate cancer workup.
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- 2021
24. A multifaceted approach to quality in the MRI-directed biopsy pathway for prostate cancer diagnosis
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Padhani, A.R., Schoots, I.G., Turkbey, B., Giannarini, G., Barentsz, J.O., Padhani, A.R., Schoots, I.G., Turkbey, B., Giannarini, G., and Barentsz, J.O.
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Contains fulltext : 235571.pdf (Publisher’s version ) (Closed access), KEY POINTS: * Identify, assure, and measure major sources of variability affecting the MRI-directed biopsy pathway for prostate cancer diagnosis.* Develop strategies to control and minimize variations that impair pathway effectiveness including the performance of main players and team working.* Assure end-to-end quality of the diagnostic chain with robust multidisciplinary team working.
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- 2021
25. Can Biparametric Prostate Magnetic Resonance Imaging Fulfill its PROMIS?
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Rooij, M. de, Israël, B., Bomers, J.G.R., Schoots, I.G., Barentsz, J.O., Rooij, M. de, Israël, B., Bomers, J.G.R., Schoots, I.G., and Barentsz, J.O.
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Contains fulltext : 225556.pdf (Publisher’s version ) (Closed access)
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- 2020
26. Focus on the Quality of Prostate Multiparametric Magnetic Resonance Imaging: Synopsis of the ESUR/ESUI Recommendations on Quality Assessment and Interpretation of Images and Radiologists' Training
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Rooij, M. de, Israël, B., Barrett, T., Giganti, F., Padhani, A.R., Panebianco, V, Richenberg, J., Salomon, G., Schoots, I.G., Villeirs, G., Walz, J., Barentsz, J.O., Rooij, M. de, Israël, B., Barrett, T., Giganti, F., Padhani, A.R., Panebianco, V, Richenberg, J., Salomon, G., Schoots, I.G., Villeirs, G., Walz, J., and Barentsz, J.O.
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Contains fulltext : 225861.pdf (Publisher’s version ) (Closed access)
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- 2020
27. Platinum Opinion Counterview: The Evidence Base for the Benefit of Magnetic Resonance Imaging-directed Prostate Cancer Diagnosis is Sound
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Padhani, A.R., Villeirs, G., Ahmed, H.U., Panebianco, V, Schoots, I.G., Tempany, C.M., Weinreb, J., Barentsz, J.O., Padhani, A.R., Villeirs, G., Ahmed, H.U., Panebianco, V, Schoots, I.G., Tempany, C.M., Weinreb, J., and Barentsz, J.O.
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Contains fulltext : 225907.pdf (Publisher’s version ) (Closed access)
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- 2020
28. Analysis of Magnetic Resonance Imaging-directed Biopsy Strategies for Changing the Paradigm of Prostate Cancer Diagnosis
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Schoots, I.G., Padhani, A.R., Rouviere, O., Barentsz, J.O., Richenberg, J., Schoots, I.G., Padhani, A.R., Rouviere, O., Barentsz, J.O., and Richenberg, J.
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Contains fulltext : 219641.pdf (Publisher’s version ) (Closed access), BACKGROUND: The use of a magnetic resonance imaging (MRI)-directed diagnostic pathway in men at first prostate cancer work-up has been introduced within European prostate cancer guidelines. Differences in MRI-directed pathway yields need elaboration. OBJECTIVE: To investigate the diagnostic yields of MRI-directed diagnostic pathways in biopsy-naive men suspected of having prostate cancer. DESIGN, SETTING, AND PARTICIPANTS: This analysis uses the data of the Cochrane diagnostic test accuracy systematic review on the utility of prostate MRI and MRI-targeted biopsy for significant disease in men at first diagnosis. The paired agreement analysis data were reformulated for five unique biopsy strategies focusing on diagnostic yields and biopsy avoidance. OUTCOME MEASUREMENTS AND STATISTICAL ANALYSIS: Significant prostate cancer was defined as International Society of Urological Pathology (ISUP) grade group >/=2. RESULTS AND LIMITATIONS: The detection-focused pathway maximises the detection of significant disease (28% [95% confidence interval {CI} 24-34%]), while not reducing biopsy or core numbers, or the overdiagnoses of insignificant cancers (21% [18-25%]). The triage-focused pathway omits systematic biopsy use (reduction of 100%) and thereby reduces overdiagnoses of ISUP grade group 1 cancers (to 14% [11-17%]), but compromises the detection of significant disease (23% [19-28%]). The MRI-focused pathway maximises the detection of significant disease in MRI-positive men at a cost of nondetection of significant disease in MRI-negative men, thus reducing biopsies and overdiagnoses of ISUP grade 1 (strategy proposed by European Association of Urology guidelines). CONCLUSIONS: All MRI-directed biopsy pathways have beneficial outcomes compared with conventional systematic biopsy, with potentially reduced risks and harms. MRI-directed biopsy management as the default strategy optimises diagnostic yields in men at first diagnosis and may be the only test required in a significa
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- 2020
29. Risk-adapted biopsy decision based on prostate magnetic resonance imaging and prostate-specific antigen density for enhanced biopsy avoidance in first prostate cancer diagnostic evaluation
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Schoots, I.G. (Ivo), Padhani, A. (Anwar), Schoots, I.G. (Ivo), and Padhani, A. (Anwar)
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- 2020
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30. Re: Andrew Vickers, Sigrid V. Carlsson, Matthew Cooperberg. Routine Use of Magnetic Resonance Imaging for Early Detection of Prostate Cancer Is Not Justified by the Clinical Trial Evidence. Eur Urol. In press. https://doi.org/10.1016/j.eururo.2020.04.016: Prebiopsy MRI: Through the Looking Glass
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Bergh, R.C.N. (Roderick) van den, Rouvière, O. (Olivier), Kwast, Th.H. (Theo) van der, Briers, E. (Erik), van den Broeck, T. (Thomas), Cornford, P. (Philip), Cumberbatch, M.G. (Marcus G.), Santis, M. (Maria) de, Fanti, S. (Stefano), Fossati, N. (Nicola), Gandaglia, G. (Giorgio), Grivas, N. (Nikolaos), Grummet, J. (Jeremy), Lam, T.B. (Thomas B.), Lardas, M. (Michael), Liew, M. (Matthew), Moris, L. (Lisa), Mason, M.D. (Malcolm), Mottet, N. (Nicolas), Oprea-Lager, D.E. (Daniela E.), Ploussard, G. (Guillaume), Schoots, I.G. (Ivo), Tilki, D. (Derya), Poel, H.G. (Henk) van der, Wiegel, T. (Thomas), Willemse, P.-P.M. (Peter-Paul M.), Bergh, R.C.N. (Roderick) van den, Rouvière, O. (Olivier), Kwast, Th.H. (Theo) van der, Briers, E. (Erik), van den Broeck, T. (Thomas), Cornford, P. (Philip), Cumberbatch, M.G. (Marcus G.), Santis, M. (Maria) de, Fanti, S. (Stefano), Fossati, N. (Nicola), Gandaglia, G. (Giorgio), Grivas, N. (Nikolaos), Grummet, J. (Jeremy), Lam, T.B. (Thomas B.), Lardas, M. (Michael), Liew, M. (Matthew), Moris, L. (Lisa), Mason, M.D. (Malcolm), Mottet, N. (Nicolas), Oprea-Lager, D.E. (Daniela E.), Ploussard, G. (Guillaume), Schoots, I.G. (Ivo), Tilki, D. (Derya), Poel, H.G. (Henk) van der, Wiegel, T. (Thomas), and Willemse, P.-P.M. (Peter-Paul M.)
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- 2020
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31. Equivocal pi-rads three lesions on prostate magnetic resonance imaging: Risk stratification strategies to avoid mri-targeted biopsies
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Osses, D.F. (Daniël), Arsov, C. (Christian), Schimmöller, L. (Lars), Schoots, I.G. (Ivo), Leenders, G.J.H.L. (Geert), Esposito, I. (I.), Remmers, S. (Sebastiaan), Albers, P. (Peter), Roobol-Bouts, M.J. (Monique), Osses, D.F. (Daniël), Arsov, C. (Christian), Schimmöller, L. (Lars), Schoots, I.G. (Ivo), Leenders, G.J.H.L. (Geert), Esposito, I. (I.), Remmers, S. (Sebastiaan), Albers, P. (Peter), and Roobol-Bouts, M.J. (Monique)
- Abstract
We aimed to investigate the relation between largest lesion diameter, prostate-specific antigen density (PSA-D), age, and the detection of clinically significant prostate cancer (csPCa) using first-time targeted biopsy (TBx) in men with Prostate Imaging—Reporting and Data System (PI-RADS) 3 index lesions. A total of 292 men (2013–2019) from two referral centers were included. A multivariable logistic regression analysis was performed. The discrimination and clinical utility of the built model was assessed by the area under the receiver operation curve (AUC) and decision curve analysis, respectively. A higher PSA-D and higher age were significantly related to a higher risk of detecting csPCa, while the largest index lesion diameter was not. The discrimination of the model was 0.80 (95% CI 0.73–0.87). When compared to a biopsy-all strategy, decision curve analysis showed a higher net benefit at threshold probabilities of ≥2%. Accepting a missing ≤5% of csPCa diagnoses, a risk-based approach would result in 34% of TBx sessions and 23% of low-risk PCa diagnoses being avoided. In men with PI-RADS 3 index lesions scheduled for first-time TBx, the balance between the number of TBx sessions, the detection of low-risk PCa, and the detection of csPCa does not warrant a biopsy-all strategy. To minimize the risk of missing the diagnosis of csPCa but acknowledging the need of avoiding unnecessary TBx sessions and overdiagnosis, a risk-based approach is advisable.
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- 2020
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32. Prostate Magnetic Resonance Imaging, with or Without Magnetic Resonance Imaging-targeted Biopsy, and Systematic Biopsy for Detecting Prostate Cancer: A Cochrane Systematic Review and Meta-analysis
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Drost, F.J.H. (Frank-Jan), Osses, D.F. (Daniël), Nieboer, D. (Daan), Bangma, C.H. (Chris), Steyerberg, E.W. (Ewout), Roobol-Bouts, M.J. (Monique), Schoots, I.G. (Ivo), Drost, F.J.H. (Frank-Jan), Osses, D.F. (Daniël), Nieboer, D. (Daan), Bangma, C.H. (Chris), Steyerberg, E.W. (Ewout), Roobol-Bouts, M.J. (Monique), and Schoots, I.G. (Ivo)
- Abstract
Context: Magnetic resonance imaging (MRI), with or without MRI-targeted biopsy (MRI pathway), is an alternative test to systematic transrectal ultrasonography-guided biopsy in men suspected of having prostate cancer. At present, evidence on which test to use is insufficient to inform detailed evidence-based decision making. Objective: To determine the diagnostic accuracy of the index t
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- 2020
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33. The 2019 International Society of Urological Pathology (ISUP) Consensus Conference on Grading of Prostatic Carcinoma
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Leenders, G.J.H.L. (Geert), Kwast, Th.H. (Theo) van der, Grignon, D.J., Evans, AJ, Kristiansen, G. (Glen), Kweldam, C.F. (Charlotte), Litjens, G., McKenney, JK, Melamed, J. (Jonathan), Mottet, N. (Nicolas), Paner, G.P., Samaratunga, H, Schoots, I.G. (Ivo), Simko, J.P., Tsuzuki, T., Varma, M, Warren, AY, Wheeler, T.M. (Thomas), Williamson, S.R., Iczkowski, KA, Leenders, G.J.H.L. (Geert), Kwast, Th.H. (Theo) van der, Grignon, D.J., Evans, AJ, Kristiansen, G. (Glen), Kweldam, C.F. (Charlotte), Litjens, G., McKenney, JK, Melamed, J. (Jonathan), Mottet, N. (Nicolas), Paner, G.P., Samaratunga, H, Schoots, I.G. (Ivo), Simko, J.P., Tsuzuki, T., Varma, M, Warren, AY, Wheeler, T.M. (Thomas), Williamson, S.R., and Iczkowski, KA
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Five years after the last prostatic carcinoma grading consensus conference of the International Society of Urological Pathology (ISUP), accrual of new data and modification of clinical practice require an update of current pathologic grading guidelines. This manuscript summarizes the proceedings of the ISUP consensus meeting for grading of prostatic carcinoma held in September 2019, in Nice, France. Topics brought to consensus included the following: (1) approaches to reporting of Gleason patterns 4 and 5 quantities, and minor/tertiary patterns, (2) an agreement to report the presence of invasive cribriform carcinoma, (3) an agreement to incorporate intraductal carcinoma into grading, and (4) individual versus aggregate grading of systematic and multiparametric magnetic resonance imaging–targeted biopsies. Finally, developments in the field of artificial intelligence in the grading of prostatic carcinoma and future research perspectives were discussed.
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- 2020
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34. Focus on the Quality of Prostate Multiparametric Magnetic Resonance Imaging: Synopsis of the ESUR/ESUI Recommendations on Quality Assessment and Interpretation of Images and Radiologists’ Training
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Rooij, M. (Maarten) de, Israël, B. (Bas), Barrett, T. (Tristan), Giganti, F. (Francesco), Padhani, A. (Anwar), Panebianco, V. (Valeria), Richenberg, J. (Jonathan), Salomon, G. (Georg), Schoots, I.G. (Ivo), Villeirs, G. (Geert), Walz, J. (Jochen), Barentsz, J. (Jelle), Rooij, M. (Maarten) de, Israël, B. (Bas), Barrett, T. (Tristan), Giganti, F. (Francesco), Padhani, A. (Anwar), Panebianco, V. (Valeria), Richenberg, J. (Jonathan), Salomon, G. (Georg), Schoots, I.G. (Ivo), Villeirs, G. (Geert), Walz, J. (Jochen), and Barentsz, J. (Jelle)
- 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 outco
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- 2020
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35. Clinically significant prostate cancer detection and segmentation in low-risk patients using a convolutional neural network on multi-parametric MRI
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Arif, M. (Muhammad), Schoots, I.G. (Ivo), Castillo Tovar, J. (Jose), Bangma, C.H. (Chris), Krestin, G.P. (Gabriel), Roobol-Bouts, M.J. (Monique), Niessen, W.J. (Wiro), Veenland, J.F. (Jifke), Arif, M. (Muhammad), Schoots, I.G. (Ivo), Castillo Tovar, J. (Jose), Bangma, C.H. (Chris), Krestin, G.P. (Gabriel), Roobol-Bouts, M.J. (Monique), Niessen, W.J. (Wiro), and Veenland, J.F. (Jifke)
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Objectives: To develop an automatic method for identification and segmentation of clinically significant prostate cancer in low-risk patients and to evaluate the performance in a routine clinical setting. Methods: A consecutive cohort (n = 292) from a prospective database of low-risk patients eligible for the active surveillance was selected. A 3-T multi-parametric MRI at 3 months after inclusion was performed. Histopathology from biopsies was used as reference standard. MRI positivity was defined as PI-RADS score ≥ 3, histopathology positivity was defined as ISUP grade ≥ 2. The selected cohort contained four patient groups: (1) MRI-positive targeted biopsy-positive (n = 116), (2) MRI-negative systematic biopsy-negative (n = 55), (3) MRI-positive targeted biopsy-negative (n = 113), (4) MRI-negative systematic biopsy-positive (n = 8). Group 1 was further divided into three sets and a 3D convolutional neural network was trained using different combinations of these sets. Two MRI sequences (T2w, b = 800 DWI) and the ADC map were used as separate input channels for the model. After training, the model was evaluated on the remaining group 1 patients together with the patients of groups 2 and 3 to identify and segment clinically significant prostate cancer. Results: The average sensitivity achieved was 82–92% at an average specificity of 43–76% with an area under the curve (AUC) of 0.65 to 0.89 for different lesion volumes ranging from >
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- 2020
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36. Automated classification of significant prostate cancer on MRI: A systematic review on the performance of machine learning applications
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Castillo, J.M.T. (Jose M. T.), Arif, M. (Muhammad), Niessen, W.J. (Wiro), Schoots, I.G. (Ivo), Veenland, J.F. (Jifke), Castillo, J.M.T. (Jose M. T.), Arif, M. (Muhammad), Niessen, W.J. (Wiro), Schoots, I.G. (Ivo), and Veenland, J.F. (Jifke)
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Significant prostate carcinoma (sPCa) classification based on MRI using radiomics or deep learning approaches has gained much interest, due to the potential application in assisting in clinical decision-making. Objective: To systematically review the literature (i) to determine which algorithms are most frequently used for sPCa classification, (ii) to investigate whether there exists a relation between the performance and the method or the MRI sequences used, (iii) to assess what study design factors affect the performance on sPCa classification, and (iv) to research whether performance had been evaluated in a clinical setting Methods: The databases Embase and Ovid MEDLINE were searched for studies describing machine learning or deep learning classification methods discriminating between significant and nonsignificant PCa on multiparametric MRI that performed a valid validation procedure. Quality was assessed by the modified radiomics quality score. We computed the median area under the receiver operating curve (AUC) from overall methods and the interquartile range. Results: From 2846 potentially relevant publications, 27 were included. The most frequent algorithms used in the literature for PCa classification are logistic regression (22%) and convolutional neural networks (CNNs) (22%). The median AUC was 0.79 (interquartile range: 0.77–0.87). No significant effect of number of included patients, image sequences, or reference standard on the reported performance was found. Three studies described an external validation and none of the papers described a validation in a prospective clinical trial. Conclusions: To unlock the promising potential of machine and deep learning approaches, validation studies and clinical prospective studies should be performed with an established protocol to assess the added value in decision-making.
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- 2020
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37. Prostate cancer upgrading with serial prostate magnetic resonance imaging and repeat biopsy in men on active surveillance: are confirmatory biopsies still necessary?
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Osses, D.F. (Daniël), Drost, F.J.H. (Frank-Jan), Verbeek, J.F.M. (Jan), Luiting, H.B. (Henk B.), Leenders, G.J.H.L. (Geert), Bangma, C.H. (Chris), Krestin, G.P. (Gabriel), Roobol-Bouts, M.J. (Monique), Schoots, I.G. (Ivo), Osses, D.F. (Daniël), Drost, F.J.H. (Frank-Jan), Verbeek, J.F.M. (Jan), Luiting, H.B. (Henk B.), Leenders, G.J.H.L. (Geert), Bangma, C.H. (Chris), Krestin, G.P. (Gabriel), Roobol-Bouts, M.J. (Monique), and Schoots, I.G. (Ivo)
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Objectives: To investigate whether serial prostate magnetic resonance imaging (MRI) may guide the utility of repeat targeted (TBx) and systematic biopsy (SBx) when monitoring men with low-risk prostate cancer (PCa) at 1-year of active surveillance (AS). Patients and Methods: We retrospectively included 111 consecutive men with low-risk (International Society of Urological Pathology [ISUP] Grade 1) PCa, who received protocolled repeat MRI with or without TBx and repeat SBx at 1-year of AS. TBx was performed in Prostate Imaging-Reporting and Data System (PI-RADS) score ≥3 lesions (MRI-positive men). Upgrading defined as ISUP Grade ≥2 PCa (I), Grade ≥2 with cribriform growth/intraductal carcinoma PCa (II), and Grade ≥3 PCa (III) was investigated. Upgrading detected by TBx only (not by SBx) and SBx only (not by TBx) was investigated in MRI-positive and -negative men, and related to radiological progression on MRI (Prostate Cancer Radiological Estimation of Change in Sequential Evaluation [PRECISE] score). Results: Overall upgrading (I) was 32% (35/111). Upgrading in MRI-positive and -negative men was 48% (30/63) and 10% (5/48) (P < 0.001), respectively. In MRI-positive men, there was upgrading in 23% (seven of 30) by TBx only and in 33% (10/30) by SBx only. Radiological progression (PRECISE score 4–5) in MRI-positive men was seen in 27% (17/63). Upgrading (I) occurred in 41% (seven of 17) of these MRI-positive men, while this was 50% (23/46) in MRI-positive men without radiological progression (PRECISE score 1–3) (P = 0.534). Overall upgrading (II) was 15% (17/111). Upgrading in MRI-positive and -negative men was 22% (14/63) and 6% (three of 48) (P = 0.021), respectively. In MRI-positive men, there was upgrading in three of 14 by TBx only and in seven of 14 by SBx only. Overall upgrading (III) occurred in 5% (five of 111). Upgrading in MRI-positive and -negative men was 6% (four of 63) and 2% (one of 48) (P = 0.283), respectively. In MRI-positive men, there was upgradin
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- 2020
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38. 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
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Rooij, M. (Maarten) de, Israël, B. (Bas), Tummers, M. (Marcia), Ahmed, H.U. (Hashim), Barrett, T. (Tristan), Giganti, F. (Francesco), Hamm, B. (Bernd), Løgager, V. (Vibeke), Padhani, A. (Anwar), Panebianco, V. (Valeria), Puech, P. (Philippe), Richenberg, J. (Jonathan), Rouvière, O. (Olivier), Salomon, G. (Georg), Schoots, I.G. (Ivo), Veltman, J., Villeirs, G. (Geert), Walz, J. (Jochen), Barentsz, J. (Jelle), Rooij, M. (Maarten) de, Israël, B. (Bas), Tummers, M. (Marcia), Ahmed, H.U. (Hashim), Barrett, T. (Tristan), Giganti, F. (Francesco), Hamm, B. (Bernd), Løgager, V. (Vibeke), Padhani, A. (Anwar), Panebianco, V. (Valeria), Puech, P. (Philippe), Richenberg, J. (Jonathan), Rouvière, O. (Olivier), Salomon, G. (Georg), Schoots, I.G. (Ivo), Veltman, J., Villeirs, G. (Geert), Walz, J. (Jochen), and Barentsz, J. (Jelle)
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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 disag
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- 2020
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39. Pre-operative MRI in guiding surgical treatment of apical tumors: Why radical resection fails
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Veerman, A.N., primary, Boellaard, T.N., additional, Hoeks, C., additional, Bekers, E., additional, Van Leeuwen, P.J., additional, Vis, A.N., additional, Schoots, I.G, additional, and Van Der Poel, H.G, additional
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- 2020
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40. Current treatment options for locally advanced prostate cancer: EAU (-SIOG) guidelines view and recommendations
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Moris, L., primary, Cumberbatch, M.C., additional, Van Den Broeck, T., additional, Gandaglia, G., additional, Fossati, N., additional, Briers, E., additional, Cornford, P., additional, De Santis, M., additional, Fanti, S., additional, Gillessen, S., additional, Grummet, J., additional, Henry, A.M., additional, Lam, T.B.L., additional, Lardas, M., additional, Liew, M., additional, Mason, M.D., additional, Rouvière, O., additional, Tilki, D., additional, Schoots, I.G., additional, Van Den Bergh, R.C.N., additional, Van Der Kwast, T.H., additional, Van Der Poel, H.G, additional, Willemse, P.M., additional, Mottet, N., additional, and Wiegel, T., additional
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- 2020
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41. EAU-EANM-ESTRO-ESUR-SIOG Prostate Cancer Guideline Panel Consensus Statements for Deferred Treatment with Curative Intent for Localised Prostate Cancer from an International Collaborative Study (DETECTIVE Study)
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Lam, T.B., MacLennan, S., Willemse, P.M., Mason, M.D., Plass, K., Shepherd, R., Baanders, R., Bangma, Chris H., Bjartell, A., Bossi, A., Briers, E., Briganti, A., Buddingh, K.T., Catto, J.W., Colecchia, M., Cox, B.W., Cumberbatch, M.G.K., Davies, J., Davis, N.F., De Santis, M., Dell'Oglio, P., Deschamps, A., Donaldson, J.F., Egawa, S., Fankhauser, C.D., Fanti, S., Fossati, N., Gandaglia, G., Gillessen, S., Grivas, N., Gross, T., Grummet, J.P., Henry, A.M., Ingels, A., Irani, J., Lardas, M., Liew, M., Lin, D.W., Moris, L., Omar, M.I., Pang, K.H., Paterson, C.C., Renard-Penna, R., Ribal, M.J., Roobol, M.J., Roupret, M., Rouviere, O., Sancho Pardo, G., Richenberg, J., Schoots, I.G., Sedelaar, J.P.M., Stricker, P., Tilki, D., Vahr Lauridsen, S., van den Bergh, R.C.N., Van den Broeck, T., van der Kwast, T.H., van der Poel, H.G., van Leenders, G., Varma, M., Violette, P.D., Wallis, C.J.D., Wiegel, T., Wilkinson, K., Zattoni, F., N'Dow, J.M.O., Van Poppel, H., Cornford, P., Mottet, N., Lam, T.B., MacLennan, S., Willemse, P.M., Mason, M.D., Plass, K., Shepherd, R., Baanders, R., Bangma, Chris H., Bjartell, A., Bossi, A., Briers, E., Briganti, A., Buddingh, K.T., Catto, J.W., Colecchia, M., Cox, B.W., Cumberbatch, M.G.K., Davies, J., Davis, N.F., De Santis, M., Dell'Oglio, P., Deschamps, A., Donaldson, J.F., Egawa, S., Fankhauser, C.D., Fanti, S., Fossati, N., Gandaglia, G., Gillessen, S., Grivas, N., Gross, T., Grummet, J.P., Henry, A.M., Ingels, A., Irani, J., Lardas, M., Liew, M., Lin, D.W., Moris, L., Omar, M.I., Pang, K.H., Paterson, C.C., Renard-Penna, R., Ribal, M.J., Roobol, M.J., Roupret, M., Rouviere, O., Sancho Pardo, G., Richenberg, J., Schoots, I.G., Sedelaar, J.P.M., Stricker, P., Tilki, D., Vahr Lauridsen, S., van den Bergh, R.C.N., Van den Broeck, T., van der Kwast, T.H., van der Poel, H.G., van Leenders, G., Varma, M., Violette, P.D., Wallis, C.J.D., Wiegel, T., Wilkinson, K., Zattoni, F., N'Dow, J.M.O., Van Poppel, H., Cornford, P., and Mottet, N.
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Contains fulltext : 215783.pdf (publisher's version ) (Closed access), BACKGROUND: There is uncertainty in deferred active treatment (DAT) programmes, regarding patient selection, follow-up and monitoring, reclassification, and which outcome measures should be prioritised. OBJECTIVE: To develop consensus statements for all domains of DAT. DESIGN, SETTING, AND PARTICIPANTS: A protocol-driven, three phase study was undertaken by the European Association of Urology (EAU)-European Association of Nuclear Medicine (EANM)-European Society for Radiotherapy and Oncology (ESTRO)-European Association of Urology Section of Urological Research (ESUR)-International Society of Geriatric Oncology (SIOG) Prostate Cancer Guideline Panel in conjunction with partner organisations, including the following: (1) a systematic review to describe heterogeneity across all domains; (2) a two-round Delphi survey involving a large, international panel of stakeholders, including healthcare practitioners (HCPs) and patients; and (3) a consensus group meeting attended by stakeholder group representatives. Robust methods regarding what constituted the consensus were strictly followed. RESULTS AND LIMITATIONS: A total of 109 HCPs and 16 patients completed both survey rounds. Of 129 statements in the survey, consensus was achieved in 66 (51%); the rest of the statements were discussed and voted on in the consensus meeting by 32 HCPs and three patients, where consensus was achieved in additional 27 statements (43%). Overall, 93 statements (72%) achieved consensus in the project. Some uncertainties remained regarding clinically important thresholds for disease extent on biopsy in low-risk disease, and the role of multiparametric magnetic resonance imaging in determining disease stage and aggressiveness as a criterion for inclusion and exclusion. CONCLUSIONS: Consensus statements and the findings are expected to guide and inform routine clinical practice and research, until higher levels of evidence emerge through prospective comparative studies and clinical trials. PATIENT
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- 2019
42. The primacy of multiparametric MRI in men with suspected prostate cancer
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Richenberg, J., Logager, V., Panebianco, V., Rouviere, O, Villeirs, G., Schoots, I.G. (Ivo), Richenberg, J., Logager, V., Panebianco, V., Rouviere, O, Villeirs, G., and Schoots, I.G. (Ivo)
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Background Multiparametric MRI (mpMRI) became recognised in investigating those with suspected prostate cancer between 2010 and 2012; in the USA, the preventative task force moratorium on PSA screening was a strong catalyst. In a few short years, it has been adopted into daily urological and oncological practice. The pace of clinical uptake, born along by countless papers proclaiming high accuracy in detecting clinically significant prostate cancer, has sparked much debate about the timing of mpMRI within the traditional biopsy-driven clinical pathways. There are strongly held opposing views on using mpMRI as a triage test regarding the need for biopsy and/or guiding the biopsy pattern. Objective To review the evidence base and present a position paper on the role of mpMRI in the diagnosis and management of prostate cancer. Methods A subgroup of experts from the ESUR Prostate MRI Working Group conducted literature review and face to face and electronic exchanges to draw up a position statement. Results This paper considers diagnostic strategies for clinically significant prostate cancer; current national and international guidance; the impact of pre-biopsy mpMRI in detection of clinically significant and clinically insignificant neoplasms; the impact of pre-biopsy mpMRI on biopsy strategies and targeting; the notion of mpMRI within a wider risk evaluation on a patient by patient basis; the problems that beset mpMRI including inter-observer variability. Conclusions The paper concludes with a set of suggestions for using mpMRI to influence who to biopsy and who not to biopsy at diagnosis.
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- 2019
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43. High Diagnostic Performance of Short Magnetic Resonance Imaging Protocols for Prostate Cancer Detection in Biopsy-naive Men: The Next Step in Magnetic Resonance Imaging Accessibility
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van der Leest, M., Israel, B., Cornel, E.B. (Erik), Zamecnik, P., Schoots, I.G. (Ivo), van der Lelij, H., Padhani, A.R., Rovers, M., van Oort, I., Sedelaar, M, Hulsbergen-van de Kaa, C.A. (Christina), Hannink, G., Veltman, J., Barentsz, J. (Jelle), van der Leest, M., Israel, B., Cornel, E.B. (Erik), Zamecnik, P., Schoots, I.G. (Ivo), van der Lelij, H., Padhani, A.R., Rovers, M., van Oort, I., Sedelaar, M, Hulsbergen-van de Kaa, C.A. (Christina), Hannink, G., Veltman, J., and Barentsz, J. (Jelle)
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Background: To make magnetic resonance imaging (MRI) more accessible to men at risk of high-grade prostate cancer (PCa), there is a need for quicker, simpler, and less costly MRI protocols. Objective: To compare the diagnostic performance of monoplanar (“fast” biparametric MRI [bp-MRI]) and triplanar noncontrast bp-MRI with that of the current contrast-enhanced multiparametric MRI (mp-MRI) in the detection of high-grade PCa in biopsy-naïve men. Design, setting, and participants: A prospective, multireader, head-to-head study included 626 biopsy-naïve men, between February 2015 and February 2018. Intervention: Men underwent prebiopsy contrast-enhanced mp-MRI. Prior to biopsy, two blinded expert readers subsequently assessed “fast” bp-MRI, bp-MRI, and mp-MRI. Thereafter, systematic transrectal ultrasound-guided biopsies (SBs) were performed. Men with suspicious mp-MRI (Prostate Imaging Reporting and Data System 3–5 lesions) also underwent MR-in-bore biopsy (MRGB). Outcome measurements and statistical analysis: Primary outcome was the diagnostic performance of each protocol for the detection of high-grade PCa. Secondary outcomes included the difference in biopsy avoidance, detection of low-grade PCa, acquisition times, decision curve analyses, inter-reader agreement, and direct costs. Results from combined MRGB and SB were used as the reference standard. High-grade PCa was defined as grade 2. Results and limitations: Sensitivity for high-grade PCa for all protocols was 95% (180/ 190; 95% confidence interval [CI]: 91–97%). Specificity was 65% (285/436; 95% CI: 61–70%) for “fast” bp-MRI and 69% (299/436; 95% CI: 64–73%) for bp-MRI and mp-MRI. With fast bp-MRI, 0.96% (6/626) more low-grade PCa was detected. Biopsy could be avoided in 47% for the fast bp-MRI and in 49% for the bp-MRI and mp-MRI protocols. Fast bp-MRI and bp-MRI can be performed in 8 and 13 min, respectively, instead of 16 m
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- 2019
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44. Personalizing prostate cancer diagnosis with multivariate risk prediction tools: how should prostate MRI be incorporated?
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Schoots, I.G. (Ivo), Padhani, A. (Anwar), Schoots, I.G. (Ivo), and Padhani, A. (Anwar)
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Risk-based patient selection for systematic biopsy in prostate cancer diagnosis has been adopted in daily clinical practice, either by clinical judgment and PSA testing, or using multivariate risk prediction tools. The use of multivariable risk prediction tools can significantly reduce unnecessary systematic biopsies, without compromising the detection of clinically significant disease. Increasingly multi-parametric magnetic resonance imaging (MRI) is performed, not only in men with a persistent suspicion of prostate cancer after prior negative systematic biopsy, but also at initial screening before the first biopsy. The combination of MRI and multivariate risk prediction tools could potentially enhance prostate cancer diagnosis using multivariate MRI incorporated risk-based models to decide on the need for prostate MRI, but also using MRI results to adjusted risk-based models, and to guide MRI-directed biopsies. In this review, we discuss the diagnostic work-up for clinically significant prostate cancer, where the combination of MRI and multivariate risk prediction tools is integrated, and how together they can contribute to personalized diagnosis.
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- 2019
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45. Concordance of cribriform architecture in matched prostate cancer biopsy and radical prostatectomy specimens
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Hollemans, E. (Eva), Verhoef, E.I. (Esther), Bangma, C.H. (Chris), Schoots, I.G. (Ivo), Rietbergen, J.B. (John), Helleman, J. (Jozien), Roobol-Bouts, M.J. (Monique), Leenders, G.J.H.L. (Geert), Hollemans, E. (Eva), Verhoef, E.I. (Esther), Bangma, C.H. (Chris), Schoots, I.G. (Ivo), Rietbergen, J.B. (John), Helleman, J. (Jozien), Roobol-Bouts, M.J. (Monique), and Leenders, G.J.H.L. (Geert)
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Aims: Invasive cribriform and/or intraductal carcinoma have been identified as independent adverse parameters for prostate cancer outcome. Little is known on biopsy undersampling of cribriform architecture. Our aim was to determine the extent of cribriform architecture undersampling and to find predictive factors for identifying false cribriform-negative cases. Methods and results: We reviewed 186 matched prostate biopsies and radical prostatectomy specimens. Of 97 biopsy grade group 2 (Gleason score 3 + 4 = 7) patients, 22 (23%) had true cribriform-negative (TN), 39 (40%) false-negative (FN) and 36 (37%) true-positive (TP) biopsies. Patients with FN biopsies had higher, although not statistically significant (P = 0.06), median PSA levels than patients with TP biopsies (12 versus 8 ng/ml). A PI-RADS 5 lesion was present in nine of 16 (54%) FN and three of 11 (27%) TN biopsies (P = 0.05). Positive biopsy rate (P = 0.47), percentage Gleason pattern 4 (P = 0.55) and glomeruloid architecture (P = 1.0) were not different. Logistic regression identified PSA as an independent pre
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- 2019
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46. Prediction Medicine: Biomarkers, Risk Calculators and Magnetic Resonance Imaging as Risk Stratification Tools in Prostate Cancer Diagnosis
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Osses, D.F. (Daniël), Roobol-Bouts, M.J. (Monique), Schoots, I.G. (Ivo), Osses, D.F. (Daniël), Roobol-Bouts, M.J. (Monique), and Schoots, I.G. (Ivo)
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This review discusses the most recent evidence for currently available risk stratification tools in the detection of clinically significant prostate cancer (csPCa), and evaluates diagnostic strategies that combine these tools. Novel blood biomarkers, such as the Prostate Health Index (PHI) and 4Kscore, show similar ability to predict csPCa. Prostate cancer antigen 3 (PCA3) is a urinary biomarker that has inferior prediction of csPCa compared to PHI, but may be combined with other markers like TMPRSS2-ERG to improve its performance. Original risk calculators (RCs) have the advantage of incorporating easy to retrieve clinical variables and being freely accessible as a web tool/mobile application. RCs perform similarly well as most novel biomarkers. New promising risk models including novel (genetic) markers are the SelectMDx and Stockholm-3 model (S3M). Prostate magnetic resonance imaging (MRI) has evolved as an appealing tool in the diagnostic arsenal with even stratifying abilities, including in the initial biopsy setting. Merging biomarkers, RCs and MRI results in higher performances than their use as standalone tests. In the current era of prostate MRI, the way forward seems to be multivariable risk assessment based on blood and clinical parameters, potentially extended with information from urine samples, as a triaging test for the selection of candidates for MRI and biopsy
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- 2019
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47. Evaluation of effectiveness of the PlasmaJet surgical device in the treatment of advanced stage ovarian cancer (PlaComOv-study): study protocol of a randomized controlled trial in the Netherlands
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Boer, G.M. (Geertje) de, Hofhuis, W., Reesink-Peters, N., Ewing-Graham, P.C., Schoots, I.G. (Ivo), Beltman, J.J., Piek, J.M.J., Baalbergen, A., Kooi, G.S. (Sjarlot), van Haaften, A., van Huisseling, H., Haans, L., Dorman, M., Beekhuizen, H.J. (Heleen) van, Boer, G.M. (Geertje) de, Hofhuis, W., Reesink-Peters, N., Ewing-Graham, P.C., Schoots, I.G. (Ivo), Beltman, J.J., Piek, J.M.J., Baalbergen, A., Kooi, G.S. (Sjarlot), van Haaften, A., van Huisseling, H., Haans, L., Dorman, M., and Beekhuizen, H.J. (Heleen) van
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Background: The most important goal for survival benefit of advanced stage ovarian cancer is to surgically remove all visible tumour, because complete cytoreductive surgery (CCS) has been shown to be associated with prolonged survival. In a remarkable number of women, CCS is very challenging. Especially in women with many small metastases on the peritoneum and intestinal surface, conventional CCS with electrosurgery is not able to be “complete” in removing safely all visible tumour. In this randomized controlled trail (RCT) we investigate whether the use of the PlasmaJet Surgical Device increases the rate of CCS, and whether this indeed leads to a longer progression free and overall survival. The main research question is: does the use of the PlasmaJet Surgical Device in surgery for advanced stage ovarian cancer result in an increased number of complete cytoreductive surgeries when compared with conventional surgical techniques. Secondary study objectives are: 30-day morbidity, duration of surgery, blood loss, length of hospitalisation, Quality of Life, disease-free survival, overall survival, percentage colostomy, cost-effectiveness. Methods: The study design is a multicentre single-blinded superiority RCT in two university and nine non-university hospitals in The Netherlands. Three hundred and thirty women undergoing cytoreductive surgery for advanced stage ovarian carcinoma (FIGO Stage IIIB-IV) will be randomized into two arms: use of the PlasmaJet (intervention group) versus the use of standard surgical instruments combined with electrocoagulation (control group). The primary outcome is the rate of complete cytoreductive surgery in both groups. Secondary study objectives are: 30-day morbidity, duration of surgery, blood loss, length of hospitalisation, Quality of Life, disease-free survival, overall survival, percentage colostomy, cost-effectiveness. Quality of life will be evaluated using validated questionnaires at baseline, at 1 and 6 months after surgery and
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- 2019
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48. P032 - Extended - targeted-plus-regional - MRI-directed biopsy approach in prostate cancer diagnosis – a systematic review and meta-analysis
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Hagens, M.J., Fernandez Salamanca, M., Phadhani, A.R., Van Leeuwen, P.J., Van Der Poel, H.G., and Schoots, I.G.
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- 2021
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49. EP004 - Pre-operative MRI in guiding surgical treatment of apical tumors: Why radical resection fails
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Veerman, A.N., Boellaard, T.N., Hoeks, C., Bekers, E., Van Leeuwen, P.J., Vis, A.N., Schoots, I.G, and Van Der Poel, H.G
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- 2020
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50. From PROMIS to PRO-MRI in primary prostate cancer diagnosis
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Schoots, I.G. (Ivo), Roobol-Bouts, M.J. (Monique), Schoots, I.G. (Ivo), and Roobol-Bouts, M.J. (Monique)
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In the emerging field of MRI in prostate cancer (PCa) diagnosis, it has become clear that targeted biopsy with MRI guidance has additional value over systematic transrectal ultrasound-guided biopsies (TRUS-Bx) alone. The targeted biopsy approach driven by a positive MRI increases the diagnostic yield of high-grade [Gleason score (GS) ≥3+4] or clinically significant (cs) PCa, while concomitantly reducing the number of biopsy cores and the detection of low-grade PCa (GS 3+3) (1-3). Consequently, the question arises what the diagnostic accuracy of MRI (with or without targeted biopsies) in current clinical practice would be?
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- 2017
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