MP51-20 MULTI-PARAMETRIC MRI ENHANCES DETECTION OF SIGNIFICANT TUMOR IN PATIENTS ON ACTIVE SURVEILLANCE FOR PROSTATE CANCER
Notice bibliographique
Résumé
You have accessJournal of UrologyProstate Cancer: Localized V1 Apr 2014MP51-20 MULTI-PARAMETRIC MRI ENHANCES DETECTION OF SIGNIFICANT TUMOR IN PATIENTS ON ACTIVE SURVEILLANCE FOR PROSTATE CANCER Hamidreza Abdi, Triona Walshe, Farshad Pourmalek, Jonathan Aning, Homi Zargar, Alison C. Harris, Silvia D. Chang, Alan I. So, Martin E. Gleave, Lindsay Machan, Peter C. Black, and S Larry Goldenberg Hamidreza AbdiHamidreza Abdi More articles by this author , Triona WalsheTriona Walshe More articles by this author , Farshad PourmalekFarshad Pourmalek More articles by this author , Jonathan AningJonathan Aning More articles by this author , Homi ZargarHomi Zargar More articles by this author , Alison C. HarrisAlison C. Harris More articles by this author , Silvia D. ChangSilvia D. Chang More articles by this author , Alan I. SoAlan I. So More articles by this author , Martin E. GleaveMartin E. Gleave More articles by this author , Lindsay MachanLindsay Machan More articles by this author , Peter C. BlackPeter C. Black More articles by this author , and S Larry GoldenbergS Larry Goldenberg More articles by this author View All Author Informationhttps://doi.org/10.1016/j.juro.2014.02.1676AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookTwitterLinked InEmail Introduction and Objectives A principal limitation of active surveillance (AS) for the management of lower risk prostate cancer (CaP) is undersampling of higher risk tumors, which may be located outside the usual template of a transrectal ultrasound guided biopsy (TRUSBx). Multi-parametric MRI of the prostate (mpMRI-P) offers a method to detect these missed lesions, and fusion biopsy enables sampling of them. Here we investigated the utility of mpMRI-P in patients on AS. Methods We reviewed the charts of 815 patients on AS for localized CaP at the Vancouver Prostate Centre. Of these patients 110 had a mpMRI-P prior to repeat TRUSBx, and selected patients underwent MRI-TRUS fusion biopsy based on the mpMRI-P findings, in addition to a standard biopsy. The results of fusion biopsy cores were compared to the standard biopsy cores, and the role of mpMRI-P in altering patient management was evaluated. Results The median time on AS was 2.47 years (range: 0.6 - 6.9) at the time of the mpMRI-P. Gleason 3+3 cancer was found on initial biopsy in 98 (89%) and Gleason 3+4 in 12 (11%). mpMRI-P detected 112 suspicious lesion in 72 (65%) patients. Of these, 80 (72%) were PIRADS 3 lesions and 32(28%) PIRADS 4 or 5. Cancer and significant cancer (any Gleason pattern 4) were detected in 20 (25%) and 9 (11%) of PIRADS 3 lesions, and in 20 (61%) and 13 (39%) of PIRADS 4/5 lesions, respectively. Fusion biopsy was carried out in 65 of these patients (37 true and 28 cognitive). Gleason grade progression compared to previous biopsy was detected in 11 (10%) patients in the fusion cores, in 7 (6.3%) patients in the standard cores, and in 3 (2.7%) patients in both fusion and standard cores. Two patients discontinued AS due to size increase of a lesion on mpMRI-P. AS was discontinued due to PSA elevation in 1 case and patient choice in 2 cases. mpMRI-P with fusion biopsy was responsible for the determination of disease progression in 13(11.8%) cases. Conclusions These preliminary findings suggest that mpMRI-P with subsequent fusion biopsy enhances the identification of AS patients requiring definitive treatment. Longer follow-up in a larger series of patients is needed to determine the real value of mpMRI-P and subsequent fusion biopsy in the management of patients on AS. © 2014FiguresReferencesRelatedDetails Volume 191Issue 4SApril 2014Page: e605 Peer Review Report Advertisement Copyright & Permissions© 2014Metrics Author Information Hamidreza Abdi More articles by this author Triona Walshe More articles by this author Farshad Pourmalek More articles by this author Jonathan Aning More articles by this author Homi Zargar More articles by this author Alison C. Harris More articles by this author Silvia D. Chang More articles by this author Alan I. So More articles by this author Martin E. Gleave More articles by this author Lindsay Machan More articles by this author Peter C. Black More articles by this author S Larry Goldenberg More articles by this author Expand All Advertisement Advertisement PDF downloadLoading ...
Récupéré en direct depuis OpenAlex et désinversé. Les résumés ne sont pas conservés dans cette base de données : les index inversés représentent 8,6 Go des 9,3 Go de texte de la base, et le serveur dispose de 13 Go libres.
Comment cette classification a été obtenuedéplier
Prédiction machine sur la base complète
Imitation des enseignantsNi prévalence calibrée, ni vérité terrain. Validation humaine à venir. Le volet Gemma est une étiquette directe du modèle pour chaque travail de la base, lue sur la notice réduite au titre. Le volet Codex est un classifieur appris des 10 348 étiquettes directes de Codex et calibré sur les taux pondérés de l'échantillon; les champs sans appui suffisant ne portent aucun appel Codex. Le mode candidate est l'union des deux volets; le consensus est leur intersection. Ces sorties portent le statut machine_predicted_unvalidated et ne sont pas des étiquettes humaines.
Scores du classifieur distillé par catégorie (deux têtes)
| Catégorie | Codex | Gemma |
|---|---|---|
| Métarecherche | 0,001 | 0,002 |
| Méta-épidémiologie (sens strict) | 0,000 | 0,000 |
| Méta-épidémiologie (sens large) | 0,000 | 0,000 |
| Bibliométrie | 0,002 | 0,000 |
| Études des sciences et des technologies | 0,000 | 0,000 |
| Communication savante | 0,001 | 0,001 |
| Science ouverte | 0,000 | 0,000 |
| Intégrité de la recherche | 0,001 | 0,001 |
| Charge utile insuffisante (le modèle a refusé de juger) | 0,017 | 0,003 |
Scores machine (provisoires)
Les deux têtes enseignantes du modèle étudiant, lues sur ce travail. Un score ordonne la base pour la relecture; il n'affirme jamais une catégorie, et le statut de validation accompagne chaque rangée tel quel.
Scores de référence d'un modèle non mature (critères de maturité non atteints, 7 itérations). Un score ordonne; il n'affirme jamais une catégorie.
score_only:v0-immature-baseline · tel quel depuis la passe de notation : score_only signifie que le nombre peut ordonner les travaux, et qu'aucune étiquette de catégorie n'en découleClassification
machine, non validéePrédiction automatique; un appel candidat d’une seule source (Gemma direct ou Codex distillé), pas un consensus.
Le détail, modèle par modèle et score par score, se trouve en fin de page sous « Comment cette classification a été obtenue ».