Imperial College London

Professor Hashim Ahmed

Faculty of MedicineDepartment of Surgery & Cancer

Chair in Urology (Clinical)
 
 
 
//

Contact

 

hashim.ahmed

 
 
//

Location

 

5L28Lab BlockCharing Cross Campus

//

Summary

 

Publications

Publication Type
Year
to

280 results found

Afaq A, Alahmed S, Chen S-H, Lengana T, Haroon A, Payne H, Ahmed H, Punwani S, Sathekge M, Bomanji Jet al., 2018, Impact of Ga-68-Prostate-Specific Membrane Antigen PET/CT on Prostate Cancer Management, JOURNAL OF NUCLEAR MEDICINE, Vol: 59, Pages: 89-92, ISSN: 0161-5505

JOURNAL ARTICLE

Ahmed HU, 2018, Opening Our Eyes to Multiparametric Magnetic Resonance Imaging Before Prostate Biopsy, EUROPEAN UROLOGY, Vol: 73, Pages: 361-362, ISSN: 0302-2838

JOURNAL ARTICLE

Appayya MB, Adshead J, Ahmed HU, Allen C, Bainbridge A, Barrett T, Giganti F, Graham J, Haslam P, Johnston EW, Kastner C, Kirkham APS, Lipton A, McNeill A, Moniz L, Moore CM, Nabi G, Padhani AR, Parker C, Patel A, Pursey J, Richenberg J, Staffurth J, van der Meulen J, Walls D, Punwani Set al., 2018, National implementation of multi-parametric magnetic resonance imaging for prostate cancer detection - recommendations from a UK consensus meeting, BJU INTERNATIONAL, Vol: 122, Pages: 13-25, ISSN: 1464-4096

JOURNAL ARTICLE

Appayya MB, Sidhu HS, Dikaios N, Johnston EW, Simons LAM, Freeman A, Kirkham APS, Ahmed HU, Punwani Set al., 2018, Characterizing indeterminate (Likert-score 3/5) peripheral zone prostate lesions with PSA density, PI-RADS scoring and qualitative descriptors on multiparametric MRI, BRITISH JOURNAL OF RADIOLOGY, Vol: 91, ISSN: 0007-1285

JOURNAL ARTICLE

Bonmati E, Hu Y, Villarini B, Rodell R, Martin P, Han L, Donaldson I, Ahmed HU, Moore CM, Emberton M, Barratt DCet al., 2018, Technical Note: Error metrics for estimating the accuracy of needle/instrument placement during transperineal magnetic resonance/ultrasound-guided prostate interventions, MEDICAL PHYSICS, Vol: 45, Pages: 1408-1414, ISSN: 0094-2405

JOURNAL ARTICLE

Brown LC, Ahmed HU, Faria R, Bosaily AE-S, Gabe R, Kaplan RS, Parmar M, Collaco-Moraes Y, Ward K, Hindley RG, Freeman A, Kirkham A, Oldroyd R, Parker C, Bott S, Burns-Cox N, Dudderidge T, Ghei M, Henderson A, Persad R, Rosario DJ, Shergill I, Winkler M, Soares M, Spackman E, Sculpher M, Emberton Met al., 2018, Multiparametric MRI to improve detection of prostate cancer compared with transrectal ultrasound-guided prostate biopsy alone: the PROMIS study, HEALTH TECHNOLOGY ASSESSMENT, Vol: 22, Pages: 1-+, ISSN: 1366-5278

JOURNAL ARTICLE

Chandak P, Byrne N, Lynch H, Allen C, Rottenberg G, Chandra A, Raison N, Ahmed H, Kasivisvanathan V, Elhage O, Dasgupta Pet al., 2018, Three-dimensional printing in robot-assisted radical prostatectomy - an Idea, Development, Exploration, Assessment, Long-term follow-up (IDEAL) Phase 2a study, BJU INTERNATIONAL, Vol: 122, Pages: 360-361, ISSN: 1464-4096

JOURNAL ARTICLE

Chau EM, Arya M, Petrides N, Aldin Z, Mckenzie J, Emberton M, Virdi J, Ahmed HU, Kasivisvanathan Vet al., 2018, Performance characteristics of multiparametric-MRI at a non-academic hospital using transperineal template mapping biopsy as a reference standard, INTERNATIONAL JOURNAL OF SURGERY OPEN, Vol: 10, Pages: 66-71, ISSN: 2405-8572

JOURNAL ARTICLE

Elliott D, Hamdy FC, Leslie TA, Rosario D, Dudderidge T, Hindley R, Emberton M, Brewster S, Sooriakumaran P, Catto JWF, Emara A, Ahmed H, Whybrow P, le Conte S, Donovan JLet al., 2018, Overcoming difficulties with equipoise to enable recruitment to a randomised controlled trial of partial ablation vs radical prostatectomy for unilateral localised prostate cancer., BJU Int

OBJECTIVE: To describe how clinicians conceptualised equipoise in the PART (Partial prostate Ablation vs Radical prosTatectomy in intermediate-risk unilateral clinically localised prostate cancer) feasibility study and how this affected recruitment. SUBJECTS AND METHODS: PART included a QuinteT Recruitment Intervention (QRI) to optimise recruitment. Phase I aimed to understand recruitment, and included: scrutinising recruitment data, interviewing the trial management group and recruiters (n = 13), and audio-recording recruitment consultations (n = 64). Data were analysed using qualitative content and thematic analysis methods. In Phase II, strategies to improve recruitment were developed and delivered. RESULTS: Initially many recruiters found it difficult to maintain a position of equipoise and held preconceptions about which treatment was best for particular patients. They did not feel comfortable about approaching all eligible patients, and when the study was discussed, biases were conveyed through the use of terminology, poorly balanced information, and direct treatment recommendations. Individual and group feedback led to presentations to patients becoming clearer and enabled recruiters to reconsider their sense of equipoise. Although the precise impact of the QRI alone cannot be determined, recruitment increased (from a mean [range] of 1.4 [0-4] to 4.5 [0-12] patients/month) and the feasibility study reached its recruitment target. CONCLUSION: Although clinicians find it challenging to recruit patients to a trial comparing different contemporary treatments for prostate cancer, training and support can enable recruiters to become more comfortable with conveying equipoise and providing clearer information to patients.

JOURNAL ARTICLE

Faria R, Soares MO, Spackman E, Ahmed HU, Brown LC, Kaplan R, Emberton M, Sculpher MJet al., 2018, Optimising the Diagnosis of Prostate Cancer in the Era of Multiparametric Magnetic Resonance Imaging: A Cost-effectiveness Analysis Based on the Prostate MR Imaging Study (PROMIS), EUROPEAN UROLOGY, Vol: 73, Pages: 23-30, ISSN: 0302-2838

JOURNAL ARTICLE

Faria R, Soares MO, Spackman E, Ahmed HU, Brown LC, Kaplan R, Emberton M, Sculpher MJet al., 2018, Re: Jochen Walz. The "PROMIS" of Magnetic Resonance Imaging Cost Effectiveness in Prostate Cancer Diagnosis? Eur Urol 2018;73:31-2, EUROPEAN UROLOGY, Vol: 73, Pages: E151-E152, ISSN: 0302-2838

JOURNAL ARTICLE

Ganzer R, Arthanareeswaran VKA, Ahmed HU, Cestari A, Rischmann P, Salomon G, Teber D, Liatsikos E, Stolzenburg J-U, Barret Eet al., 2018, Which technology to select for primary focal treatment of prostate cancer?-European Section of Urotechnology (ESUT) position statement, PROSTATE CANCER AND PROSTATIC DISEASES, Vol: 21, Pages: 175-186, ISSN: 1365-7852

JOURNAL ARTICLE

Giancarlo M, Ploussard G, Ost P, De Visschere PJL, Sooriakumaran P, Briganti A, Gandaglia G, Tilki D, Surcel CI, Tsaur I, Van den Bergh R, Kretschmer A, Borgmann H, Gontero P, Ahmed H, Valerio Met al., 2018, AN INTERNATIONAL SURVEY ABOUT FOCAL THERAPY FOR PROSTATE CANCER FROM THE YOUNG ACADEMIC UROLOGISTS (YAU): THE OPINION OF 484 PHYSICIANS, Publisher: INT INST ANTICANCER RESEARCH, Pages: 2567-2568, ISSN: 0250-7005

CONFERENCE PAPER

Grey A, Scott R, Charman S, van der Meulen J, Frinking P, Acher P, Liyanage S, Madaan S, Constantinescu G, Shah B, Graves CB, Freeman A, Jameson C, Ramachandran N, Emberton M, Arya M, Ahmed HUet al., 2018, The CADMUS trial - Multi-parametric ultrasound targeted biopsies compared to multi-parametric MRI targeted biopsies in the diagnosis of clinically significant prostate cancer, CONTEMPORARY CLINICAL TRIALS, Vol: 66, Pages: 86-92, ISSN: 1551-7144

JOURNAL ARTICLE

Guillaumier S, Peters M, Arya M, Afzal N, Charman S, Dudderidge T, Hosking-Jervis F, Hindley RG, Lewi H, McCartan N, Moore CM, Nigam R, Ogden C, Persad R, Shah K, van der Meulen J, Virdi J, Winkler M, Emberton M, Ahmed HUet al., 2018, A Multicentre Study of 5-year Outcomes Following Focal Therapy in Treating Clinically Significant Nonmetastatic Prostate Cancer, EUROPEAN UROLOGY, Vol: 74, Pages: 422-429, ISSN: 0302-2838

JOURNAL ARTICLE

Hamdy FC, Elliott D, le Conte S, Davies LC, Burns RM, Thomson C, Gray R, Wolstenholme J, Donovan JL, Fitzpatrick R, Verrill C, Gleeson F, Singh S, Rosario D, Catto JW, Brewster S, Dudderidge T, Hindley R, Emara A, Sooriakumaran P, Ahmed HU, Leslie TAet al., 2018, Partial ablation versus radical prostatectomy in intermediate-risk prostate cancer: the PART feasibility RCT., Health Technol Assess, Vol: 22, Pages: 1-96

BACKGROUND: Prostate cancer (PCa) is the most common cancer in men in the UK. Patients with intermediate-risk, clinically localised disease are offered radical treatments such as surgery or radiotherapy, which can result in severe side effects. A number of alternative partial ablation (PA) technologies that may reduce treatment burden are available; however the comparative effectiveness of these techniques has never been evaluated in a randomised controlled trial (RCT). OBJECTIVES: To assess the feasibility of a RCT of PA using high-intensity focused ultrasound (HIFU) versus radical prostatectomy (RP) for intermediate-risk PCa and to test and optimise methods of data capture. DESIGN: We carried out a prospective, multicentre, open-label feasibility study to inform the design and conduct of a future RCT, involving a QuinteT Recruitment Intervention (QRI) to understand barriers to participation. SETTING: Five NHS hospitals in England. PARTICIPANTS: Men with unilateral, intermediate-risk, clinically localised PCa. INTERVENTIONS: Radical prostatectomy compared with HIFU. PRIMARY OUTCOME MEASURE: The randomisation of 80 men. SECONDARY OUTCOME MEASURES: Findings of the QRI and assessment of data capture methods. RESULTS: Eighty-seven patients consented to participate by 31 March 2017 and 82 men were randomised by 4 May 2017 (41 men to the RP arm and 41 to the HIFU arm). The QRI was conducted in two iterative phases: phase I identified a number of barriers to recruitment, including organisational challenges, lack of recruiter equipoise and difficulties communicating with patients about the study, and phase II comprised the development and delivery of tailored strategies to optimise recruitment, including group training, individual feedback and 'tips' documents. At the time of data extraction, on 10 October 2017, treatment data were available for 71 patients. Patient characteristics were similar at baseline and the rate of return of all clinical case report forms (CRFs) was

JOURNAL ARTICLE

Kasivisvanathan V, Ahmed H, Cashman S, Challacombe B, Emberton M, Gao C, Lamb BW, Nambiar A, Pickard R, Shah TT, Smith Det al., 2018, The British Urology Researchers in Surgical Training (BURST) Research Collaborative: an alternative research model for carrying out large scale multi-centre urological studies, BJU INTERNATIONAL, Vol: 121, Pages: 6-9, ISSN: 1464-4096

JOURNAL ARTICLE

Lovegrove CE, Matanhelia M, Randeva J, Eldred-Evans D, Tam H, Miah S, Winkler M, Ahmed HU, Shah TTet al., 2018, Prostate imaging features that indicate benign or malignant pathology on biopsy, TRANSLATIONAL ANDROLOGY AND UROLOGY, Vol: 7, Pages: S420-S435, ISSN: 2223-4683

JOURNAL ARTICLE

Miah S, Dunford C, Edison M, Eldred-Evans D, Gan C, Shah TT, Lunn P, Winkler M, Ahmed HU, Gibbons N, Hrouda Det al., 2018, A prospective clinical, cost and environmental analysis of a clinician-led virtual urology clinic., Ann R Coll Surg Engl, Pages: 1-5

INTRODUCTION: Minimally invasive parathyroidectomy (MIP) for primary hyperparathyroidism is dependent upon accurate prediction of single-gland disease on the basis of preoperative imaging and biochemistry. The aims of this study were to validate currently available predictive models of single-gland disease in two UK cohorts and to determine if these models can facilitate MIP. MATERIAL AND METHODS: We collected data prospectively from our weekly follow-up virtual clinic over a continuous four-month period between July and September 2017. RESULTS: In total, we reviewed 409 patients. Following virtual clinic consultation, 68.5% of our patients were discharged from further follow-up. The majority of our patients (male 57.7%, female 55.5%) were of working age. The satisfaction scores were high, at 90.1%, and there were no reported adverse events as a result of using the virtual clinic. Our calculated cost savings were £18,744, with a predicted 12-month cost saving of £56,232. The creation of additional face-to-face clinic capacity has created an estimated 12-month increase in tariff generation for our unit of £72,072. In total, 4623 travel miles were avoided by patients using the virtual clinic, with an estimated avoided carbon footprint of 0.35-1.45 metric tonnes of CO2e, depending on mode of transport. Our predicted 12-month avoided carbon footprint is 1.04-4.04 metric tonnes of CO2e. CONCLUSIONS: Our virtual clinic model has demonstrated a trifecta of positive outcomes, namely, clinical, financial and environmental benefits. The environmental importance and benefits of a virtual clinic should be promoted as a social enterprise value when engaging stakeholders in setting up such a urological service. We propose the adoption of our virtual clinic model in those urological units considering this method of telemedicine.

JOURNAL ARTICLE

Miah S, Eldred-Evans D, Simmons LAM, Shah TT, Kanthabalan A, Arya M, Winkler M, McCartan N, Freeman A, Punwani S, Moore CM, Emberton M, Ahmed HUet al., 2018, Patient Reported Outcome Measures for Transperineal Prostate Mapping Biopsies in the PICTURE Study., J Urol

PURPOSE: Transperineal prostate mapping biopsy is an increasingly used method of procuring tissue from men with suspected prostate cancer. We report patient related outcome measures and adverse events in men in the PICTURE trial (ClinicalTrials.gov NCT01492270) who underwent this diagnostic test. MATERIALS AND METHODS: A total of 249 men underwent multiparametric magnetic resonance imaging followed by transperineal template prostate mapping biopsy as a validation study. Functional outcomes before and after transperineal template prostate mapping were prospectively collected and recorded with questionnaires, including the I-PSS (International Prostate Symptom Score), the I-PSS-QoL (Quality of Life), the IIEF-15 (International Index of Erectile Function-15) and the EPIC (Expanded Prostate Cancer Index Composite) urinary function. RESULTS: Mean age was 62 years, median prostate specific antigen was 6.8 ng/ml and median gland size was 37 ml. At transperineal template prostate mapping biopsy a median of 49 cores (IQR 40-55) were taken. Mean time to complete the post-procedure patient related outcome measure questionnaires was 46 days. Adverse events included post-procedure acute urinary retention in 24% of patents, rectal pain in 26% and perineal pain in 41%. Transperineal template prostate mapping biopsy resulted in a statistically significant increase in scores on the I-PSS from 10.9 to 11.8 (p = 0.024) and the I-PSS-QoL from 1.57 to 1.76 (p = 0.03). The IIEF-15 erectile function score decreased by 23.2% from 47.7 to 38.7 (p <0.001). Significant deterioration was noted in all 5 of IIEF-15 functional domains, including erectile and orgasmic function, sexual desire, and intercourse and overall satisfaction (p <0.001). EPIC urinary scores showed no overall change from baseline. CONCLUSIONS: Transperineal template prostate mapping biopsy causes a high urinary retention rate and a detrimental impact on genitourinary functional outcomes, including deterioration in

JOURNAL ARTICLE

Miah S, Winkler M, Ahmed HU, 2018, Re: Predictors of Infectious Complications After Targeted Prophylaxis for Prostate Needle Biopsy, EUROPEAN UROLOGY, Vol: 74, Pages: 523-524, ISSN: 0302-2838

JOURNAL ARTICLE

Olivier J, Stavrinides V, Kay J, Freeman A, Pye H, Ahmed Z, Carmona Echeverria L, Heavey S, Simmons LAM, Kanthabalan A, Arya M, Briggs T, Barratt D, Charman SC, Gelister J, Hawkes D, Hu Y, Jameson C, McCartan N, Punwani S, van der Muelen J, Moore C, Emberton M, Ahmed HU, Whitaker HCet al., 2018, Immunohistochemical biomarker validation in highly selective needle biopsy microarrays derived from mpMRI-characterized prostates., Prostate

INTRODUCTION: Diagnosing prostate cancer routinely involves tissue biopsy and increasingly image guided biopsy using multiparametric MRI (mpMRI). Excess tissue after diagnosis can be used for research to improve the diagnostic pathway and the vertical assembly of prostate needle biopsy cores into tissue microarrays (TMAs) allows the parallel immunohistochemical (IHC) validation of cancer biomarkers in routine diagnostic specimens. However, tissue within a biopsy core is often heterogeneous and cancer is not uniformly present, resulting in needle biopsy TMAs that suffer from highly variable cancer detection rates that complicate parallel biomarker validation. MATERIALS AND METHODS: The prostate cores with the highest tumor burden (in terms of Gleason score and/or maximum cancer core length) were obtained from 249 patients in the PICTURE trial who underwent transperineal template prostate mapping (TPM) biopsy at 5 mm intervals preceded by mpMRI. From each core, 2 mm segments containing tumor or benign tissue (as assessed on H&E pathology) were selected, excised and embedded vertically into a new TMA block. TMA sections were then IHC-stained for the routinely used prostate cancer biomarkers PSA, PSMA, AMACR, p63, and MSMB and assessed using the h-score method. H-scores in patient matched malignant and benign tissue were correlated with the Gleason grade of the original core and the MRI Likert score for the sampled prostate area. RESULTS: A total of 2240 TMA cores were stained and IHC h-scores were assigned to 1790. There was a statistically significant difference in h-scores between patient matched malignant and adjacent benign tissue that is independent of Likert score. There was no association between the h-scores and Gleason grade or Likert score within each of the benign or malignant groups. CONCLUSION: The construction of highly selective TMAs from prostate needle biopsy cores is possible. IHC data obtained through this method are highly reliable

JOURNAL ARTICLE

Peters M, Kanthabalan A, Shah TT, McCartan N, Moore CM, Arya M, van Zyp JRVDV, Moerland MA, Hindley RG, Emberton M, Ahmed HUet al., 2018, 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, UROLOGIC ONCOLOGY-SEMINARS AND ORIGINAL INVESTIGATIONS, Vol: 36, ISSN: 1078-1439

JOURNAL ARTICLE

Rouhani MJ, Burleigh EJ, Hobbis C, Dunford C, Osman NI, Gan C, Gibbons NB, Ahmed HU, Miah Set al., 2018, UK medical students' perceptions, attitudes, and interest toward medical leadership and clinician managers, ADVANCES IN MEDICAL EDUCATION AND PRACTICE, Vol: 9, Pages: 119-124, ISSN: 1179-7258

JOURNAL ARTICLE

Rouhani MJ, Burleigh EJ, Hobbis C, Dunford C, Osman NI, Gan C, Gibbons NB, Ahmed HU, Miah Set al., 2018, Expanding management and leadership education in medical schools Response, ADVANCES IN MEDICAL EDUCATION AND PRACTICE, Vol: 9, Pages: 277-278, ISSN: 1179-7258

JOURNAL ARTICLE

Shah TT, Peters M, Guillaumier S, Arya M, Afzal N, Hosking-Jervis F, Dudderidge T, Hindley R, Lewi H, McCartan N, Moore CM, Nigam R, Ogden C, Persad R, Shah K, Virdi J, Winkler M, Emberton M, Ahmed HU, Minhas Set al., 2018, PREDICTORS OF POOR FUNCTIONAL OUTCOMES AFTER FOCAL HIGH INTENSITY FOCUSSED ULTRASOUND (HIFU), American-Urological-Association(AUA) Annual Meeting, Publisher: ELSEVIER SCIENCE INC, Pages: E378-E379, ISSN: 0022-5347

CONFERENCE PAPER

Shah TT, Valerio M, Ahmed HU, 2018, Re: Effect of Prior Focal Therapy on Perioperative, Oncologic and Functional Outcomes of Salvage Robotic Assisted Radical Prostatectomy, JOURNAL OF UROLOGY, Vol: 199, Pages: 1634-1635, ISSN: 0022-5347

JOURNAL ARTICLE

Simmons LAM, Kanthabalan A, Arya M, Briggs T, Barratt D, Charman SC, Freeman A, Hawkes D, Hu Y, Jameson C, McCartan N, Moore CM, Punwani S, van der Muelen J, Emberton M, Ahmed HUet al., 2018, Accuracy of Transperineal Targeted Prostate Biopsies, Visual Estimation and Image Fusion, in Men Needing Repeat Biopsy in the PICTURE Trial., J Urol

PURPOSE: We evaluated the detection of clinically significant prostate cancer using magnetic resonance imaging targeted biopsies and compared visual estimation to image fusion targeting in patients requiring repeat prostate biopsies. MATERIALS AND METHODS: The prospective, ethics committee approved PICTURE trial (ClinicalTrials.gov NCT01492270) enrolled 249 consecutive patients from January 11, 2012 to January 29, 2014. Men underwent multiparametric magnetic resonance imaging and were blinded to the results. All underwent transperineal template prostate mapping biopsies. In 200 men with a lesion this was preceded by visual estimation and image fusion targeted biopsies. As the primary study end point clinically significant prostate cancer was defined as Gleason 4 + 3 or greater and/or any grade of cancer with a length of 6 mm or greater. Other definitions of clinically significant prostate cancer were also evaluated. RESULTS: Mean ± SD patient age was 62.6 ± 7 years, median prostate specific antigen was 7.17 ng/ml (IQR 5.25-10.09), mean primary lesion size was 0.37 ± 1.52 cc with a mean of 4.3 ± 2.3 targeted cores per lesion on visual estimation and image fusion combined, and a mean of 48.7 ± 12.3 transperineal template prostate mapping biopsy cores. Transperineal template prostate mapping biopsies detected 97 clinically significant prostate cancers (48.5%) and 85 insignificant cancers (42.5%). Overall multiparametric magnetic resonance imaging targeted biopsies detected 81 clinically significant prostate cancers (40.5%) and 63 insignificant cancers (31.5%). In the 18 cases (9%) of clinically significant prostate cancer on magnetic resonance imaging targeted biopsies were benign or clinically insignificant on transperineal template prostate mapping biopsy. Clinically significant prostate cancer was detected in 34 cases (17%) on transperineal template prostate mapping biopsy but not on magnetic resonance imaging target

JOURNAL ARTICLE

Simmons LAM, Kanthabalan A, Arya M, Briggs T, Charman SC, Freeman A, Gelister J, Jameson C, McCartan N, Moore CM, van der Muelen J, Emberton M, Ahmed HUet al., 2018, Prostate Imaging Compared to Transperineal Ultrasound-guided biopsy for significant prostate cancer Risk Evaluation (PICTURE): a prospective cohort validating study assessing Prostate HistoScanning., Prostate Cancer Prostatic Dis

BACKGROUND: Men with negative prostate biopsies or those diagnosed with low-risk or low-volume intermediate-risk prostate cancers often require a second prostate biopsy prior to a treatment decision. Prostate HistoScanning (PHS) is an ultrasound imaging test that might inform prostate biopsy in such men. METHODS: PICTURE was a prospective, paired-cohort validating trial to assess the diagnostic accuracy of imaging in men requiring a further biopsy (clinicaltrials.gov, NCT01492270) (11 January 2012-29 January 2014). We enrolled 330 men who had undergone a prior TRUS biopsy but where diagnostic uncertainty remained. All eligible men underwent PHS and transperineal template prostate mapping (TTPM) biopsy (reference standard). Men were blinded to the imaging results until after undergoing TTPM biopsies. We primarily assessed the ability of PHS to rule out clinically significant prostate (negative predictive value [NPV] and sensitivity) for a target histological condition of Gleason ≥4+3 and/or a cancer core length (MCCL) ≥6 mm. We also assessed the role of visually estimated PHS-targeted biopsies. RESULTS: Of the 330 men enrolled, 249 underwent both PHS and TTPM biopsy. Mean (SD) age was 62 (7) years, median (IQR) PSA 6.8 (4.98-9.50) ng/ml, median (IQR) number of previous biopsies 1 (1-2) and mean (SD) gland size 37 (15.5) ml. One hundred and forty six (59%) had no clinically significant cancer. PHS classified 174 (70%) as suspicious. Sensitivity was 70.3% (95% CI 59.8-79.5) and NPV 41.3% (95% CI 27.0-56.8). Specificity and positive predictive value (PPV) were 14.7% (95% CI 9.1-22.0) and 36.8% (95% CI 29.6-44.4), respectively. In all, 213/220 had PHS suspicious areas targeted with targeting sensitivity 13.6% (95% CI 7.3-22.6), specificity 97.6% (95% CI 93.1-99.5), NPV 61.6% (95% CI 54.5-68.4) and PPV 80.0% (95% CI 51.9-95.7). CONCLUSIONS: PHS is not a useful test in men seeking risk stratification following initial prostate biopsy.

JOURNAL ARTICLE

This data is extracted from the Web of Science and reproduced under a licence from Thomson Reuters. You may not copy or re-distribute this data in whole or in part without the written consent of the Science business of Thomson Reuters.

Request URL: http://wlsprd.imperial.ac.uk:80/respub/WEB-INF/jsp/search-html.jsp Request URI: /respub/WEB-INF/jsp/search-html.jsp Query String: respub-action=search.html&id=00936994&limit=30&person=true