Imperial College London

Professor Hashim Ahmed

Faculty of MedicineDepartment of Surgery & Cancer

Chair in Urology (Clinical)
 
 
 
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Contact

 

hashim.ahmed

 
 
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Location

 

5L28Lab BlockCharing Cross Campus

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Summary

 

Publications

Publication Type
Year
to

274 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 Int

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 versus radical prostatectomy for unilateral localised prostate cancer., BJU Int

OBJECTIVE: To describe how clinicians conceptualised equipoise in the PART (Partial prostate Ablation versus 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 mean 1.4 (range=0-4) to 4.5 (range=0-12) patients per month) and the feasibility study reached its recruitment target. CONCLUSION: Although clinicians find it challenging to recruit participants 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. This article is protected by copyright. All rights reserved.

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., Eur Urol

BACKGROUND: Clinically significant nonmetastatic prostate cancer (PCa) is currently treated using whole-gland therapy. This approach is effective but can have urinary, sexual, and rectal side effects. OBJECTIVE: To report on 5-yr PCa control following focal high-intensity focused ultrasound (HIFU) therapy to treat individual areas of cancer within the prostate. DESIGN, SETTING, AND PARTICIPANTS: This was a prospective study of 625 consecutive patients with nonmetastatic clinically significant PCa undergoing focal HIFU therapy (Sonablate) in secondary care centres between January 1, 2006 and December 31, 2015. A minimum of 6-mo follow-up was available for599 patients. Intermediate- or high-risk PCa was found in 505 patients (84%). INTERVENTION: Disease was localised using multiparametric magnetic resonance imaging (mpMRI) combined with targeted and systematic biopsies, or transperineal mapping biopsies. Areas of significant disease were treated. Follow-up included prostate-specific antigen (PSA) measurement, mpMRI, and biopsies. OUTCOME MEASUREMENTS AND STATISTICAL ANALYSIS: The primary endpoint, failure-free survival (FFS), was defined as freedom from radical or systemic therapy, metastases, and cancer-specific mortality. RESULTS AND LIMITATIONS: The median follow-up was 56 mo (interquartile range [IQR] 35-70). The median age was 65 yr (IQR 61-71) and median preoperative PSA was 7.2 ng/ml (IQR 5.2-10.0). FFS was 99% (95% confidence interval [CI] 98-100%) at 1 yr, 92% (95% CI 90-95%) at 3 yr, and 88% (95% 85-91%) at 5 yr. For the whole patient cohort, metastasis-free, cancer-specific, and overall survival at 5 yr was 98% (95% CI 97-99%), 100%, and 99% (95% CI 97-100%), respectively. Among patients who returned validated questionnaires, 241/247 (98%) achieved complete pad-free urinary continence and none required more than 1 pad/d. Limitations include the lack of long-term follow-up. CONCLUSIONS: Focal therapy for select patients with clinically significant nonmetasta

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

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 template prostate mapping biopsies in the PICTURE study., J Urol

PURPOSE: Transperineal prostate mapping (TTPM) biopsy is an increasingly utilized method of procuring tissue from men with suspected prostate cancer. We sought to report the patient related outcome measures (PROMs) and adverse events in men undergoing this diagnostic test within the PICTURE trial. MATERIAL AND METHODS: 249 men underwent a mpMRI followed by a TTPM biopsy as a validation study. Pre-and post-TTPM functional outcomes were prospectively collected and recorded using IPSS, IPSS-QoL, IIEF-15 and EPIC-Urinary function questionnaires. RESULTS: Mean age, median PSA and median gland size was 62 years, 6.8 ng/ml and 37ml, respectively. At TTPM biopsy, a median (IQR) 49 (40-55) cores were taken. Mean time for completion of post-procedure PROMs questionnaires was 46 days. Adverse events included post procedure acute urinary retention (24%), rectal pain (26%) and perineal pain (41%). TTPM-biopsy resulted in a statistically significant increase in IPSS (10.9 to 11.8; p=0.024) and IPSS-QoL score (1.57 to 1.76; p=0.03). The erectile function score on IIEF-15 declined by 23.2% (47.7 to 38.7; p<0.001). Significant deterioration in all 5 functional domains of IIEF-15 (erectile and orgasmic function, sexual desire, intercourse and overall satisfaction; p<0.001) occurred. EPIC-Urinary scores showed no overall change from baseline. CONCLUSIONS: TTPM-biopsy causes a high urinary retention rate and a detrimental impact on genitourinary functional outcomes including deterioration in urinary flow and sexual function. Our findings can be used to ensure adequate counselling about TTPM-biopsies and point to a need for strategies such as mpMRI and targeted biopsies to minimize harms of TTPM-biopsy.

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, both visual-estimation and image-fusion for men needing a repeat biopsy in the PICTURE trial., J Urol

PURPOSE: To evaluate detection of clinically significant prostate cancer (csPCa) using MRI-targeted biopsies, and compare visual-estimation to image-fusion targeting, in patients requiring repeat prostate biopsies. MATERIALS AND METHODS: Prospective, ethics-committee approved, registered PICTURE trial enrolling 249 consecutive patients (11th/January/2012-29th/January/2014). Men underwent an mpMRI and were blinded to its results. All underwent transperineal template prostate mapping (TTPM) biopsies. In 200 with a lesion, this was preceded by visual-estimation and image-fusion targeted biopsies. For the primary endpoint, csPCa was defined as Gleason >/=4+3 and/or any grade of cancer length >/=6mm. Other definitions of csPCa were also evaluated. RESULTS: Mean (SD) age was 62.6 (7) years, median (IQR) PSA 7.17ng/ml (5.25, 10.09), mean primary lesion size 0.37cc (SD1.52), with mean 4.3 (SD2.3) targeted cores per lesion (visual-estimation and image-fusion combined) and mean 48.7 (SD12.3) TTPM-biopsy cores. TTPM-biopsies detected 97 (48.5%) cases of csPCa and 85 (42.5%) insignificant cancers. Overall, mpMRI-targeted biopsies detected 81 (40.5%) csPCa and 63 (31.5%) insignificant cancers. Eighteen (9%) with csPCa on MRI-targeted biopsies were benign or clinically insignificant on TTPM-biopsy. Thirty-four (17%) had csPCa detected on TTPM-biopsy but not on MRI-targeted biopsies; approximately half of these were present in non-targeted areas. csPCa was found with visual-estimation and image-fusion in 53/169 (31.3%) and 48/169 (28.4%) (McNemar's test, p=0.5322). Visual-estimation missed 23 (13.6%) csPCa detected by image-fusion; image-fusion missed 18 (10.8%) csPCa that visual-estimation detected. CONCLUSIONS: MRI-targeted biopsies are accurate at detection of csPCa and reducing over-diagnosis of insignificant cancers. To maximise detection both visual-estimation and image-fusion targeted biopsies are required.

JOURNAL ARTICLE

Walker NAF, Norris JM, Shah TT, Yap T, Cathcart P, Moore CM, Ahmed HU, Emberton M, Minhas Set al., 2018, A comparison of time taken to return to baseline erectile function following focal and whole gland ablative therapies for localized prostate cancer: A systematic review, UROLOGIC ONCOLOGY-SEMINARS AND ORIGINAL INVESTIGATIONS, Vol: 36, Pages: 67-76, ISSN: 1078-1439

JOURNAL ARTICLE

Ahmed HU, Bosaily AE-S, Brown LC, Gabe R, Kaplan R, Parmar MK, Collaco-Moraes Y, Ward K, Hindley RG, Freeman A, Kirkham AP, Oldroyd R, Parker C, Emberton Met al., 2017, Diagnostic accuracy of multi-parametric MRI and TRUS biopsy in prostate cancer (PROMIS): a paired validating confirmatory study, LANCET, Vol: 389, Pages: 815-822, ISSN: 0140-6736

JOURNAL ARTICLE

Ahmed HU, Brown LC, Kaplan R, Parker C, Emberton Met al., 2017, Diagnostic accuracy of the PROMIS study Reply, LANCET, Vol: 390, Pages: 362-362, ISSN: 0140-6736

JOURNAL ARTICLE

Bass EJ, Donaldson IA, Freeman A, Jameson C, Punwani S, Moore C, Arya M, Emberton M, Ahmed HUet al., 2017, Magnetic resonance imaging targeted transperineal prostate biopsy: a local anaesthetic approach, PROSTATE CANCER AND PROSTATIC DISEASES, Vol: 20, Pages: 311-317, ISSN: 1365-7852

JOURNAL ARTICLE

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