Imperial College London

ProfessorAndreaRockall

Faculty of MedicineDepartment of Surgery & Cancer

Clinical Chair in Radiology
 
 
 
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a.rockall

 
 
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Location

 

ICTEM buildingHammersmith Campus

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Summary

 

Publications

Publication Type
Year
to

234 results found

Fotopoulou C, Rockall A, Lu H, Lee P, Avesani G, Russo L, Petta F, Ataseven B, Waltering K-U, Koch JA, Crum WR, Cunnea P, Heitz F, Harter P, Aboagye EO, du Bois A, Prader Set al., 2021, Validation analysis of the novel imaging-based prognostic radiomic signature in patients undergoing primary surgery for advanced high-grade serous ovarian cancer (HGSOC), BRITISH JOURNAL OF CANCER, ISSN: 0007-0920

Journal article

Reinhold C, Sadowski EA, Rockall A, Thomassin-Naggara Iet al., 2021, Clarifying Postcontrast Enhancement Sequences for Implementation and Interpretation of the ACR OvarianAdnexal Reporting and Data Systems MRI Risk Stratification and Management System Response, JOURNAL OF THE AMERICAN COLLEGE OF RADIOLOGY, Vol: 18, Pages: 1594-1595, ISSN: 1546-1440

Journal article

Shinagare AB, Sadowski EA, Park H, Brook OR, Forstner R, Wallace SK, Horowitz JM, Horowitz N, Javitt M, Jha P, Kido A, Lakhman Y, Lee S, Manganaro L, Maturen KE, Nougaret S, Poder L, Rauch GM, Reinhold C, Sala E, Thomassin-Naggara I, Vargas HA, Venkatesan A, Nikolic O, Rockall AGet al., 2021, Ovarian cancer reporting lexicon for computed tomography (CT) and magnetic resonance (MR) imaging developed by the SAR Uterine and Ovarian Cancer Disease-Focused Panel and the ESUR Female Pelvic Imaging Working Group, EUROPEAN RADIOLOGY, ISSN: 0938-7994

Journal article

Raison N, Servian P, Patel A, Santhirasekaram A, Smith A, Yeung M, Lloyd J, Mannion E, Rockall A, Ahmed H, Winkler Met al., 2021, Is tumour volume an independent predictor of outcome after radical prostatectomy for high-risk prostate cancer?, PROSTATE CANCER AND PROSTATIC DISEASES, ISSN: 1365-7852

Journal article

Seebacher V, Rockall A, Nobbenhuis M, Sohaib SA, Knogler T, Alvarez RM, Kolomainen D, Shepherd JH, Shaw C, Barton DPet al., 2021, The impact of nutritional risk factors and sarcopenia on survival in patients treated with pelvic exenteration for recurrent gynaecological malignancy: a retrospective cohort study, ARCHIVES OF GYNECOLOGY AND OBSTETRICS, ISSN: 0932-0067

Journal article

Cushnan D, Berka R, Bertolli O, Williams P, Schofield D, Joshi I, Favaro A, Halling-Brown M, Imreh G, Jefferson E, Sebire NJ, Reilly G, Rodrigues JCL, Robinson G, Copley S, Malik R, Bloomfield C, Gleeson F, Crotty M, Denton E, Dickson J, Leeming G, Hardwick HE, Baillie K, Openshaw PJM, Semple MG, Rubin C, Howlett A, Rockall AG, Bhayat A, Fascia D, Sudlow C, Jacob Jet al., 2021, Towards nationally curated data archives for clinical radiology image analysis at scale: Learnings from national data collection in response to a pandemic, DIGITAL HEALTH, Vol: 7, ISSN: 2055-2076

Journal article

Thomassin-Naggara I, Sadowski E, Rockall A, Reinhold Cet al., 2021, Correspondence on "ESGO/ISUOG/IOTA/ESGE consensus statement on pre-operative diagnosis of ovarian tumors" by Timmerman et al, INTERNATIONAL JOURNAL OF GYNECOLOGICAL CANCER, Vol: 31, Pages: 1394-1395, ISSN: 1048-891X

Journal article

Qaiser T, Winzeck S, Barfoot T, Barwick T, Doran SJ, Kaiser MF, Wedlake L, Tunariu N, Koh D-M, Messiou C, Rockall A, Glocker Bet al., 2021, Multiple instance learning with auxiliary task weighting for multiple myeloma classification, International Conference on Medical Image Computing and Computer Assisted Intervention (MICCAI)

Whole body magnetic resonance imaging (WB-MRI) is the recommended modalityfor diagnosis of multiple myeloma (MM). WB-MRI is used to detect sites ofdisease across the entire skeletal system, but it requires significantexpertise and is time-consuming to report due to the great number of images. Toaid radiological reading, we propose an auxiliary task-based multiple instancelearning approach (ATMIL) for MM classification with the ability to localizesites of disease. This approach is appealing as it only requires patient-levelannotations where an attention mechanism is used to identify local regions withactive disease. We borrow ideas from multi-task learning and define anauxiliary task with adaptive reweighting to support and improve learningefficiency in the presence of data scarcity. We validate our approach on bothsynthetic and real multi-center clinical data. We show that the MIL attentionmodule provides a mechanism to localize bone regions while the adaptivereweighting of the auxiliary task considerably improves the performance.

Conference paper

Rockall A, Barwick T, Wilson W, Singh N, Bharwani N, Sohaib A, Nobbenhuis M, Warbey V, Miquel M, Koh D-M, De Paepe KN, Martin-Hirsch P, Ghaem-Maghami S, Fotopoulou C, Stringfellow H, Sundar S, Manchanda R, Sahdev A, Hackshaw A, Cook GJ, MAPPING Study Groupet al., 2021, Diagnostic accuracy of FEC-PET/CT, FDG-PET/CT and diffusion-weighted MRI in detection of nodal metastases in surgically treated endometrial and cervical carcinoma, Clinical Cancer Research, ISSN: 1078-0432

Purpose:Pre-operative nodal staging is important for planning treatment in cervical cancer (CC) and endometrial cancer (EC) but remains challenging. We compare nodal staging accuracy of 18F-ethyl-choline-(FEC)-PET/CT, 18F-Fluoro-deoxy-glucose-(FDG)-PET/CT and diffusion-weighted-MRI (DW-MRI) with conventional morphological MRI.Experimetal Design:A prospective, multicentre observational study of diagnostic accuracy for nodal metastases was undertaken in 5 gyne-oncology centres. FEC-PET/CT, FDG-PET/CT and DW-MRI were compared to nodal size and morphology on MRI. Reference standard was strictly correlated nodal histology. Eligibility included operable CC stage=>1B1 or EC (grade 3 any stage with myometrial invasion or grade 1-2 stage=>II). Results:Among 162 consenting participants, 136 underwent study DW-MRI and FDG-PET/CT, and 60 underwent FEC-PET/CT. 267 nodal regions in 118 women were strictly correlated at histology (nodal positivity rate 25%). Sensitivity per-patient (n=118) for nodal size, morphology, DW-MRI, FDG- and FEC-PET/CT were 40%*, 53%, 53%, 63%* and 67% for all cases (*p=0.016); 10%, 10%, 20%, 30% and 25% in CC (n=40); 65%, 75%, 70%, 80% and 88% in EC (n=78). FDG-PET/CT outperformed nodal size (p=0.006) and size ratio (p=0.04) for per-region sensitivity. False positive rates were all <10%. Conclusions:All imaging techniques had low sensitivity for detection of nodal metastases and cannot replace surgical nodal staging. The performance of FEC-PET/CT was not statistically different to other techniques that are more widely available. FDG-PET/CT had higher sensitivity than size in detecting nodal metastases. False positive rates were low across all methods. The low false positive rate demonstrated by FDG-PET/CT may be helpful in arbitration of challenging surgical planning decisions.

Journal article

Bass E, Pantovic A, Connor M, Gabe R, Padhani A, Rockall A, Sokhi H, Tam H, Winkler M, Ahmed Het al., 2021, A systematic review and meta-analysis of the diagnostic accuracy of biparametric prostate MRI for prostate cancer in men at risk, Prostate Cancer and Prostatic Diseases, Vol: 24, Pages: 596-611, ISSN: 1365-7852

IntroductionMultiparametric magnetic resonance imaging (mpMRI), the use of three multiple imaging sequences, typically T2-weighted, diffusion weighted (DWI) and dynamic contrast enhanced (DCE) images, has a high sensitivity and specificity for detecting significant cancer. Current guidance now recommends its use prior to biopsy. However, the impact of DCE is currently under debate regarding test accuracy. Biparametric MRI (bpMRI), using only T2 and DWI has been proposed as a viable alternative. We conducted a contemporary systematic review and meta-analysis to further examine the diagnostic performance of bpMRI in the diagnosis of any and clinically significant prostate cancer.MethodsA systematic review of the literature from 01/01/2017 to 06/07/2019 was performed by two independent reviewers using predefined search criteria. The index test was biparametric MRI and the reference standard whole-mount prostatectomy or prostate biopsy. Quality of included studies was assessed by the QUADAS-2 tool. Statistical analysis included pooled diagnostic performance (sensitivity; specificity; AUC), meta-regression of possible covariates and head-to-head comparisons of bpMRI and mpMRI where both were performed in the same study.ResultsForty-four articles were included in the analysis. The pooled sensitivity for any cancer detection was 0.84 (95% CI, 0.80–0.88), specificity 0.75 (95% CI, 0.68–0.81) for bpMRI. The summary ROC curve yielded a high AUC value (AUC = 0.86). The pooled sensitivity for clinically significant prostate cancer was 0.87 (95% CI, 0.78–0.93), specificity 0.72 (95% CI, 0.56–0.84) and the AUC value was 0.87. Meta-regression analysis revealed no difference in the pooled diagnostic estimates between bpMRI and mpMRI.ConclusionsThis meta-analysis on contemporary studies shows that bpMRI offers comparable test accuracies to mpMRI in detecting prostate cancer. These data are broadly supportive of the bpMRI approach but heterogeneity does not al

Journal article

Brady AP, Visser J, Frija G, Bargallo N, Rockall A, Brkljacic B, Fuchsjaeger M, Birch J, Becker M, Kroencke Tet al., 2021, Value-based radiology: what is the ESR doing, and what should we do in the future?, INSIGHTS INTO IMAGING, Vol: 12, ISSN: 1869-4101

Journal article

Manganaro L, Lakhman Y, Bharwani N, Gui B, Gigli S, Vinci V, Rizzo S, Kido A, Cunha TM, Sala E, Rockall A, Forstner R, Nougaret Set al., 2021, Staging, recurrence and follow-up of uterine cervical cancer using MRI: Updated Guidelines of the European Society of Urogenital Radiology after revised FIGO staging 2018 (Apr, 10.1007/s00330-020-07632-9, 2021), EUROPEAN RADIOLOGY, Vol: 32, Pages: 738-738, ISSN: 0938-7994

Journal article

Thomassin-Naggara I, Belghitti M, Milon A, Wahab CA, Sadowski E, Rockall AGet al., 2021, O-RADS MRI score: analysis of misclassified cases in a prospective multicentric European cohort, EUROPEAN RADIOLOGY, Vol: 31, Pages: 9588-9599, ISSN: 0938-7994

Journal article

Reinhold C, Rockall A, Sadowski EA, Siegelman ES, Maturen KE, Vargas HA, Forstner R, Glanc P, Andreotti RF, Thomassin-Naggara Iet al., 2021, Ovarian-Adnexal Reporting Lexicon for MRI: A White Paper of the ACR Ovarian-Adnexal Reporting and Data Systems MRI Committee, JOURNAL OF THE AMERICAN COLLEGE OF RADIOLOGY, Vol: 18, Pages: 713-729, ISSN: 1546-1440

Journal article

Bernstein D, Taylor A, Nill S, Imseeh G, Kothari G, Llewelyn M, De Paepe KN, Rockall A, Shiarli A-M, Oelfke Uet al., 2021, An Inter-observer Study to Determine Radiotherapy Planning Target Volumes for Recurrent Gynaecological Cancer Comparing Magnetic Resonance Imaging Only With Computed Tomography-Magnetic Resonance Imaging, CLINICAL ONCOLOGY, Vol: 33, Pages: 307-313, ISSN: 0936-6555

Journal article

Manganaro L, Lakhman Y, Bharwani N, Gui B, Gigli S, Vinci V, Rizzo S, Kido A, Cunha TM, Sala E, Rockall A, Forstner R, Nougaret Set al., 2021, Staging, recurrence and follow-up of uterine cervical cancer using MRI: Updated Guidelines of the European Society of Urogenital Radiology after revised FIGO staging 2018, EUROPEAN RADIOLOGY, Vol: 31, Pages: 7802-7816, ISSN: 0938-7994

Journal article

Dawood MT, Naik M, Bharwani N, Sudderuddin SA, Rockall AG, Stewart VRet al., 2021, Adnexal Torsion: Review of Radio-logic Appearances, RADIOGRAPHICS, Vol: 41, Pages: 609-624, ISSN: 0271-5333

Journal article

Barwick T, Orton M, Koh DM, Kaiser M, Rockall A, Tunariu N, Blackledge M, Messiou Cet al., 2021, Repeatability and reproducibility of apparent diffusion coefficient and fat fraction measurement of focal myeloma lesions on whole body magnetic resonance imaging, BRITISH JOURNAL OF RADIOLOGY, Vol: 94, ISSN: 0007-1285

Journal article

Sadowski EA, Maturen KE, Rockall A, Reinhold C, Addley H, Jha P, Bharwani N, Thomassin-Naggara Iet al., 2021, Ovary: MRI characterisation and O-RADS MRI, BRITISH JOURNAL OF RADIOLOGY, Vol: 94, ISSN: 0007-1285

Journal article

Santhirasekaram A, Pinto K, Winkler M, Aboagye E, Glocker B, Rockall Aet al., 2021, Multi-scale Hybrid Transformer Networks: Application to Prostate Disease Classification, Pages: 12-21, ISSN: 0302-9743

Automated disease classification could significantly improve the accuracy of prostate cancer diagnosis on MRI, which is a difficult task even for trained experts. Convolutional neural networks (CNNs) have shown some promising results for disease classification on multi-parametric MRI. However, CNNs struggle to extract robust global features about the anatomy which may provide important contextual information for further improving classification accuracy. Here, we propose a novel multi-scale hybrid CNN/transformer architecture with the ability of better contextualising local features at different scales. In our application, we found this to significantly improve performance compared to using CNNs. Classification accuracy is even further improved with a stacked ensemble yielding promising results for binary classification of prostate lesions into clinically significant or non-significant.

Conference paper

Arshad MA, Gitau S, Tam H, Park W-HE, Patel NH, Rockall A, Aboagye EO, Bharwani N, Barwick TDet al., 2020, Optimal method for metabolic tumour volume assessment of cervical cancers with inter-observer agreement on [18F]-fluoro-deoxy-glucose positron emission tomography with computed tomography, European Journal of Nuclear Medicine and Molecular Imaging, Pages: 1-15, ISSN: 0340-6997

PurposeCervical cancer metabolic tumour volume (MTV) derived from [18F]-FDG PET/CT has a role in prognostication and therapy planning. There is no standard method of outlining MTV on [18F]-FDG PET/CT. The aim of this study was to assess the optimal method to outline primary cervical tumours on [18F]-FDG PET/CT using MRI-derived tumour volumes as the reference standard.Methods81 consecutive cervical cancer patients with pre-treatment staging MRI and [18F]-FDG PET/CT imaging were included. MRI volumes were compared with different PET segmentation methods. Method 1 measured MTVs at different SUVmax thresholds ranging from 20 to 60% (MTV20-MTV60) with bladder masking and manual adjustment when required. Method 2 created an isocontour around the tumour prior to different SUVmax thresholds being applied. Method 3 used an automated gradient method. Inter-observer agreement of MTV, following manual adjustment when required, was recorded.ResultsFor method 1, the MTV25 and MTV30 were closest to the MRI volumes for both readers (mean percentage change from MRI volume of 2.9% and 13.4% for MTV25 and − 13.1% and − 2.0% for MTV30 for readers 1 and 2). 70% of lesions required manual adjustment at MTV25 compared with 45% at MTV30. There was excellent inter-observer agreement between MTV30 to MTV60 (ICC ranged from 0.898–0.976 with narrow 95% confidence intervals (CIs)) and moderate agreement at lower thresholds (ICC estimates of 0.534 and 0.617, respectively for the MTV20 and MTV25 with wide 95% CIs). Bladder masking was performed in 86% of cases overall. For method 2, excellent correlation was demonstrated at MTV25 and MTV30 (mean % change from MRI volume of −3.9% and − 8.6% for MTV25 and − 16.9% and 19% for MTV30 for readers 1 and 2, respectively). This method also demonstrated excellent ICC across all thresholds with no manual adjustment. Method 3 demonstrated excellent ICC of 0.96 (95% CI 0.94–0.97) but had a

Journal article

Rockall A, Rockall A, Brady AP, Derchi LE, Birch Jet al., 2020, The identity and role of the radiologist in 2020: a survey among ESR full radiologist members, INSIGHTS INTO IMAGING, Vol: 11, ISSN: 1869-4101

Journal article

Salib MY, Russell JHB, Stewart VR, Sudderuddin SA, Barwick TD, Rockall AG, Bharwani Net al., 2020, 2018 FIGO Staging Classification for Cervical Cancer: Added Benefits of Imaging, RADIOGRAPHICS, Vol: 40, Pages: 1807-1822, ISSN: 0271-5333

Journal article

Thomassin-Naggara I, Rockall A, 2020, Editorial for "Validity and Reproducibility of ADNEX MR SCORING System in Diagnosis of Sonographically Indeterminate Adnexal Masses", JOURNAL OF MAGNETIC RESONANCE IMAGING, Vol: 53, Pages: 640-641, ISSN: 1053-1807

Journal article

Kanavati F, Islam S, Arain Z, Aboagye EO, Rockall Aet al., 2020, Fully-automated deep learning slice-based muscle estimation from CT images for sarcopenia assessment, Publisher: arXiv

Objective: To demonstrate the effectiveness of using a deep learning-basedapproach for a fully automated slice-based measurement of muscle mass forassessing sarcopenia on CT scans of the abdomen without any case exclusioncriteria. Materials and Methods: This retrospective study was conducted using acollection of public and privately available CT images (n = 1070). The methodconsisted of two stages: slice detection from a CT volume and single-slice CTsegmentation. Both stages used Fully Convolutional Neural Networks (FCNN) andwere based on a UNet-like architecture. Input data consisted of CT volumes witha variety of fields of view. The output consisted of a segmented muscle mass ona CT slice at the level of L3 vertebra. The muscle mass is segmented intoerector spinae, psoas, and rectus abdominus muscle groups. The output wastested against manual ground-truth segmentation by an expert annotator. Results: 3-fold cross validation was used to evaluate the proposed method.The slice detection cross validation error was 1.41+-5.02 (in slices). Thesegmentation cross validation Dice overlaps were 0.97+-0.02, 0.95+-0.04,0.94+-0.04 for erector spinae, psoas, and rectus abdominus, respectively, and0.96+-0.02 for the combined muscle mass. Conclusion: A deep learning approach to detect CT slices and segment musclemass to perform slice-based analysis of sarcopenia is an effective andpromising approach. The use of FCNN to accurately and efficiently detect aslice in CT volumes with a variety of fields of view, occlusions, and slicethicknesses was demonstrated.

Working paper

Miles A, Evans REC, Halligan S, Beare S, Bridgewater J, Goh V, Janes SM, Navani N, Oliver A, Morton A, Morris S, Rockall A, Taylor SAet al., 2020, Predictors of patient preference for either whole body magnetic resonance imaging (WB-MRI) or CT/ PET-CT for staging colorectal or lung cancer, JOURNAL OF MEDICAL IMAGING AND RADIATION ONCOLOGY, Vol: 64, Pages: 537-545, ISSN: 1754-9477

Journal article

Avesani G, Arshad M, Lu H, Fotopoulou C, Cannone F, Melotti R, Aboagye E, Rockall Aet al., 2020, Radiological assessment of Peritoneal Cancer Index on preoperative CT in ovarian cancer is related to surgical outcome and survival, RADIOLOGIA MEDICA, Vol: 125, Pages: 770-776, ISSN: 0033-8362

Journal article

Evans REC, Taylor SA, Kalasthry J, Sakai NS, Miles A, Streamline investigatorset al., 2020, Patient deprivation and perceived scan burden negatively impact the quality of whole-body MRI., Clinical Radiology, Vol: 75, Pages: 308-315, ISSN: 0009-9260

AIM: To evaluate the association between the image quality of cancer staging whole-body magnetic resonance imaging (WB-MRI) and patient demographics, distress, and perceived scan burden. MATERIALS AND METHODS: A sample of patients recruited prospectively to multicentre trials comparing WB-MRI with standard scans for staging lung and colorectal cancer were invited to complete two questionnaires. The baseline questionnaire, administered at recruitment, collated data on demographics, distress and co-morbidity. The follow-up questionnaire, completed after staging investigations, measured perceived WB-MRI scan burden (scored 1 low to 7 high). WB-MRI anatomical coverage, and technical quality was graded by a radiographic technician and grading combined to categorise the scan as "optimal", "sub-optimal" or "degraded". A radiologist categorised 30 scans to test interobserver agreement. Data were analysed using the chi-square, Fisher's exact, t-tests, and multinomial regression. RESULTS: One hundred and fourteen patients were included in the study (53 lung, 61 colorectal; average age 65.3 years, SD=11.8; 66 men [57.9%]). Overall, 45.6% (n=52), scans were classified as "optimal" quality, 39.5% (n=45) "sub-optimal", and 14.9% (n=17) as "degraded". In adjusted analyses, greater deprivation level and higher patient-reported scan burden were both associated with a higher likelihood of having a sub-optimal versus an optimal scan (odds ratio [OR]: 4.465, 95% confidence interval [CI]: 1.454 to 13.709, p=0.009; OR: 1.987, CI: 1.153 to 3.425, p=0.013, respectively). None of the variables predicted the likelihood of having a degraded scan. CONCLUSIONS: Deprivation and patients' perceived experience of the WB-MRI are related to image quality. Tailored protocols and individualised patient management before and during WB-MRI may improve image quality.

Journal article

Rockall A, Howlett D, Brady A, Bonomo L, Frija G, Hierath Met al., 2020, The current status of radiological clinical audit and feedback on the ESR Guide to Clinical Audit in Radiology and the ESR Clinical Audit Tool (Esperanto) – an ESR Survey of European Radiology Departments, Insights into Imaging, Vol: 11, ISSN: 1869-4101

Clinical audit “according to national procedures” is a legal requirement as defined within the recently implemented European Council Basic Safety Standards Directive (BSSD), 2013/59/Euratom. A survey was undertaken in 2019 to assess the current status of clinical audit in European radiology departments and for feedback on the recently published “ESR Guide to Clinical Audit in Radiology” and the “ESR Clinical Audit Tool (Esperanto)”. The survey was distributed within the European Society of Radiology (ESR) EuroSafe Imaging Star network and also to European national radiological societies which are institutional members of the ESR.

Journal article

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