Publications
621 results found
Connor MJ, Genie MG, Burns D, et al., 2022, A systematic review of patients' values, preferences, and expectations for the treatment of metastatic prostate cancer, European Urology Open Science, Vol: 36, Pages: 9-18, ISSN: 2666-1683
Context: Advances in systemic agents have increased overall survival for men diagnosed with metastatic prostate cancer. Additional cytoreductive prostate treatments and metastasis-directed therapies are under evaluation. These confer toxicity but may offer incremental survival benefits. Thus, an understanding of patients' values and treatment preferences is important for counselling, decision-making, and guideline development. Objective: To perform a systematic review of patients' values, preferences, and expectations regarding treatment of metastatic prostate cancer. Evidence acquisition: The MEDLINE, Embase, and CINAHL databases were systematically searched for qualitative and preference elucidation studies reporting on patients' preferences for treatment of metastatic prostate cancer. Certainty of evidence was assessed using Grading of Recommendation, Assessment, Development and Evaluation (GRADE) or GRADE Confidence in the Evidence from Reviews of Qualitative Research (CERQual). The protocol was registered on PROSPERO as CRD42020201420. Evidence synthesis: A total of 1491 participants from 15 studies met the prespecified eligibility for inclusion. The study designs included were discrete choice experiments (n = 5), mixed methods (n = 3), and qualitative methods (n = 7). Disease states reported per study were: metastatic castration-resistant prostate cancer in nine studies (60.0%), metastatic hormone-sensitive prostate cancer in two studies (13.3%), and a mixed cohort in four studies (26.6%). In quantitative preference elicitation studies, patients consistently valued treatment effectiveness and delay in time to symptoms as the two top-ranked treatment attributes (low or very low certainty). Patients were willing to trade off treatment-related toxicity for potential oncological benefits (low certainty). In qualitative studies, thematic analysis revealed cancer progression and/or survival, pain, and fatigue as key components in treatment decisions (low or very low
Brembilla G, Giganti F, Sidhu H, et al., 2022, Diagnostic accuracy of abbreviated Bi-parametric MRI (a-bpMRI) for prostate cancer detection and screening: a multi-reader study, Diagnostics, Vol: 12, Pages: 1-10, ISSN: 2075-4418
(1) Background: There is currently limited evidence on the diagnostic accuracy of abbreviated biparametric MRI (a-bpMRI) protocols for prostate cancer (PCa) detection and screening. In the present study, we aim to investigate the performance of a-bpMRI among multiple readers and its potential application to an imaging-based screening setting. (2) Methods: A total of 151 men who underwent 3T multiparametric MRI (mpMRI) of the prostate and transperineal template prostate mapping biopsies were retrospectively selected. Corresponding bpMRI (multiplanar T2WI, DWI, ADC maps) and a-bpMRI (axial T2WI and b 2000 s/mm2 DWI only) dataset were derived from mpMRI. Three experienced radiologists scored a-bpMRI, standard biparametric MRI (bpMRI) and mpMRI in separate sessions. Diagnostic accuracy and interreader agreement of a-bpMRI was tested for different positivity thresholds and compared to bpMRI and mpMRI. Predictive values of a-bpMRI were computed for lower levels of PCa prevalence to simulate a screening setting. The primary definition of clinically significant PCa (csPCa) was Gleason ≥ 4 + 3, or cancer core length ≥ 6 mm. (3) Results: The median age was 62 years, the median PSA was 6.8 ng/mL, and the csPCa prevalence was 40%. Using a cut off of MRI score ≥ 3, the sensitivity and specificity of a-bpMRI were 92% and 48%, respectively. There was no significant difference in sensitivity compared to bpMRI and mpMRI. Interreader agreement of a-bpMRI was moderate (AC1 0.58). For a low prevalence of csPCa (e.g., <10%), higher cut offs (MRI score ≥ 4) yield a more favourable balance between the predictive values and positivity rate of MRI. (4) Conclusion: Abbreviated bpMRI protocols could match the diagnostic accuracy of bpMRI and mpMRI for the detection of csPCa. If a-bpMRI is used in low-prevalence settings, higher cut-offs for MRI positivity should be prioritised.
Torres M C, Morote J, Pye H, et al., 2022, Proclarix aids in resolving indeterminate multi-parametric magnetic resonance imaging for the improved diagnosis of prostate cancer, Publisher: ELSEVIER, Pages: S727-S728, ISSN: 0302-2838
Connor MJ, Eldred-Evans D, Tam H, et al., 2022, An evaluation of screening pathways using a combination of MRI and PSA: Results from the IP1-PROSTAGRAM study, Publisher: ELSEVIER, Pages: S552-S553, ISSN: 0302-2838
Bass EJ, Tanaka BM, Connor MJ, et al., 2022, A prospective blinded validation of the rapid prostate cancer risk calculator for patients following initial multiparametric magnetic resonance imaging, Publisher: ELSEVIER, Pages: S677-S677, ISSN: 0302-2838
Bass EJ, Tanaka BM, Connor MJ, et al., 2022, Identifying men affected by changes in PSA screening in the COVID-19 pandemic, Publisher: ELSEVIER, Pages: S573-S573, ISSN: 0302-2838
Reddy DT, Eldred-Evans D, Connor M, et al., 2022, Assessing the regional variability of a pre-biopsy mpMRI and targeted prostate cancer diagnostic pathway, Publisher: ELSEVIER, Pages: S672-S673, ISSN: 0302-2838
Bass EJ, Klimowska-Nassar N, Sasikaran T, et al., 2022, PROState pathway embedded comparative trial: An update to the IP3-PROSPECT study, Publisher: ELSEVIER, Pages: S506-S506, ISSN: 0302-2838
Reddy DT, Peters M, Shah T, et al., 2022, Primary focal cryotherapy for non-metastatic prostate cancer: Update from the UK ICE registry, Publisher: ELSEVIER, Pages: S495-S496, ISSN: 0302-2838
Connor MJ, Rai A, Khoo C, et al., 2022, Patient-reported outcome measures and surgical retreatment rates from 181 patients treated with water vapor thermal therapy (Rezum™), Publisher: ELSEVIER, Pages: S1072-S1072, ISSN: 0302-2838
James C, Brunckhorst O, Fanshawe J, et al., 2022, Evaluating the baseline mental wellbeing of newly diagnosed prostate cancer patients, Publisher: ELSEVIER, Pages: S414-S414, ISSN: 0302-2838
Bertoncelli Tanaka M, Sahota K, Burn J, et al., 2022, Prostate cancer in transgender women: what does a urologist need to know?, BJU INTERNATIONAL, Vol: 129, Pages: 113-122, ISSN: 1464-4096
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- Citations: 15
Mehta P, Antonelli M, Singh S, et al., 2021, AutoProstate: towards automated reporting of prostate MRI for prostate cancer assessment using deep learning, Cancers, Vol: 13, Pages: 1-21, ISSN: 2072-6694
Multiparametric magnetic resonance imaging (mpMRI) of the prostate is used by radiologists to identify, score, and stage abnormalities that may correspond to clinically significant prostate cancer (CSPCa). Automatic assessment of prostate mpMRI using artificial intelligence algorithms may facilitate a reduction in missed cancers and unnecessary biopsies, an increase in inter-observer agreement between radiologists, and an improvement in reporting quality. In this work, we introduce AutoProstate, a deep learning-powered framework for automatic MRI-based prostate cancer assessment. AutoProstate comprises of three modules: Zone-Segmenter, CSPCa-Segmenter, and Report-Generator. Zone-Segmenter segments the prostatic zones on T2-weighted imaging, CSPCa-Segmenter detects and segments CSPCa lesions using biparametric MRI, and Report-Generator generates an automatic web-based report containing four sections: Patient Details, Prostate Size and PSA Density, Clinically Significant Lesion Candidates, and Findings Summary. In our experiment, AutoProstate was trained using the publicly available PROSTATEx dataset, and externally validated using the PICTURE dataset. Moreover, the performance of AutoProstate was compared to the performance of an experienced radiologist who prospectively read PICTURE dataset cases. In comparison to the radiologist, AutoProstate showed statistically significant improvements in prostate volume and prostate-specific antigen density estimation. Furthermore, AutoProstate matched the CSPCa lesion detection sensitivity of the radiologist, which is paramount, but produced more false positive detections.
van Son MJ, Peters M, Reddy D, et al., 2021, Conventional radical versus focal treatment for localised prostate cancer: a propensity score weighted comparison of 6-year tumour control, PROSTATE CANCER AND PROSTATIC DISEASES, Vol: 24, Pages: 1120-1128, ISSN: 1365-7852
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- Citations: 9
Connor M, Genie M, Gonzalez M, et al., 2021, Metastatic prostate cancer men’s Attitudes towards Treatment of the local Tumour and metastasis Evaluative Research (IP5-MATTER): Protocol for a prospective, multicentre discrete choice experiment study, BMJ Open, Vol: 11, Pages: 1-8, ISSN: 2044-6055
Introduction Systemic therapy with androgen deprivation therapy (ADT) and intensification with agents such as docetaxel, abiraterone acetate and enzalutamide has resulted in improved overall survival in men with de novo synchronous metastatic hormone-sensitive prostate cancer (mHSPC). Novel local cytoreductive treatments and metastasis-directed therapy are now being evaluated. Such interventions may provide added survival benefit or delay the requirement for further systemic agents and associated toxicity but can confer additional harm. Understanding men’s preferences for treatment options in this disease state is crucial for patients, clinicians, carers and future healthcare service providers.Methods Using a prospective, multicentre discrete choice experiment (DCE), we aim to determine the attributes associated with treatment that are most important to men with mHSPC. Furthermore, we plan to determine men’s preferences for, and trade-offs between, the attributes (survival and side effects) of different treatment options including systemic therapy, local cytoreductive approaches (external beam radiotherapy, cytoreductive radical prostatectomy or minimally invasive ablative therapy) and metastases-directed therapies (metastasectomy or stereotactic ablative body radiotherapy). All men with newly diagnosed mHSPC within 4 months of commencing ADT and WHO performance status 0–2 are eligible. Men who have previously consented to a cytoreductive treatment or have developed castrate-resistant disease will be excluded. This study includes a qualitative analysis component, with patients (n=15) and healthcare professionals (n=5), to identify and define the key attributes associated with treatment options that would warrant trade-off evaluation in a DCE. The main phase component planned recruitment is 300 patients over 1 year, commencing in January 2021, with planned study completion in March 2022.Ethics and dissemination Ethical approval was obt
Green S, Tuck S, Long J, et al., 2021, ReIMAGINE: a prostate cancer research consortium with added value through its patient and public involvement and engagement, Research Involvement and Engagement, Vol: 7, ISSN: 2056-7529
BACKGROUND: ReIMAGINE aims to improve the current prostate specific antigen (PSA)/biopsy risk stratification for prostate cancer (PCa) and develop a new image-based method (with biomarkers) for diagnosing high/low risk PCa in men. ReIMAGINE's varied patient and public involvement (PPI) and engagement (PE) strategy maximises the impact of its scientific output by informing and shaping the different stages of research. AIMS: Through including the voice of patients and the public, the ReIMAGINE Consortium aims to translate these different perspectives into the design and implementation process. This will improve the overall quality of the research by: reflecting the needs and priorities of patients and the public, ensuring methods and procedures are feasible and appropriate ensuring information is relevant and accessible to those being recruited to the study identifying dissemination channels relevant to patients/the public and developing outputs that are accessible to a lay audience With support from our patient/user groups, the ReIMAGINE Consortium aims to improve our ability to derive prognostic information and allocate men to the most appropriate and effective therapies, using a novel image-based risk stratification with investigation of non-imaging biomarkers. FINDINGS: We have been working with patients and the public from initiation of the project to ensure that the research is relevant to men and their families. Our PPI Sub-Committee, led by a PCa patient, has been involved in our dissemination strategy, outreach activities, and study design recommendations. For example, the sub-committee have developed a variety of informative videos relevant and accessible to those being recruited, and organised multiple online research engagement events that are accessible to a lay audience. As quoted by one of the study participants, "the more we present the benefits and opportunities to patients and the public, the more research commitment we obtain, and the sooner cr
Santaolalla A, Hulsen T, Davis J, et al., 2021, The ReIMAGINE multimodal warehouse: using artificial intelligence for accurate risk stratification of prostate cancer, Frontiers in Artificial Intelligence, Vol: 4, ISSN: 2624-8212
Introduction. Prostate cancer (PCa) is the most frequent cancer diagnosis in men worldwide. Our ability to identify those men whose cancer will decrease their lifespan and/or quality of life remains poor. The ReIMAGINE Consortium has been established to improve PCa diagnosis. Materials and methods. MRI will likely become the future cornerstone of the risk-stratification process for men at risk of early prostate cancer. We will, for the first time, be able to combine the underlying molecular changes in PCa with the state-of-the-art imaging. ReIMAGINE Screening invites men for MRI and PSA evaluation. ReIMAGINE Risk includes men at risk of prostate cancer based on MRI, and includes biomarker testing. Results. Baseline clinical information, genomics, blood, urine, fresh prostate tissue samples, digital pathology and radiomics data will be analysed. Data will be de-identified, stored with correlated mpMRI disease endotypes and linked with long term follow-up outcomes in an instance of the Philips Clinical Data Lake, consisting of cloud-based software. The ReIMAGINE platform includes application programming interfaces and a user interface that allows users to browse data, select cohorts, manage users and access rights, query data, and more. Connection to analytics tools such as Python allows statistical and stratification method pipelines to run profiling regression analyses. Discussion. The ReIMAGINE Multimodal Warehouse comprises a unique data source for PCa research, to improve risk stratification for PCa and inform clinical practice. The de-identified dataset characterized by clinical, imaging, genomics and digital pathology PCa patient phenotypes will be a valuable resource for the scientific and medical community.
Khadhouri S, Gallagher KM, MacKenzie KR, et al., 2021, The IDENTIFY study: the investigation and detection of urological neoplasia in patients referred with suspected urinary tract cancer - a multicentre observational study, Publisher: WILEY, Pages: 440-450, ISSN: 1464-4096
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- Citations: 20
Cathcart P, Ribeiro L, Moore C, et al., 2021, Outcomes of the RAFT trial: robotic surgery after focal therapy, BJU INTERNATIONAL, Vol: 128, Pages: 504-510, ISSN: 1464-4096
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- Citations: 3
Marsden T, Ahmed HU, Emberton M, 2021, An update from the ReIMAGINE Prostate Cancer Risk Study (NCT04060589): A prospective cohort study in men with a suspicion of prostate cancer who are referred onto a magnetic resonance imaging-based diagnostic pathway with donation of tissue, blood, and urine for biomarker analyses, EUROPEAN UROLOGY, Vol: 80, Pages: 398-399, ISSN: 0302-2838
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- Citations: 1
Mehta P, Antonelli M, Ahmed HU, et al., 2021, Computer-aided diagnosis of prostate cancer using multiparametric MRI and clinical features: A patient-level classification framework, MEDICAL IMAGE ANALYSIS, Vol: 73, ISSN: 1361-8415
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- Citations: 13
Bass E, Pantovic A, Connor M, et 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
Connor M, Dubash S, Bass E, et al., 2021, Clinical translation of positive metastases identified on prostate-specific membrane antigen positron emission tomography/computed tomography imaging in the management of de novo synchronous oligometastatic prostate cancer, European Urology Focus, Vol: 7, Pages: 951-954, ISSN: 2405-4569
Recent randomised evidence supports the diagnostic superiority of prostate-specific membrane antigen (PSMA) PET/CT, over conventional imaging, in the detection of distant occult metastasis in men with newly diagnosed high-risk prostate cancer. This may result in a rise in the detection of de novo synchronous hormone-sensitive “oligometastatic” prostate cancer. We outline the evidence supporting PSMA PET/CT imaging in primary staging. We also discuss the translation of positive areas, with a high probability of distant metastasis, into clinical therapeutic targets for metastasis-directed interventions. Finally, we highlight the role of PSMA PET/CT as an imaging biomarker. This may have future utility in disease monitoring and prediction of response to systemic, local cytoreductive and metastasis-directed interventions. Patient Summary: A new whole-body scan can accurately detect cancer deposits, in men in whom distant prostate cancer spread is suspected. This may be useful to monitor and predict response to drug therapy, treatments to the prostate and cancer deposits.
Connor MJ, Rai A, Khoo C, et al., 2021, PRESERVATION OF SEXUAL FUNCTION FOLLOWING REZUM® THERAPY FOR LUTS/BPHTOOGOODTO BE TRUE? REAL WORLD OUTCOMES FROM 181 CASES, Publisher: LIPPINCOTT WILLIAMS & WILKINS, Pages: E3-E3, ISSN: 0022-5347
Connor MJ, van Son M, Eldred-Evans D, et al., 2021, IMPACT OF NON-TARGETED PROSTATE SAMPLING HISTOLOGY ON THE PROBABILITY OF RECEIVING INVASIVE LOCAL TREATMENT IN AN MPMRI-TARGETED PATHWAY-ANALYSIS OF 1,719 MEN, Publisher: LIPPINCOTT WILLIAMS & WILKINS, Pages: E81-E82, ISSN: 0022-5347
Rai A, Connor MJ, Khoo CC, et al., 2021, Patient-Reported Outcomes Measures From 153 Men Treated with Water Vapour Thermal Therapy (Rezumtm) For Symptomatic Benign Prostate Hyperplasia, Publisher: OXFORD UNIV PRESS, Pages: 9-9, ISSN: 0007-1323
Stonier T, Simson N, Shah T, et al., 2021, The "Is mpMRI Enough" or IMRIE Study: A Multicentre Evaluation of Prebiopsy Multiparametric Magnetic Resonance Imaging Compared with Biopsy, EUROPEAN UROLOGY FOCUS, Vol: 7, Pages: 1027-1034
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- Citations: 14
Mehta A, Kim WC, Aswad KG, et al., 2021, Erectile Function Post Prostate Biopsy: A Systematic Review and Meta-analysis, UROLOGY, Vol: 155, Pages: 1-8, ISSN: 0090-4295
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- Citations: 5
Raison N, Musollari G, Man K, et al., 2021, PATIENT-SPECIFIC RISK FACTORS AND POST-OPERATIVE COMPLICATIONS HAVE A SIGNIFICANT IMPACT ON LONG TERM FUNCTIONAL OUTCOMES FOLLOWING RADICAL PROSTATECTOMY, Publisher: LIPPINCOTT WILLIAMS & WILKINS, Pages: E895-E895, ISSN: 0022-5347
Tanaka MB, Walter U, Eldred-Evans D, et al., 2021, RE-REFERRAL RATES IN THE MEDIUM TERM IN PATIENTS WITH A NON-SUSPICIOUS MPMRI WITHIN THE RAPID PATHWAY, Publisher: LIPPINCOTT WILLIAMS & WILKINS, Pages: E181-E181, ISSN: 0022-5347
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