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Evaluating Diagnostic Accuracy and Inter-reader Agreement of the Prostate Imaging After Focal Ablation Scoring System.
Gelikman, David G; Kenigsberg, Alexander P; Mee Law, Yan; Yilmaz, Enis C; Harmon, Stephanie A; Parikh, Sahil H; Hyman, Jason A; Huth, Hannah; Koller, Christopher R; Nethala, Daniel; Hesswani, Charles; Merino, Maria J; Gurram, Sandeep; Choyke, Peter L; Wood, Bradford J; Pinto, Peter A; Turkbey, Baris.
Afiliación
  • Gelikman DG; Molecular Imaging Branch, National Cancer Institute, National Institutes of Health, Bethesda, MD, USA.
  • Kenigsberg AP; Urologic Oncology Branch, National Cancer Institute, National Institutes of Health, Bethesda, MD, USA.
  • Mee Law Y; Department of Radiology, Singapore General Hospital, Singapore.
  • Yilmaz EC; Molecular Imaging Branch, National Cancer Institute, National Institutes of Health, Bethesda, MD, USA.
  • Harmon SA; Molecular Imaging Branch, National Cancer Institute, National Institutes of Health, Bethesda, MD, USA.
  • Parikh SH; Urologic Oncology Branch, National Cancer Institute, National Institutes of Health, Bethesda, MD, USA.
  • Hyman JA; Urologic Oncology Branch, National Cancer Institute, National Institutes of Health, Bethesda, MD, USA.
  • Huth H; Center for Interventional Oncology, National Cancer Institute, National Institutes of Health, Bethesda, MD, USA.
  • Koller CR; Department of Radiology, Clinical Center, National Institutes of Health, Bethesda, MD, USA.
  • Nethala D; Urologic Oncology Branch, National Cancer Institute, National Institutes of Health, Bethesda, MD, USA.
  • Hesswani C; Urologic Oncology Branch, National Cancer Institute, National Institutes of Health, Bethesda, MD, USA.
  • Merino MJ; Urologic Oncology Branch, National Cancer Institute, National Institutes of Health, Bethesda, MD, USA.
  • Gurram S; Laboratory of Pathology, National Cancer Institute, National Institutes of Health, Bethesda, MD, USA.
  • Choyke PL; Urologic Oncology Branch, National Cancer Institute, National Institutes of Health, Bethesda, MD, USA.
  • Wood BJ; Molecular Imaging Branch, National Cancer Institute, National Institutes of Health, Bethesda, MD, USA.
  • Pinto PA; Center for Interventional Oncology, National Cancer Institute, National Institutes of Health, Bethesda, MD, USA.
  • Turkbey B; Department of Radiology, Clinical Center, National Institutes of Health, Bethesda, MD, USA.
Eur Urol Open Sci ; 62: 74-80, 2024 Apr.
Article en En | MEDLINE | ID: mdl-38468864
ABSTRACT
Background and

objective:

Focal therapy (FT) is increasingly recognized as a promising approach for managing localized prostate cancer (PCa), notably reducing treatment-related morbidities. However, post-treatment anatomical changes present significant challenges for surveillance using current imaging techniques. This study aimed to evaluate the inter-reader agreement and efficacy of the Prostate Imaging after Focal Ablation (PI-FAB) scoring system in detecting clinically significant prostate cancer (csPCa) on post-FT multiparametric magnetic resonance imaging (mpMRI).

Methods:

A retrospective cohort study was conducted involving patients who underwent primary FT for localized csPCa between 2013 and 2023, followed by post-FT mpMRI and a prostate biopsy. Two expert genitourinary radiologists retrospectively evaluated post-FT mpMRI using PI-FAB. The key measures included inter-reader agreement of PI-FAB scores, assessed by quadratic weighted Cohen's kappa (κ), and the system's efficacy in predicting in-field recurrence of csPCa, with a PI-FAB score cutoff of 3. Additional diagnostic metrics including sensitivity, specificity, positive predictive value (PPV), negative predictive value (NPV), and overall accuracy were also evaluated. Key findings and

limitations:

Scans from 38 patients were analyzed, revealing a moderate level of agreement in PI-FAB scoring (κ = 0.56). Both radiologists achieved sensitivity of 93% in detecting csPCa, although specificity, PPVs, NPVs, and accuracy varied. Conclusions and clinical implications The PI-FAB scoring system exhibited high sensitivity with moderate inter-reader agreement in detecting in-field recurrence of csPCa. Despite promising results, its low specificity and PPV necessitate further refinement. These findings underscore the need for larger studies to validate the clinical utility of PI-FAB, potentially aiding in standardizing post-treatment surveillance. Patient

summary:

Focal therapy has emerged as a promising approach for managing localized prostate cancer, but limitations in current imaging techniques present significant challenges for post-treatment surveillance. The Prostate Imaging after Focal Ablation (PI-FAB) scoring system showed high sensitivity for detecting in-field recurrence of clinically significant prostate cancer. However, its low specificity and positive predictive value necessitate further refinement. Larger, more comprehensive studies are needed to fully validate its clinical utility.
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Texto completo: 1 Colección: 01-internacional Base de datos: MEDLINE Idioma: En Revista: Eur Urol Open Sci Año: 2024 Tipo del documento: Article País de afiliación: Estados Unidos Pais de publicación: Países Bajos
Texto completo
Añadir a Mi BVS
Imprimir
XML
PubMed Links
Buscar en Google

Texto completo: 1 Colección: 01-internacional Base de datos: MEDLINE Idioma: En Revista: Eur Urol Open Sci Año: 2024 Tipo del documento: Article País de afiliación: Estados Unidos Pais de publicación: Países Bajos