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1. On Undesired Emergent Behaviors in Compound Prostate Cancer Detection Systems

Author

Sortland Rolfsnes, Erlend, Thangngat, Philip, Eftestøl, Trygve, Nordström, Tobias, Jäderling, Fredrik, Eklund, Martin, Fernandez-Quilez, Alvaro, Goos, Gerhard, Series Editor, Hartmanis, Juris, Founding Editor, Bertino, Elisa, Editorial Board Member, Gao, Wen, Editorial Board Member, Steffen, Bernhard, Editorial Board Member, Yung, Moti, Editorial Board Member, Ali, Sharib, editor, van der Sommen, Fons, editor, Papież, Bartłomiej Władysław, editor, Ghatwary, Noha, editor, Jin, Yueming, editor, and Kolenbrander, Iris, editor

Published
2025
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4. Reconsidering evaluation practices in modular systems: On the propagation of errors in MRI prostate cancer detection

Author

Rolfsnes, Erlend Sortland, Thangngat, Philip, Eftestøl, Trygve, Nordström, Tobias, Jäderling, Fredrik, Eklund, Martin, and Fernandez-Quilez, Alvaro

Subjects
Electrical Engineering and Systems Science - Image and Video Processing, Computer Science - Computer Vision and Pattern Recognition, Physics - Medical Physics
Abstract

Magnetic resonance imaging has evolved as a key component for prostate cancer (PCa) detection, substantially increasing the radiologist workload. Artificial intelligence (AI) systems can support radiological assessment by segmenting and classifying lesions in clinically significant (csPCa) and non-clinically significant (ncsPCa). Commonly, AI systems for PCa detection involve an automatic prostate segmentation followed by the lesion detection using the extracted prostate. However, evaluation reports are typically presented in terms of detection under the assumption of the availability of a highly accurate segmentation and an idealistic scenario, omitting the propagation of errors between modules. For that purpose, we evaluate the effect of two different segmentation networks (s1 and s2) with heterogeneous performances in the detection stage and compare it with an idealistic setting (s1:89.90+-2.23 vs 88.97+-3.06 ncsPCa, P<.001, 89.30+-4.07 and 88.12+-2.71 csPCa, P<.001). Our results depict the relevance of a holistic evaluation, accounting for all the sub-modules involved in the system., Comment: Under review

Published
2023

5. Leveraging multi-view data without annotations for prostate MRI segmentation: A contrastive approach

Author

Lindeijer, Tim Nikolass, Ytredal, Tord Martin, Eftestøl, Trygve, Nordström, Tobias, Jäderling, Fredrik, Eklund, Martin, and Fernandez-Quilez, Alvaro

Subjects
Electrical Engineering and Systems Science - Image and Video Processing, Computer Science - Computer Vision and Pattern Recognition
Abstract

An accurate prostate delineation and volume characterization can support the clinical assessment of prostate cancer. A large amount of automatic prostate segmentation tools consider exclusively the axial MRI direction in spite of the availability as per acquisition protocols of multi-view data. Further, when multi-view data is exploited, manual annotations and availability at test time for all the views is commonly assumed. In this work, we explore a contrastive approach at training time to leverage multi-view data without annotations and provide flexibility at deployment time in the event of missing views. We propose a triplet encoder and single decoder network based on U-Net, tU-Net (triplet U-Net). Our proposed architecture is able to exploit non-annotated sagittal and coronal views via contrastive learning to improve the segmentation from a volumetric perspective. For that purpose, we introduce the concept of inter-view similarity in the latent space. To guide the training, we combine a dice score loss calculated with respect to the axial view and its manual annotations together with a multi-view contrastive loss. tU-Net shows statistical improvement in dice score coefficient (DSC) with respect to only axial view (91.25+-0.52% compared to 86.40+-1.50%,P<.001). Sensitivity analysis reveals the volumetric positive impact of the contrastive loss when paired with tU-Net (2.85+-1.34% compared to 3.81+-1.88%,P<.001). Further, our approach shows good external volumetric generalization in an in-house dataset when tested with multi-view data (2.76+-1.89% compared to 3.92+-3.31%,P=.002), showing the feasibility of exploiting non-annotated multi-view data through contrastive learning whilst providing flexibility at deployment in the event of missing views., Comment: Under review

Published
2023

6. Prostate Age Gap (PAG): An MRI surrogate marker of aging for prostate cancer detection

Author

Fernandez-Quilez, Alvaro, Nordström, Tobias, Jäderling, Fredrik, Kjosavik, Svein Reidar, and Eklund, Martin

Subjects
Computer Science - Computer Vision and Pattern Recognition
Abstract

Background: Prostate cancer (PC) MRI-based risk calculators are commonly based on biological (e.g. PSA), MRI markers (e.g. volume), and patient age. Whilst patient age measures the amount of years an individual has existed, biological age (BA) might better reflect the physiology of an individual. However, surrogates from prostate MRI and linkage with clinically significant PC (csPC) remain to be explored. Purpose: To obtain and evaluate Prostate Age Gap (PAG) as an MRI marker tool for csPC risk. Study type: Retrospective. Population: A total of 7243 prostate MRI slices from 468 participants who had undergone prostate biopsies. A deep learning model was trained on 3223 MRI slices cropped around the gland from 81 low-grade PC (ncsPC, Gleason score <=6) and 131 negative cases and tested on the remaining 256 participants. Assessment: Chronological age was defined as the age of the participant at the time of the visit and used to train the deep learning model to predict the age of the patient. Following, we obtained PAG, defined as the model predicted age minus the patient's chronological age. Multivariate logistic regression models were used to estimate the association through odds ratio (OR) and predictive value of PAG and compared against PSA levels and PI-RADS>=3. Statistical tests: T-test, Mann-Whitney U test, Permutation test and ROC curve analysis. Results: The multivariate adjusted model showed a significant difference in the odds of clinically significant PC (csPC, Gleason score >=7) (OR =3.78, 95% confidence interval (CI):2.32-6.16, P <.001). PAG showed a better predictive ability when compared to PI-RADS>=3 and adjusted by other risk factors, including PSA levels: AUC =0.981 vs AUC =0.704, p<.001. Conclusion: PAG was significantly associated with the risk of clinically significant PC and outperformed other well-established PC risk factors., Comment: Under review

Published
2023

7. Artificial intelligence and radiologists in prostate cancer detection on MRI (PI-CAI): an international, paired, non-inferiority, confirmatory study

Author

Saha, Anindo, Bosma, Joeran S., Twilt, Jasper J., van Ginneken, Bram, Noordman, Constant R., Slootweg, Ivan, Roest, Christian, Fransen, Stefan J., Sunoqrot, Mohammed R.S., Bathen, Tone F., Rouw, Dennis, Immerzeel, Jos, Geerdink, Jeroen, van Run, Chris, Groeneveld, Miriam, Meakin, James, Karagöz, Ahmet, Bône, Alexandre, Routier, Alexandre, Marcoux, Arnaud, Abi-Nader, Clément, Li, Cynthia Xinran, Feng, Dagan, Alis, Deniz, Karaarslan, Ercan, Ahn, Euijoon, Nicolas, François, Sonn, Geoffrey A., Bhattacharya, Indrani, Kim, Jinman, Shi, Jun, Jahanandish, Hassan, An, Hong, Kan, Hongyu, Oksuz, Ilkay, Qiao, Liang, Rohé, Marc-Michel, Yergin, Mert, Khadra, Mohamed, Şeker, Mustafa E., Kartal, Mustafa S., Debs, Noëlie, Fan, Richard E., Saunders, Sara, Soerensen, Simon J.C., Moroianu, Stefania, Vesal, Sulaiman, Yuan, Yuan, Malakoti-Fard, Afsoun, Mačiūnien, Agnė, Kawashima, Akira, de Sousa Machadov, Ana M.M. de M.G., Moreira, Ana Sofia L., Ponsiglione, Andrea, Rappaport, Annelies, Stanzione, Arnaldo, Ciuvasovas, Arturas, Turkbey, Baris, de Keyzer, Bart, Pedersen, Bodil G., Eijlers, Bram, Chen, Christine, Riccardo, Ciabattoni, Courrech Staal, Ewout F.W., Jäderling, Fredrik, Langkilde, Fredrik, Aringhieri, Giacomo, Brembilla, Giorgio, Son, Hannah, Vanderlelij, Hans, Raat, Henricus P.J., Pikūnienė, Ingrida, Macova, Iva, Schoots, Ivo, Caglic, Iztok, Zawaideh, Jeries P., Wallström, Jonas, Bittencourt, Leonardo K., Khurram, Misbah, Choi, Moon H., Takahashi, Naoki, Tan, Nelly, Franco, Paolo N., Gutierrez, Patricia A., Thimansson, Per Erik, Hanus, Pieter, Puech, Philippe, Rau, Philipp R., de Visschere, Pieter, Guillaume, Ramette, Cuocolo, Renato, Falcão, Ricardo O., van Stiphout, Rogier S.A., Girometti, Rossano, Briediene, Ruta, Grigienė, Rūta, Gitau, Samuel, Withey, Samuel, Ghai, Sangeet, Penzkofer, Tobias, Barrett, Tristan, Tammisetti, Varaha S., Løgager, Vibeke B., Černý, Vladimír, Venderink, Wulphert, Law, Yan M., Lee, Young J., Bjartell, Anders, Padhani, Anwar R., Bonekamp, David, Villeirs, Geert, Salomon, Georg, Giannarini, Gianluca, Kalpathy-Cramer, Jayashree, Barentsz, Jelle, Maier-Hein, Klaus H., Rusu, Mirabela, Obuchowski, Nancy A., Rouvière, Olivier, van den Bergh, Roderick, Panebianco, Valeria, Kasivisvanathan, Veeru, Yakar, Derya, Elschot, Mattijs, Veltman, Jeroen, Fütterer, Jurgen J., de Rooij, Maarten, Huisman, Henkjan, Bosma, Joeran S, Twilt, Jasper J, Padhani, Anwar R, Maier-Hein, Klaus H, Obuchowski, Nancy A, and Fütterer, Jurgen J

Published
2024
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10. Characteristics of Patients in SPCG-15—A Randomized Trial Comparing Radical Prostatectomy with Primary Radiotherapy plus Androgen Deprivation Therapy in Men with Locally Advanced Prostate Cancer

Author

Gongora, Magdalena, Stranne, Johan, Johansson, Eva, Bottai, Matteo, Thellenberg Karlsson, Camilla, Brasso, Klaus, Hansen, Steinbjørn, Jakobsen, Henrik, Jäderling, Fredrik, Lindberg, Henriette, Lilleby, Wolfgang, Meidahl Petersen, Peter, Mirtti, Tuomas, Olsson, Mats, Rannikko, Antti, Røder, Martin Andreas, Henrik Vincent, Per, and Akre, Olof

Published
2022
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12. Prostate cancer screening using a combination of risk-prediction, MRI, and targeted prostate biopsies (STHLM3-MRI): a prospective, population-based, randomised, open-label, non-inferiority trial

Author

Cavalli-Björkman, Carin, Björklund, Astrid, Hune, Britt-Marie, Clements, Mark, Hao, Shuang, Discacciati, Andrea, Grönberg, Henrik, Eklund, Martin, Nordström, Tobias, Carlsson, Stefan, Aly, Markus, Walldén, Mats, Steinberg, Ola, Andersson, Karl, Jäderling, Fredrik, Wimmercranz, Fredrik, Meurling, Edward, Gleassgen, Axel, Majeed, Nada, Awadelkarim, Rihab, Fyhr, Ing-Marie, Sandström, Dag, Waage, Linda, Imamov, Otabek, Lantz, Rafael, Thorstensson, Andreas, Stiernstedt, Carl, Wande, Dushaid, Trygg, Gunnar, Söderbäck, Harald, Michajlowski, Jerzy, Leykamm, Lars, Svedberg, Nils-Erik, Bergman, Tommy, Sabockis, Raimundas, Akrawi, Sirvan, Bergman, Martin, Annerstedt, Magnus, and Glaessgen, Axel

Published
2021
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15. Prostate Age Gap: An MRI Surrogate Marker of Aging for Prostate Cancer Detection.

Author

Fernandez‐Quilez, Alvaro, Nordström, Tobias, Jäderling, Fredrik, Kjosavik, Svein Reidar, and Eklund, Martin

Subjects
BIOMARKERS, EARLY detection of cancer, RADIOLOGIC technology, PROSTATE, PROSTATE cancer, MAGNETIC resonance imaging, HOOKAHS
Abstract

Background: Aging is the most important risk factor for prostate cancer (PC). Imaging techniques can be useful to measure age‐related changes associated with the transition to diverse pathological states. However, biomarkers of aging from prostate magnetic resonance imaging (MRI) remain to be explored. Purpose: To develop an aging biomarker from prostate MRI and to examine its relationship with clinically significant PC (csPC, Gleason score ≥7) risk occurrence. Study Type: Retrospective. Population: Four hundred and sixty‐eight (65.97 ± 6.91 years) biopsied males, contributing 7243 prostate MRI slices. A deep learning (DL) model was trained on 3223 MRI slices from 81 low‐grade PC (Gleason score ≤6) and 131 negative patients, defined as non‐csPC. The model was tested on 90 negative, 52 low‐grade (142 non‐csPC), and 114 csPC patients. Field Strength/Sequence: 3‐T, axial T2‐weighted spin sequence. Assessment: Chronological age was defined as the age of the participant at the time of the visit. Prostate‐specific antigen (PSA), prostate volume, Gleason, and Prostate Imaging‐Reporting and Data System (PI‐RADS) scores were also obtained. Manually annotated prostate masks were used to crop the MRI slices, and a DL model was trained with those from non‐csPC patients to estimate the age of the patients. Following, we obtained the prostate age gap (PAG) on previously unseen csPC and non‐csPC cropped MRI exams. PAG was defined as the estimated model age minus the patient's age. Finally, the relationship between PAG and csPC risk occurrence was assessed through an adjusted multivariate logistic regression by PSA levels, age, prostate volume, and PI‐RADS ≥ 3 score. Statistical Tests: T‐test, Mann–Whitney U test, permutation test, receiver operating characteristics (ROC), area under the curve (AUC), and odds ratio (OR). A P value <0.05 was considered statistically significant. Results: After adjusting, there was a significant difference in the odds of csPC (OR = 3.78, 95% confidence interval [CI]: 2.32–6.16). Further, PAG showed a significantly larger bootstrapped AUC to discriminate between csPC and non‐csPC than that of adjusted PI‐RADS ≥ 3 (AUC = 0.981, 95% CI: 0.975–0.987). Data Conclusion: PAG may be associated with the risk of csPC and could outperform other PC risk factors. Level of Evidence: 3 Technical Efficacy: Stage 3 [ABSTRACT FROM AUTHOR]

Published
2024
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21. Prostate Cancer IRE Study (PRIS): A Randomized Controlled Trial Comparing Focal Therapy to Radical Treatment in Localized Prostate Cancer

Author

Lantz, Anna, primary, Nordlund, Per, additional, Falagario, Ugo, additional, Jäderling, Fredrik, additional, Özbek, Orhan, additional, Clements, Mark, additional, Discacciati, Andrea, additional, Grönberg, Henrik, additional, Eklund, Martin, additional, Stricker, Phillip, additional, Emberton, Mark, additional, Aly, Markus, additional, and Nordström, Tobias, additional

Published
2023
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23. Incorporating Magnetic Resonance Imaging and Biomarkers in Active Surveillance Protocols - Results From the Prospective Stockholm3 Active Surveillance Trial (STHLM3AS)

Author

Olsson, Henrik, Nordström, Tobias, Jäderling, Fredrik, Egevad, Lars, Vigneswaran, Hari T, Annerstedt, Magnus, Grönberg, Henrik, Eklund, Martin, and Lantz, Anna

Subjects
Image-Guided Biopsy, Male, Biomarkers, Tumor, Humans, Prostatic Neoplasms, Articles, Prospective Studies, Neoplasm Grading, AcademicSubjects/MED00010, Watchful Waiting, Magnetic Resonance Imaging
Abstract

Background Active surveillance (AS) for men with low-risk prostate cancer (PC) can lead to patient morbidity and healthcare overutilization. The aim of this study was to evaluate an AS protocol using the Stockholm3 test and magnetic resonance imaging (MRI) to reduce biopsy intensity. Methods We conducted a prospective multicenter study of 280 invited men from a contemporary screening study (STHLM3), with Gleason Score (GS) 3 + 3 PC on a current AS protocol. Patients underwent prostate-MRI and blood sampling for analysis of the Stockholm3 test including protein biomarkers, genetic variants, and clinical variables to predict risk of GS ≥3 + 4 PC followed by systematic biopsies and targeted biopsies (for Prostate Imaging Reporting and Data System version 2 ≥3 lesions) in all men. Primary outcomes were reclassification to GS ≥3 + 4 PC and clinically significant PC (csPCa), including unfavorable intermediate risk PC or higher based on National Comprehensive Cancer Network guidelines. Results Adding MRI-targeted biopsies to systematic biopsies increased sensitivity of GS ≥3 + 4 PC compared with systematic biopsies alone (relative sensitivity [RS] = 1.52, 95% confidence interval [CI] = 1.28 to 1.85). Performing biopsies in only MRI positive increased sensitivity of GS ≥3 + 4 PC (RS = 1.30, 95% CI = 1.04 to 1.67) and reduced number of biopsy procedures by 49.3% while missing 7.2% GS ≥3 + 4 PC and 1.4% csPCa. Excluding men with negative Stockholm3 test reduced the number of MRI investigations at follow-up by 22.5% and biopsies by 56.8% while missing 6.9% GS ≥3 + 4 PC and 1.3% csPCa. Conclusion Including MRI and targeted/systematic biopsies in the follow-up for men on AS increased sensitivity of PC reclassification. Incorporation of risk prediction models including biomarkers may reduce the need for MRI use in men with low-risk PC.

Published
2020

25. MRI-Targeted or Standard Biopsy in Prostate Cancer Screening

Author

Eklund, Martin, primary, Jäderling, Fredrik, additional, Discacciati, Andrea, additional, Bergman, Martin, additional, Annerstedt, Magnus, additional, Aly, Markus, additional, Glaessgen, Axel, additional, Carlsson, Stefan, additional, Grönberg, Henrik, additional, and Nordström, Tobias, additional

Published
2021
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26. Prostate cancer screening using a combination of risk-prediction, MRI, and targeted prostate biopsies (STHLM3-MRI): a prospective, population-based, randomised, open-label, non-inferiority trial

Author

Nordström, Tobias, primary, Discacciati, Andrea, additional, Bergman, Martin, additional, Clements, Mark, additional, Aly, Markus, additional, Annerstedt, Magnus, additional, Glaessgen, Axel, additional, Carlsson, Stefan, additional, Jäderling, Fredrik, additional, Eklund, Martin, additional, Grönberg, Henrik, additional, Cavalli-Björkman, Carin, additional, Björklund, Astrid, additional, Hune, Britt-Marie, additional, Hao, Shuang, additional, Nordström, Tobias, additional, Walldén, Mats, additional, Steinberg, Ola, additional, Andersson, Karl, additional, Wimmercranz, Fredrik, additional, Meurling, Edward, additional, Gleassgen, Axel, additional, Majeed, Nada, additional, Awadelkarim, Rihab, additional, Fyhr, Ing-Marie, additional, Sandström, Dag, additional, Waage, Linda, additional, Imamov, Otabek, additional, Lantz, Rafael, additional, Thorstensson, Andreas, additional, Stiernstedt, Carl, additional, Wande, Dushaid, additional, Trygg, Gunnar, additional, Söderbäck, Harald, additional, Michajlowski, Jerzy, additional, Leykamm, Lars, additional, Svedberg, Nils-Erik, additional, Bergman, Tommy, additional, Sabockis, Raimundas, additional, and Akrawi, Sirvan, additional

Published
2021
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30. Prostate Cancer Screening Using a Combination of Risk-Prediction, Magnetic Resonance Imaging and Targeted Prostate Biopsies: A Randomised Trial

Author

Nordström, Tobias, primary, Discacciati, Andrea, additional, Bergman, Martin, additional, Clements, Mark, additional, Aly, Markus, additional, Annerstedt, Magnus, additional, Glaessgen, Axel, additional, Carlsson, Stefan, additional, Jäderling, Fredrik, additional, Eklund, Martin, additional, and Grönberg, Henrik, additional

Published
2021
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36. Safety and Activity of Sorafenib in Addition to Vinflunine in Post-Platinum Metastatic Urothelial Carcinoma (Vinsor):Phase I Trial

Author

Shah, Carl-Henrik, Pappot, Helle, Agerbæk, Mads, Holmsten, Karin, Jäderling, Fredrik, Yachnin, Jeffrey, Grybäck, Per, von der Maase, Hans, Ullén, Anders, Shah, Carl-Henrik, Pappot, Helle, Agerbæk, Mads, Holmsten, Karin, Jäderling, Fredrik, Yachnin, Jeffrey, Grybäck, Per, von der Maase, Hans, and Ullén, Anders

Abstract

LESSONS LEARNED: First trial to report safety and activity of the microtubule inhibitor vinflunine plus the tyrosine kinase inhibitor sorafenib in post-platinum metastatic urothelial cancer (mUC) patients.A recommended phase II dose was identified for the treatment combination of vinflunine plus sorafenib, with main adverse events including fatigue, febrile neutropenia, neutropenia, hypertension, and hyponatremia.An overall response rate of 41% to second-line vinflunine plus sorafenib treatment in patients with platinum-resistant mUC was confirmed.BACKGROUND: Platinum-progressive metastatic urothelial carcinoma (mUC) is a clinical challenge. The tyrosine kinase inhibitor sorafenib has demonstrated varied activity in mUC. This trial was designed to examine safety and activity of vinflunine plus sorafenib in mUC.METHODS: In addition to standard dose of vinflunine (320 or 280 mg/m2), patients received sorafenib (400, 600, or 800 mg/day), in a 3 + 3 dose-escalation phase I design.RESULTS: Twenty-two patients (median age 62.5 years) were included. Five patients received vinflunine 320 mg/m2 and 17 received 280 mg/m2. The maximum tolerated dose (MTD) of sorafenib with vinflunine 280 mg/m2 was 600 mg, and with vinflunine 320 mg/m2 it was not determined, owing to toxicity. Adverse events (AEs) grades 3 + 4 consisted of neutropenia (6 patients), febrile neutropenia (5), and hyponatremia (5). The overall response rate (ORR) in the efficacy-evaluable patients was 41% (7 of 17), all partial responses evaluated by RECIST version 1.1. Median overall survival (OS) was 7.0 months (1.8-41.7).CONCLUSION: The defined recommended phase II dose (RPTD) was vinflunine 280 mg/m2 plus sorafenib 400 mg. Sorafenib was too toxic in combination with vinflunine 320 mg/m2. The ORR of 41% to this second-line combination treatment of mUC is noteworthy and supports further trials.

Published
2019

37. A novel approach to integrated prostate cancer diagnostics: insights from MRI, prostate biopsy, and pathology reports in a pilot study.

Author

Thimansson, Erik, Axén, Elin, Jäderling, Fredrik, Styrke, Johan, Nyberg, Maria, Hageman, Nina, Ivarsson, Johan, Malmberg, Gert, Gaspar, Viktoria, and Törnblom, Magnus

Subjects
*PROSTATE-specific membrane antigen, *PICTURE archiving & communication systems, *RADICAL prostatectomy, *ENDORECTAL ultrasonography, *PROSTATE biopsy, *POSITRON emission tomography
Abstract

The article discusses a novel model for integrated prostate cancer diagnostics that combines MRI, prostate biopsy, and pathology reports. Developed by a multi-professional group in Sweden, the model aims to streamline data collection, improve patient outcomes, and enhance quality assessment. The model was tested in a pilot study with positive feedback from urologists, radiologists, and pathologists, showing potential for widespread implementation and validation in clinical practice. The structured approach offers a concise summary of relevant information, benefiting both healthcare providers and patients. [Extracted from the article]

Published
2024
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39. Supplementary figures Legends -Supplemental material for Accuracy in local staging of prostate cancer by adding a three-dimensional T2-weighted sequence with radial reconstructions in magnetic resonance imaging

Author

Jäderling, Fredrik, Nyberg, Tommy, Öberg, Michael, Carlsson, Stefan, Skorpil, Mikael, and Blomqvist, Lennart

Subjects
110320 Radiology and Organ Imaging, FOS: Clinical medicine
Abstract

Supplemental material, Supplementary figures Legends for Accuracy in local staging of prostate cancer by adding a three-dimensional T2-weighted sequence with radial reconstructions in magnetic resonance imaging by Fredrik Jäderling, Tommy Nyberg, Michael Öberg, Stefan Carlsson, Mikael Skorpil and Lennart Blomqvist in Acta Radiologica Open

Published
2018
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40. Supplementary figures -Supplemental material for Accuracy in local staging of prostate cancer by adding a three-dimensional T2-weighted sequence with radial reconstructions in magnetic resonance imaging

Author

Jäderling, Fredrik, Nyberg, Tommy, Öberg, Michael, Carlsson, Stefan, Skorpil, Mikael, and Blomqvist, Lennart

Subjects
110320 Radiology and Organ Imaging, FOS: Clinical medicine
Abstract

Supplemental material, Supplementary figures for Accuracy in local staging of prostate cancer by adding a three-dimensional T2-weighted sequence with radial reconstructions in magnetic resonance imaging by Fredrik Jäderling, Tommy Nyberg, Michael Öberg, Stefan Carlsson, Mikael Skorpil and Lennart Blomqvist in Acta Radiologica Open

Published
2018
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41. MRI protocol prostata urologi actaopen -Supplemental material for Accuracy in local staging of prostate cancer by adding a three-dimensional T2-weighted sequence with radial reconstructions in magnetic resonance imaging

Author

Jäderling, Fredrik, Nyberg, Tommy, Öberg, Michael, Carlsson, Stefan, Skorpil, Mikael, and Blomqvist, Lennart

Subjects
110320 Radiology and Organ Imaging, FOS: Clinical medicine
Abstract

Supplemental material, MRI protocol prostata urologi actaopen for Accuracy in local staging of prostate cancer by adding a three-dimensional T2-weighted sequence with radial reconstructions in magnetic resonance imaging by Fredrik Jäderling, Tommy Nyberg, Michael Öberg, Stefan Carlsson, Mikael Skorpil and Lennart Blomqvist in Acta Radiologica Open

Published
2018
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42. PCASTt/SPCG-17—a randomised trial of active surveillance in prostate cancer: rationale and design

Author

Ahlberg, Mats Steinholtz, primary, Adami, Hans-Olov, additional, Beckmann, Kerri, additional, Bertilsson, Helena, additional, Bratt, Ola, additional, Cahill, Declan, additional, Egevad, Lars, additional, Garmo, Hans, additional, Holmberg, Lars, additional, Johansson, Eva, additional, Rannikko, Antti, additional, Van Hemelrijck, Mieke, additional, Jäderling, Fredrik, additional, Wassberg, Cecilia, additional, Åberg, Ulrika W N, additional, and Bill-Axelson, Anna, additional

Published
2019
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45. Incorporating Magnetic Resonance Imaging and Biomarkers in Active Surveillance Protocols - Results From the Prospective Stockholm3 Active Surveillance Trial (STHLM3AS).

Author

Olsson, Henrik, Nordström, Tobias, Jäderling, Fredrik, Egevad, Lars, Vigneswaran, Hari T, Annerstedt, Magnus, Grönberg, Henrik, Eklund, Martin, and Lantz, Anna

Subjects
ENDORECTAL ultrasonography, MAGNETIC resonance imaging, GLEASON grading system, MAGNETIC testing, BLOOD testing, EVALUATION of medical care, RESEARCH, BIOPSY, RESEARCH methodology, EVALUATION research, COMPARATIVE studies, PROSTATE tumors, TUMOR grading, LONGITUDINAL method
Abstract

Background: Active surveillance (AS) for men with low-risk prostate cancer (PC) can lead to patient morbidity and healthcare overutilization. The aim of this study was to evaluate an AS protocol using the Stockholm3 test and magnetic resonance imaging (MRI) to reduce biopsy intensity.Methods: We conducted a prospective multicenter study of 280 invited men from a contemporary screening study (STHLM3), with Gleason Score (GS) 3 + 3 PC on a current AS protocol. Patients underwent prostate-MRI and blood sampling for analysis of the Stockholm3 test including protein biomarkers, genetic variants, and clinical variables to predict risk of GS ≥3 + 4 PC followed by systematic biopsies and targeted biopsies (for Prostate Imaging Reporting and Data System version 2 ≥3 lesions) in all men. Primary outcomes were reclassification to GS ≥3 + 4 PC and clinically significant PC (csPCa), including unfavorable intermediate risk PC or higher based on National Comprehensive Cancer Network guidelines.Results: Adding MRI-targeted biopsies to systematic biopsies increased sensitivity of GS ≥3 + 4 PC compared with systematic biopsies alone (relative sensitivity [RS] = 1.52, 95% confidence interval [CI] = 1.28 to 1.85). Performing biopsies in only MRI positive increased sensitivity of GS ≥3 + 4 PC (RS = 1.30, 95% CI = 1.04 to 1.67) and reduced number of biopsy procedures by 49.3% while missing 7.2% GS ≥3 + 4 PC and 1.4% csPCa. Excluding men with negative Stockholm3 test reduced the number of MRI investigations at follow-up by 22.5% and biopsies by 56.8% while missing 6.9% GS ≥3 + 4 PC and 1.3% csPCa.Conclusion: Including MRI and targeted/systematic biopsies in the follow-up for men on AS increased sensitivity of PC reclassification. Incorporation of risk prediction models including biomarkers may reduce the need for MRI use in men with low-risk PC. [ABSTRACT FROM AUTHOR]

Published
2021
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46. Accuracy in local staging of prostate cancer by adding a three-dimensional T2-weighted sequence with radial reconstructions in magnetic resonance imaging

Author

Jäderling, Fredrik, Nyberg, Tommy, Öberg, Michael, Carlsson, Stefan, Skorpil, Mikael, Blomqvist, Lennart, Jäderling, Fredrik, Nyberg, Tommy, Öberg, Michael, Carlsson, Stefan, Skorpil, Mikael, and Blomqvist, Lennart

Abstract

Background: The evidence supporting the use of magnetic resonance imaging (MRI) in prostate cancer detection has been established, but its accuracy in local staging is questioned. Purpose: To investigate the additional value of multi-planar radial reconstructions of a three-dimensional (3D) T2-weighted (T2W) MRI sequence, intercepting the prostate capsule perpendicularly, for improving local staging of prostate cancer. Material and Methods: Preoperative, bi-parametric prostate MRI examinations in 94 patients operated between June 2014 and January 2015 where retrospectively reviewed by two experienced abdominal radiologists. Each patient was presented in two separate sets including diffusion-weighted imaging, without and with the 3D T2W set that included radial reconstructions. Each set was read at least two months apart. Extraprostatic tumor extension (EPE) was assessed according to a 5-point grading scale. Sensitivity and specificity for EPE was calculated and presented as receiver operating characteristics (ROC) with area under the curve (AUC), using histology from whole-mount prostate specimen as gold standard. Inter-rater agreement was calculated for the two different reading modes using Cohen's kappa. Results: The AUC for detection of EPE for Readers 1 and 2 in the two-dimensional (2D) set was 0.70 and 0.68, respectively, and for the 2D+3D set 0.62 and 0.65, respectively. Inter-rater agreement (Reader 1 vs. Reader 2) on EPE using Cohen's kappa for the 2D and 2D+3D set, respectively, was 0.42 and 0.17 (i.e. moderate and poor agreement, respectively). Conclusion: The addition of 3D T2W MRI with radial reconstructions did not improve local staging in prostate cancer.

Published
2018
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