Giganti Francesco, Allen Clare, Piper Jonathan W, Mirando David, Stabile Armando, Punwani Shonit, Kirkham Alex, Emberton Mark, Moore Caroline M
Department of Radiology, University College London Hospital NHS, Foundation Trust, London, UK; Division of Surgery & Interventional Science, University College London, London, UK.
Department of Radiology, University College London Hospital NHS, Foundation Trust, London, UK.
Magn Reson Imaging. 2019 Apr;57:34-39. doi: 10.1016/j.mri.2018.10.013. Epub 2018 Oct 20.
There is interest in using sequential multiparametric magnetic resonance imaging (mpMRI) to assess men on active surveillance (AS) for prostate cancer. The Prostate Cancer Radiological Estimation of Change in Sequential Evaluation (PRECISE) recommendations propose standardised reporting mpMRI data for these men. This includes accurate size measurements of lesions over time, but such approach is time consuming for the radiologist and there is a strong need of dedicated tools to report serial scans in a systematic manner. We present the results from an initial validation cohort using dedicated PRECISE reporting software to allow automated comparison between sequential scans on AS.
We retrospectively analysed baseline and follow-up scans of 20 men randomised to 6 months of daily dutasteride (n = 10) or placebo (n = 10) from the MAPPED trial. Men underwent 3T mpMRI at baseline and after 6 months, and a dedicated radiologist reported the scans using both a widespread commercially-available platform (Osirix®) and a semi-automated dedicated PRECISE reporting tool (MIM®). Tumour volume by planimetry in all sequences and conspicuity on diffusion-weighted imaging were assessed. Reporting time was recorded, and we used the Wilcoxon test for statistical analysis.
Median tumour volumes and conspicuity were similar using both approaches. The reporting time of the follow-up scan was quicker using the PRECISE reporting workflow both in the whole population (12'33″ vs 10'52″; p = 0.005) and in the dutasteride arm (15'50″ vs 12'59″; p = 0.01). A structured report including clinical and imaging data was generated according to the PRECISE recommendations and a comparison table between lesion characteristics at baseline and follow-up scans was also included.
We conclude that a dedicated PRECISE reporting tool for sequential scans in men on AS results in a significant reduction in the reporting time and allows the radiologist to easily compare scans over time. This tool will help with our understanding of the natural history of mpMRI changes during AS.
人们对使用序贯多参数磁共振成像（mpMRI）来评估接受前列腺癌主动监测（AS）的男性感兴趣。前列腺癌序贯评估变化的放射学估计（PRECISE）建议提出了针对这些男性的标准化mpMRI数据报告方式。这包括随时间准确测量病变大小，但这种方法对放射科医生来说很耗时，并且非常需要专门的工具来系统地报告系列扫描结果。我们展示了使用专用的PRECISE报告软件对初始验证队列进行分析的结果，以实现对AS患者序贯扫描之间的自动比较。
我们回顾性分析了来自MAPPED试验的20名男性的基线扫描和随访扫描，这些男性被随机分为两组，一组每天服用度他雄胺6个月（n = 10），另一组服用安慰剂（n = 10）。男性在基线时和6个月后接受3T mpMRI检查，一名专业放射科医生使用广泛使用的商业平台（Osirix®）和半自动专用PRECISE报告工具（MIM®）对扫描结果进行报告。评估了所有序列中通过面积测量法得到的肿瘤体积以及扩散加权成像上的病变显影情况。记录报告时间，并使用Wilcoxon检验进行统计分析。
两种方法得到的肿瘤体积中位数和病变显影情况相似。在整个人群中（12分33秒对10分52秒；p = 0.005）以及在度他雄胺组中（15分50秒对12分59秒；p = 0.01），使用PRECISE报告流程进行随访扫描的报告时间更快。根据PRECISE建议生成了一份包含临床和影像数据的结构化报告，还包括了基线扫描和随访扫描之间病变特征的比较表。
我们得出结论，用于AS男性序贯扫描的专用PRECISE报告工具可显著减少报告时间，并使放射科医生能够轻松比较不同时间的扫描结果。该工具将有助于我们了解AS期间mpMRI变化的自然史。
