Daniel Junker1, Thomas R W Herrmann2, Markus Bader3, Jasmin Bektic4, Gregor Henkel5, Stephan Kruck6, Markus Sandbichler7, David Schilling8, Georg Schäfer9, Udo Nagele10. 1. Department of Radiology, Medical University of Innsbruck, Anichstraße 35, 6020, Innsbruck, Austria. junkerda@gmail.com. 2. Department of Urology and Urooncology, Hanover Medical School [MHH], Carl Neuberg Str. 1, 30625, Hannover, Germany. Herrmann.Thomas@mh-hannover.de. 3. UroClinic München Giesing, Tegernseer Landstraße 44a, 81541, Munich, Germany. markus.bader@urologie-giesing.de. 4. Department of Urology, Medical University of Innsbruck, Anichstrasse 35, 6020, Innsbruck, Austria. Jasmin.bektic@i-med.ac.at. 5. Urologic Practice Dr. Gregor Henkel, Prof. Sinwel Weg 4/2, 6330, Kufstein, Austria. gregor.henkel@kufnet.at. 6. University Hospital for Urology Tübingen, Hoppe-Seyler-Str. 3, 72076, Tübingen, Germany. stephan.kruck@gmail.com. 7. Urologic Practice Dr. Sandbichler, Speckbacherstraße 20, 6380, St. Johann in Tirol, Austria. office@urologie-sandbichler.at. 8. University Hospital Frankfurt, Theodor-Stern-Kai 7, 60590, Frankfurt Am Main, Germany. schilling_david@hotmail.com. 9. Department of Pathology, Medical University Innsbruck, Anichstraße 35, 6020, Innsbruck, Austria. Georg.schaefer@i-med.ac.at. 10. Landeskrankenhaus Hall, Abteilung für Urologie und Andrologie, Milser Straße 10, 6060, Hall in Tirol, Austria. udo.nagele@tilak.at.
Abstract
INTRODUCTION: Experience from interdisciplinary cooperation revealed the need for a prostate mapping scheme to communicate multiparametric MRI (mpMRI) findings between radiologists, urologists, and pathologists, which should be detailed, yet easy to memorize. For this purpose, the 'Prostate interdisciplinary communication and mapping algorithm for biopsy and pathology' (PIC-MABP) was developed. This study evaluated the accuracy of the PIC-MABP system. METHODS: PIC-MABP was tested and validated in findings of 10 randomly selected patients from routine clinical practise with 18 histologically proven cancer lesions. Patients received an mpMRI of the prostate prior to prostatectomy. After surgery the prostates were prepared as whole-mount step sections. Cancer lesions, which were found suspicious on mpMRI, were assigned to the according PIC-MABP sectors by a radiologist. MpMRI slides were masked and sent to seven urologists from different centres, providing only the PIC-MABP location of each lesion. Urologists marked the accordant regions. Then mpMRI slides were unmasked, and the correctness of each mark was evaluated. RESULTS: One hundred and seventeen of the 126 marks (93%) were correctly assigned. Detection rates differed for lesions >0.5 cc compared with lesions <0.5 cc (p < 0.005): 3/7 (43%) marks were correctly assigned in lesions <0.3 cc, 16/21 (76%) in lesions with 0.3-0.5 cc, and 98/98 (100%) in lesions >0.5 cc. Interobserver agreement was good for lesions >0.5 cc and poor for lesions <0.3 cc (Fleiss Kappa 1 vs. 0.0175). CONCLUSION: PIC-MABP seems to be a reliable system to communicate the location of mpMRI findings >0.5 cc between different disciplines and can be a useful guidance for cognitive mpMRI/TRUS fusion biopsy.
INTRODUCTION: Experience from interdisciplinary cooperation revealed the need for a prostate mapping scheme to communicate multiparametric MRI (mpMRI) findings between radiologists, urologists, and pathologists, which should be detailed, yet easy to memorize. For this purpose, the 'Prostate interdisciplinary communication and mapping algorithm for biopsy and pathology' (PIC-MABP) was developed. This study evaluated the accuracy of the PIC-MABP system. METHODS: PIC-MABP was tested and validated in findings of 10 randomly selected patients from routine clinical practise with 18 histologically proven cancer lesions. Patients received an mpMRI of the prostate prior to prostatectomy. After surgery the prostates were prepared as whole-mount step sections. Cancer lesions, which were found suspicious on mpMRI, were assigned to the according PIC-MABP sectors by a radiologist. MpMRI slides were masked and sent to seven urologists from different centres, providing only the PIC-MABP location of each lesion. Urologists marked the accordant regions. Then mpMRI slides were unmasked, and the correctness of each mark was evaluated. RESULTS: One hundred and seventeen of the 126 marks (93%) were correctly assigned. Detection rates differed for lesions >0.5 cc compared with lesions <0.5 cc (p < 0.005): 3/7 (43%) marks were correctly assigned in lesions <0.3 cc, 16/21 (76%) in lesions with 0.3-0.5 cc, and 98/98 (100%) in lesions >0.5 cc. Interobserver agreement was good for lesions >0.5 cc and poor for lesions <0.3 cc (Fleiss Kappa 1 vs. 0.0175). CONCLUSION: PIC-MABP seems to be a reliable system to communicate the location of mpMRI findings >0.5 cc between different disciplines and can be a useful guidance for cognitive mpMRI/TRUS fusion biopsy.
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