Evidence map›Paper›PMID 27401032›Full record

Trial reportProstate cancer and prostatic diseases2016

The concordance between the volume hotspot and the grade hotspot: a 3-D reconstructive model using the pathology outputs from the PROMIS trial.

A El-Shater Bosaily, M Valerio, Y Hu, A Freeman, C Jameson, L Brown, R Kaplan, R G Hindley, D Barratt, M Emberton and 1 more

Erratum issuedOpen access · hybridAbstract readClinical TrialMulticenter Study
PubMed Full text at PMC Publisher
In one paragraph

Trial report in Prostate cancer and prostatic diseases, 2016. The graph could read no effect estimate from its abstract, so it casts no vote on the map. An erratum has been issued. Cited by 4 papers.

0numbers the graph read from it
0cells of the map it votes in
4citing papers in PubMed
1.0field-weighted citation impact, top 21% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

4 citing papers in PubMed, 12 citations in OpenAlex.

  1. Article
  2. Review
  3. Article
  4. Article
4 · The record

Corrections and comments

5 · Who and what money

Authors and funding

11 authors at 4 institutions in 2 countries.

A El-Shater BosailyDivision of Surgery and Interventional Science, University College London, London, UK.
M ValerioDivision of Surgery and Interventional Science, University College London, London, UK.
Y HuCentre for Medical Image Computing, University College London, London, UK.
A FreemanDepartment of Histopathology, College London Hospitals NHS Foundation Trust, London, UK.
C JamesonDepartment of Histopathology, College London Hospitals NHS Foundation Trust, London, UK.
L BrownMedical Research Council Clinical Trials Unit, University College London, London, UK.
R KaplanMedical Research Council Clinical Trials Unit, University College London, London, UK.
R G HindleyDepartment of Urology, Basingstoke Hospital, Hampshire Hospitals NHS Foundation Trust, Hampshire, UK.
D BarrattCentre for Medical Image Computing, University College London, London, UK.
M EmbertonDivision of Surgery and Interventional Science, University College London, London, UK.
H U AhmedDivision of Surgery and Interventional Science, University College London, London, UK.
University College London Hospitals NHS Foundation Trust · GBUniversity College London · GBHampshire Hospitals NHS Foundation Trust · GBMedical Research Council · GB

Funding

Medical Research Council MC_EX_G0800814Medical Research Council MC_EX_UU_G0800814Medical Research Council MC_UU_12023/20Medical Research Council MC_UU_12023/28Medical Research Council MR/M009092/1Wellcome Trust
6 · The paper itself

Abstract

objectivesThe rationale for directing targeted biopsy towards the centre of lesions has been questioned in light of prostate cancer grade heterogeneity. In this study, we assess the assumption that the maximum cancer Gleason grade (Gleason grade hotspot) lies within the maximum dimension (volume hotspot) of a prostate cancer lesion.

methods3-D histopathological models were reconstructed using the outputs of the 5-mm transperineal mapping (TPM) biopsies used as the reference test in the pilot phase of Prostate Mri Imaging Study (PROMIS), a paired validating cohort study investigating the performance of multi-parametric magnetic resonance imaging (MRI) against transrectal ultrasound (TRUS) biopsies. The prostate was fully sampled with 5 mm intervals; each core was separately labelled, inked and orientated in space to register 3-D cancer lesions location. The data from the histopathology results were used to create a 3-D interpolated reconstruction of each lesion and identify the spatial coordinates of the largest dimension (volume hot spot) and highest Gleason grade (Gleason grade hotspot) and assess their concordance.

resultsNinety-four men, with median age 62 years (interquartile range, IQR= 58-68) and median PSA 6.5 ng ml(-1) (4.6-8.8), had a median of 80 (I69-89) cores each with a median of 4.5 positive cores (0-12). In the primary analysis, the prevalence of homogeneous lesions was 148 (76%; 95% confidence interval (CI) ±6.0%). In all, 184 (94±3.2%) lesions showed concordant hotspots and 11/47 (23±12.1%) of heterogeneous lesions showed discordant hotspots. The median 3-D distance between discordant hotspots was 12.8 mm (9.9-15.5). These figures remained stable on secondary analyses using alternative reconstructive assumptions. Limitations include a certain degree of error within reconstructed models.

conclusionsGuiding one biopsy needle to the maximum cancer diameter would lead to correct Gleason grade attribution in 94% of all lesions and 79% of heterogeneous ones if a true hit was obtained. Further correlation of histological lesions, their MRI appearance and the detectability of these hotspots on MRI will be undertaken once PROMIS results are released.

Indexed as

AgedAged, 80 and overBiomarkers, TumorHumansImage-Guided BiopsyImaging, Three-DimensionalMagnetic Resonance ImagingMaleMiddle AgedNeoplasm GradingProstatic NeoplasmsTumor BurdenBiomarkers, Tumor

Identifiers

PMID27401032
PMCPMC5411671
OpenAlexW2463050623

What OpenQuestion holds

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Registered trials

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.