ArticleBJU international2021
Defining prostate cancer size and treatment margin for focal therapy: does intralesional heterogeneity impact the performance of multiparametric MRI?
Article in BJU international, 2021. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 16 papers, 1 of them a synthesis that pooled it.
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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.
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Who cites it
16 citing papers in PubMed, 1 synthesis or guideline pooled it.
- Established focal therapy-HIFU, IRE, or cryotherapy-where are we now?-a systematic review and meta-analysis.Prostate cancer and prostatic diseases · 2025Pooled it
- Trial
- Inter- and intra-rater variability of MRI-based lesion size measurements in active surveillance for prostate cancer: a multicentre study.European radiology · 2026Article
- Expanding the boundaries: rethinking ablation coverage in focal therapy for prostate cancer.European radiology · 2026Article
- Article
- Focal Therapy for Prostate Cancer: State of the Art, Physical Principles, Potentials, and Challenges.Cancers · 2026Review
- Comparison of 7-teslaProstate international · 2025Article
- Image-Guided Adaptive Cryotherapy for Prostate Cancer Treatment.Annals of biomedical engineering · 2025Article
- Transcriptomic predictors of prostate cancer recurrence following focal cryotherapy: a pooled analysis of phase II trial and prospective cohort data.Journal of the National Cancer Center · 2025Article
- Salvage treatments after focal therapy for prostate cancer - a comprehensive review.Prostate cancer and prostatic diseases · 2025Review
- Evaluating deep learning and radiologist performance in volumetric prostate cancer analysis with biparametric MRI and histopathologically mapped slides.Abdominal radiology (New York) · 2025Article
- Multiparametric MRI before and after Focal Therapy for Prostate Cancer: Pearls and Pitfalls for the Reporting Radiologist.Radiology. Imaging cancer · 2025Review
- Role of Systematic Biopsy in the Era of Targeted Biopsy: A Review.Current oncology (Toronto, Ont.) · 2024Review
- [Diagnostic efficacy of targeted biopsy combined with regional systematic biopsy in prostate cancer in patients with PI-RADS 4-5].Beijing da xue xue bao. Yi xue ban = Journal of Peking University. Health sciences · 2024Article
- Revisiting Delphi to Create a Basis for the Future of Focal Therapy for Prostate Cancer.The world journal of men's health · 2024Article
- Intensive sampling of the umbra and penumbra improves clinically significant prostate cancer detection and reduces risk of grade group upgrading at radical prostatectomy.World journal of urology · 2023Article
Corrections and comments
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Authors and funding
11 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
objectivesTo evaluate the impact of intralesional heterogeneity on the performance of multiparametric magnetic resonance imaging (mpMRI) in determining cancer extent and treatment margins for focal therapy (FT) of prostate cancer. PATIENTS AND
methodsWe identified men who underwent primary radical prostatectomy for organ- confined prostate cancer over a 3-year period. Cancer foci on whole-mount histology were marked out, coding low-grade (LG; Gleason 3) and high-grade (HG; Gleason 4-5) components separately. Measurements of entire tumours were grouped according to intralesional proportion of HG cancer: 0%, <50% and ≥50%; the readings were corrected for specimen shrinkage and correlated with matching lesions on mpMRI. Separate measurements were also taken of HG cancer components only, and correlated against entire lesions on mpMRI. Size discrepancies were used to derive the optimal tumour size and treatment margins for FT.
resultsThere were 122 MRI-detected cancer lesions in 70 men. The mean linear specimen shrinkage was 8.4%. The overall correlation between histology and MRI dimensions was r = 0.79 (P < 0.001). Size correlation was superior for tumours with high burden (≥50%) compared to low burden (<50%) of HG cancer (r = 0.84 vs r = 0.63; P = 0.007). Size underestimation by mpMRI was more likely for larger tumours (51% for >12 mm vs 26% for ≤12 mm) and those containing HG cancer (44%, vs 20% for LG only). Size discrepancy analysis suggests an optimal tumour size of ≤12 mm and treatment margins of 5-6 mm for FT. For tumours ≤12 mm in diameter, applying 5- and 6-mm treatment margins would achieve 98.6% and 100% complete tumour ablation, respectively. For tumours of all sizes, using the same margins would ablate >95% of the HG cancer components.
conclusionsMultiparametric MRI performance in estimating prostate cancer size, and consequently the treatment margin for FT, is impacted by tumour size and the intralesional heterogeneity of cancer grades.
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