Evidence map›Paper›PMID 34337543›Full record

ArticleEuropean urology open science2021

Which Prostate Cancers are Undetected by Multiparametric Magnetic Resonance Imaging in Men with Previous Prostate Biopsy? An Analysis from the PICTURE Study.

Joseph M Norris, Lucy A M Simmons, Abi Kanthabalan, Alex Freeman, Neil McCartan, Caroline M Moore, Shonit Punwani, Hayley C Whitaker, Mark Emberton, Hashim U Ahmed

Open access · goldAbstract read
PubMed Full text at PMC Publisher
In one paragraph

Article in European urology open science, 2021. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 3 papers.

0numbers the graph read from it
0cells of the map it votes in
3citing papers in PubMed
0.6field-weighted citation impact, top 31% 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

3 citing papers in PubMed, 4 citations in OpenAlex.

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4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

10 authors at 5 institutions in 1 country.

Joseph M NorrisUCL Division of Surgery & Interventional Science, University College London, London, UK.
Lucy A M SimmonsUCL Division of Surgery & Interventional Science, University College London, London, UK.
Abi KanthabalanUCL Division of Surgery & Interventional Science, University College London, London, UK.
Alex FreemanDepartment of Pathology, University College London Hospitals NHS Foundation Trust, London, UK.
Neil McCartanUCL Division of Surgery & Interventional Science, University College London, London, UK.
Caroline M MooreUCL Division of Surgery & Interventional Science, University College London, London, UK.
Shonit PunwaniUCL Division of Surgery & Interventional Science, University College London, London, UK.
Hayley C WhitakerUCL Division of Surgery & Interventional Science, University College London, London, UK.
Mark EmbertonUCL Division of Surgery & Interventional Science, University College London, London, UK.
Hashim U AhmedDepartment of Urology, Imperial College Healthcare NHS Trust, London, UK.
University College London Hospitals NHS Foundation Trust · GBUniversity College London · GBImperial College Healthcare NHS Trust · GBNorth Bristol NHS Trust · GBPeterborough City Hospital · GB

Funding

Medical Research Council MR/S00680X/1Wellcome Trust 204998/Z/16/Z
6 · The paper itself

Abstract

backgroundMultiparametric magnetic resonance imaging (mpMRI) has improved risk stratification for suspected prostate cancer in patients following prior biopsy. However, not all significant cancers are detected by mpMRI. The PICTURE study provides the ideal opportunity to investigate cancer undetected by mpMRI owing to the use of 5 mm transperineal template mapping (TTPM) biopsy.

objectiveTo summarise attributes of cancers systematically undetected by mpMRI in patients with prior biopsy. DESIGN SETTING AND

participantsPICTURE was a paired-cohort confirmatory study in which men requiring repeat biopsy underwent mpMRI followed by TTPM biopsy. OUTCOME MEASUREMENTS AND STATISTICAL ANALYSIS: Attributes were compared between cancers detected and undetected by mpMRI at the patient level. Four predefined histopathological thresholds were used as the target condition for TTPM biopsy. Application of prostate-specific antigen density (PSAD) was explored. RESULTS AND LIMITATIONS: When nonsuspicious mpMRI was defined as Likert score 1-2, 2.9% of patients (3/103; 95% confidence interval [CI] 0.6-8.3%) with definition 1 disease (Gleason ≥ 4 + 3 of any length or maximum cancer core length [MCCL] ≥ 6 mm of any grade) had their cancer not detected by mpMRI. This proportion was 6.5% (11/168; 95% CI 3.3-11%) for definition 2 disease (Gleason ≥ 3 + 4 of any length or MCCL ≥ 4 mm of any grade), 4.8% (7/146; 95% CI 2.0-9.6%) for any amount of Gleason ≥ 3 + 4 cancer, and 9.3% (20/215; 95% CI 5.8-14%) for any cancer. Definition 1 cancers undetected by mpMRI had lower overall Gleason score (

conclusionsFew significant cancers are undetected by mpMRI in patients requiring repeat prostate biopsy. Undetected tumours are of lower overall and maximum Gleason grade and shorter cancer length compared to cancers detected by mpMRI. PATIENT SUMMARY: In patients with a previous prostate biopsy, magnetic resonance imaging (MRI) overlooks few prostate cancers, and these tend to be smaller and less aggressive than cancer that is detected.

Indexed as

False-negative magnetic resonance imagingMultiparametric magnetic resonance imagingPICTURE studyProstate cancerUndetected cancer

Identifiers

PMID34337543
PMCPMC8277581
OpenAlexW3173351936

What OpenQuestion holds

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LicenceCC BY
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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.