To Evaluate an MRI-based Optimized Prostate Cancer Diagnostic Pathway Powered by Artificial Intelligence

Prostate Cancer Clinical Trial

Official title:

ProstateAI - A Prospective Paired Validating Cohort Study to Evaluate an MRI-based Optimized Prostate Cancer Diagnostic Pathway Powered by Artificial Intelligence

Clinical Trial Details — Status: Not yet recruiting

Administrative data

• NCT number: NCT06360523
• Other study ID #: CRE-2024.141
• Status: Not yet recruiting
• Start date: May 1, 2024
• Est. completion date: July 20, 2025

Study information

• Verified date: April 2024
• Source: Chinese University of Hong Kong
• Contact: Peter Ka-Fung CHIU, FRCS, PhD
• Phone: 35052625
• Email: peterchiu[@]surgery.cuhk.edu.hk
• Is FDA regulated: No
• Study type: Observational

Clinical Trial Summary

It is a prospective paired-cohort study for diagnostic test evaluation. The study aim to determine the accuracy of AI review and investigate whether AI review could detect MRI visible significant cancer as effective as radiologist review. MRI image of about 102 men recommended for biopsy will be reviewed by an AI model and an experienced radiologist, respectively. AI review (index) and radiologist review (standard) will be blinded to each other, while biopsy urologists will be well-informed of the findings of both AI review and radiologist review and make personalized biopsy plan by combining both findings. The pathological results of MRI-ultrasound fusion biopsy (reference) will serve as the gold standard to assess the diagnostic accuracy.

Description:

ProstateAI is a prospective paired-cohort study for diagnostic test evaluation. ProstateAI will determine the accuracy of AI review and investigate whether AI review could detect MRI visible significant cancer as effective as radiologist review. MRI image of about 102 men recommended for biopsy will be reviewed by an AI model and an experienced radiologist, respectively. AI review (index) and radiologist review (standard) will be blinded to each other, while biopsy urologists will be well-informed of the findings of both AI review and radiologist review and make personalized biopsy plan by combining both findings. The pathological results of MRI-ultrasound fusion biopsy (reference) will serve as the gold standard to assess the diagnostic accuracy.

Recruitment information / eligibility

• Status: Not yet recruiting
• Enrollment: 102
• Est. completion date: July 20, 2025
• Est. primary completion date: May 31, 2025
• Gender: Male
• Age group: 18 Years and older

Eligibility

Inclusion Criteria:

• Patients recommended for prostate biopsy for diagnosis or re-assessment.

• Men at least 18 years or over

• Patients with prostate MRI image eligible for radiologist review and AI review.

• Patient Informed Consent is signed.

Exclusion Criteria:

• Patient contraindicated to prostate biopsy

• Patient failed to complete the biopsy procedure

Related Conditions & MeSH terms

• Prostate Cancer
• Prostatic Neoplasms

Intervention

Diagnostic Test:
• AI modal
The MRI image will be reviewed by radiologist and AI model(s) respectively. The urologist will combine the results of the two approaches to optimize the biopsy strategy which is expected to result in more accurate diagnosis.

Locations

Country	Name	City	State
Hong Kong	Prince of Wales Hospital, Chinese University of Hong Kong	Hong Kong

Sponsors (1)

Lead Sponsor	Collaborator
Chinese University of Hong Kong

Country where clinical trial is conducted

Hong Kong, 

References & Publications (16)

Ahmed HU, El-Shater Bosaily A, Brown LC, Gabe R, Kaplan R, Parmar MK, Collaco-Moraes Y, Ward K, Hindley RG, Freeman A, Kirkham AP, Oldroyd R, Parker C, Emberton M; PROMIS study group. Diagnostic accuracy of multi-parametric MRI and TRUS biopsy in prostate cancer (PROMIS): a paired validating confirmatory study. Lancet. 2017 Feb 25;389(10071):815-822. doi: 10.1016/S0140-6736(16)32401-1. Epub 2017 Jan 20. — View Citation

Annamalai A, Fustok JN, Beltran-Perez J, Rashad AT, Krane LS, Triche BL. Interobserver Agreement and Accuracy in Interpreting mpMRI of the Prostate: a Systematic Review. Curr Urol Rep. 2022 Jan;23(1):1-10. doi: 10.1007/s11934-022-01084-y. Epub 2022 Feb 28. — View Citation

Bass EJ, Pantovic A, Connor MJ, Loeb S, Rastinehad AR, Winkler M, Gabe R, Ahmed HU. Diagnostic accuracy of magnetic resonance imaging targeted biopsy techniques compared to transrectal ultrasound guided biopsy of the prostate: a systematic review and meta-analysis. Prostate Cancer Prostatic Dis. 2022 Feb;25(2):174-179. doi: 10.1038/s41391-021-00449-7. Epub 2021 Sep 21. — View Citation

Bhattacharya I, Khandwala YS, Vesal S, Shao W, Yang Q, Soerensen SJC, Fan RE, Ghanouni P, Kunder CA, Brooks JD, Hu Y, Rusu M, Sonn GA. A review of artificial intelligence in prostate cancer detection on imaging. Ther Adv Urol. 2022 Oct 10;14:17562872221128791. doi: 10.1177/17562872221128791. eCollection 2022 Jan-Dec. — View Citation

Halabi S, Lin CY, Kelly WK, Fizazi KS, Moul JW, Kaplan EB, Morris MJ, Small EJ. Updated prognostic model for predicting overall survival in first-line chemotherapy for patients with metastatic castration-resistant prostate cancer. J Clin Oncol. 2014 Mar 1;32(7):671-7. doi: 10.1200/JCO.2013.52.3696. Epub 2014 Jan 21. Erratum In: J Clin Oncol. 2014 May 1;32(13):1387. — View Citation

Halstuch D, Baniel J, Lifshitz D, Sela S, Ber Y, Margel D. Characterizing the learning curve of MRI-US fusion prostate biopsies. Prostate Cancer Prostatic Dis. 2019 Dec;22(4):546-551. doi: 10.1038/s41391-019-0137-2. Epub 2019 Mar 6. — View Citation

Ilic D, Djulbegovic M, Jung JH, Hwang EC, Zhou Q, Cleves A, Agoritsas T, Dahm P. Prostate cancer screening with prostate-specific antigen (PSA) test: a systematic review and meta-analysis. BMJ. 2018 Sep 5;362:k3519. doi: 10.1136/bmj.k3519. — View Citation

Kasabwala K, Patel N, Cricco-Lizza E, Shimpi AA, Weng S, Buchmann RM, Motanagh S, Wu Y, Banerjee S, Khani F, Margolis DJ, Robinson BD, Hu JC. The Learning Curve for Magnetic Resonance Imaging/Ultrasound Fusion-guided Prostate Biopsy. Eur Urol Oncol. 2019 Mar;2(2):135-140. doi: 10.1016/j.euo.2018.07.005. Epub 2018 Aug 17. — View Citation

Lenfant L, Beitone C, Troccaz J, Roupret M, Seisen T, Voros S, Mozer PC. Learning curve for fusion magnetic resonance imaging targeted prostate biopsy and three-dimensional transrectal ultrasonography segmentation. BJU Int. 2024 Jan 31. doi: 10.1111/bju.16287. Online ahead of print. — View Citation

Lomas DJ, Ahmed HU. All change in the prostate cancer diagnostic pathway. Nat Rev Clin Oncol. 2020 Jun;17(6):372-381. doi: 10.1038/s41571-020-0332-z. Epub 2020 Feb 28. — View Citation

Mottet N, van den Bergh RCN, Briers E, Van den Broeck T, Cumberbatch MG, De Santis M, Fanti S, Fossati N, Gandaglia G, Gillessen S, Grivas N, Grummet J, Henry AM, van der Kwast TH, Lam TB, Lardas M, Liew M, Mason MD, Moris L, Oprea-Lager DE, van der Poel HG, Rouviere O, Schoots IG, Tilki D, Wiegel T, Willemse PM, Cornford P. EAU-EANM-ESTRO-ESUR-SIOG Guidelines on Prostate Cancer-2020 Update. Part 1: Screening, Diagnosis, and Local Treatment with Curative Intent. Eur Urol. 2021 Feb;79(2):243-262. doi: 10.1016/j.eururo.2020.09.042. Epub 2020 Nov 7. — View Citation

Schergna E, Armani M. [Muscular diseases: epidemiology of progressive muscular dystrophies]. Minerva Med. 1981 Apr 28;72(17):1045-9. Italian. — View Citation

Siddiqui MM, Rais-Bahrami S, Truong H, Stamatakis L, Vourganti S, Nix J, Hoang AN, Walton-Diaz A, Shuch B, Weintraub M, Kruecker J, Amalou H, Turkbey B, Merino MJ, Choyke PL, Wood BJ, Pinto PA. Magnetic resonance imaging/ultrasound-fusion biopsy significantly upgrades prostate cancer versus systematic 12-core transrectal ultrasound biopsy. Eur Urol. 2013 Nov;64(5):713-719. doi: 10.1016/j.eururo.2013.05.059. Epub 2013 Jun 12. — View Citation

Wegelin O, van Melick HHE, Hooft L, Bosch JLHR, Reitsma HB, Barentsz JO, Somford DM. Comparing Three Different Techniques for Magnetic Resonance Imaging-targeted Prostate Biopsies: A Systematic Review of In-bore versus Magnetic Resonance Imaging-transrectal Ultrasound fusion versus Cognitive Registration. Is There a Preferred Technique? Eur Urol. 2017 Apr;71(4):517-531. doi: 10.1016/j.eururo.2016.07.041. Epub 2016 Aug 25. — View Citation

Wei C, Szewczyk-Bieda M, Bates AS, Donnan PT, Rauchhaus P, Gandy S, Ragupathy SKA, Singh P, Coll K, Serhan J, Wilson J, Nabi G. Multicenter Randomized Trial Assessing MRI and Image-guided Biopsy for Suspected Prostate Cancer: The MULTIPROS Study. Radiology. 2023 Jul;308(1):e221428. doi: 10.1148/radiol.221428. — View Citation

Wei JT, Barocas D, Carlsson S, Coakley F, Eggener S, Etzioni R, Fine SW, Han M, Kim SK, Kirkby E, Konety BR, Miner M, Moses K, Nissenberg MG, Pinto PA, Salami SS, Souter L, Thompson IM, Lin DW. Early Detection of Prostate Cancer: AUA/SUO Guideline Part II: Considerations for a Prostate Biopsy. J Urol. 2023 Jul;210(1):54-63. doi: 10.1097/JU.0000000000003492. Epub 2023 Apr 25. — View Citation

* Note: There are 16 references in all — Click here to view all references

Outcome

Type	Measure	Description	Time frame	Safety issue
Primary	Prostate Cancer detection rate of ISUP grade group =2	Assessed by AI review, Radiologist review, and Biopsy (Targeted).	Through study completion, an average of 1 year
Secondary	Diagnosis of any grade of prostate cancer	Assessed by prostate biopsy	Through study completion, an average of 1 year