Ignite Creation Date:
2024-05-06 @ 12:09 PM
Last Modification Date:
2024-10-26 @ 12:55 PM
Study NCT ID:
NCT03687918
Status:
UNKNOWN
Last Update Posted:
2018-09-27
First Post:
2018-09-26
Brief Title:
External Validation of Prostate MRI QCADLyon
Sponsor:
Hospices Civils de Lyon
Organization:
Hospices Civils de Lyon
Study Overview
Official Title:
External Validation of a Quantitative Computer Aided Diagnostic QCAD System for Prostate mpMRI
Status:
UNKNOWN
Status Verified Date:
2018-09
Last Known Status:
RECRUITING
Delayed Posting:
No
If Stopped, Why?:
Not Stopped
Has Expanded Access:
False
If Expanded Access, NCT#:
N/A
Has Expanded Access, NCT# Status:
N/A
Acronym:
DIJON-CAD
Brief Summary:
Multiparametric magnetic resonance imaging mpMRI of the prostate combines T2-weighted imaging diffusion-weighted imaging and dynamic contrast-enhanced imaging Correlation with radical prostatectomy specimens has demonstrated that mpMRI has excellent sensitivity in detecting prostate cancers PCa with a Gleason score 7 and cancers with a Gleason 6 and a volume 05 cc Nevertheless its specificity is poor and there is large overlapping between the appearances of benign and malignant prostate lesions As a result the use of a 5-point subjective score has been widely encouraged to describe the level of suspicion of prostate lesions This so-called Likert score is a highly significant predictor of the malignant nature of prostate focal lesions However because there are no descriptions of specific criteria to be used in the scoring process the Likert score relies heavily on the readers experience
In an attempt to standardize mpMRI interpretation the European Society of Urogenital Radiology and the American College of Radiology recently endorsed the so-called Prostate Imaging-Reporting and Data System PIRADS score The second version of this scoring system PI-RADS v2 score gave good results in characterizing prostate focal lesions However Inter-reader agreement remains moderate at best even after training and there is still a high-rate of false positives These results have led some authors to suggest that there might be structural limits to the ability of any score based on MR imaging to allow detection of prostate cancer with high specificity
Using quantitative magnetic resonance MR image features to characterize prostate lesions seen on mpMRI could improve interpretation standardization and recently several computer-aided diagnosis CAD systems combining various image features have shown promising results in characterizing prostate tissues However most CAD systems have been trained and evaluated on images from the same MR scanner Unfortunately quantification in MR imaging is limited by substantial inter-manufacturer variability in the calculation of quantitative image parameters The quantitative thresholds defined for one manufacturer may therefore not be valid for another manufacturer Of the many reported CAD systems only few have shown robust results at cross-validation in datasets from different manufacturers
We developed in Lyon a mpMRI CAD system for discriminating Gleason 7 cancers in the peripheral zone PZ That CAD system was trained using mpMRI from patients treated by radical prostatectomy It combines the 10th percentile of the apparent diffusion coefficient ADC_10th and the time to the peak of enhancement TTP at dynamic contrast-enhanced DCE imaging It provided good results when cross-validated in two datasets from two different manufacturers General Electric and Philips We then tested the CAD on a cohort of 130 patients who underwent mpMRI General Electric or Philips MR unit before prostate biopsy Each MR lesion targeted at biopsy had prospectively received a Likert score of likelihood of malignancy at the time of the biopsy Retrospective analysis of these MR lesions with the CAD showed that the stand-alone CAD outperformed the Likert score in predicting the presence of Gleason 7 cancer at biopsy Area under the receiver operating characteristic curve AUC 094 95 confidence interval 95CI 090-098 versus 081 95CI 075-088 p00002 These good results encourage us to perform an external validation of the CAD testing its performance on mpMRI from another manufacturer Siemens and another institution
The principal objective of the DIJON-CAD study is to evaluate the performances of the QCAD developed in Lyon QCADLyon in a cohort of consecutive patients treated by prostatectomy and who underwent preoperative mpMRI on a Siemens 3 Tesla MR imager at the Dijon University Hospital center or at the Dijon Cancer Center both institutions share the same MR unit This study is the first step of the external validation of the QCADLyon system It is only aimed at verifying that the diagnostic performance of the system is not very poor on external mpMRI which is a substantial risk If the results are good a proper multicentric prospective validation study will be planned
In an attempt to standardize mpMRI interpretation the European Society of Urogenital Radiology and the American College of Radiology recently endorsed the so-called Prostate Imaging-Reporting and Data System PIRADS score The second version of this scoring system PI-RADS v2 score gave good results in characterizing prostate focal lesions However Inter-reader agreement remains moderate at best even after training and there is still a high-rate of false positives These results have led some authors to suggest that there might be structural limits to the ability of any score based on MR imaging to allow detection of prostate cancer with high specificity
Using quantitative magnetic resonance MR image features to characterize prostate lesions seen on mpMRI could improve interpretation standardization and recently several computer-aided diagnosis CAD systems combining various image features have shown promising results in characterizing prostate tissues However most CAD systems have been trained and evaluated on images from the same MR scanner Unfortunately quantification in MR imaging is limited by substantial inter-manufacturer variability in the calculation of quantitative image parameters The quantitative thresholds defined for one manufacturer may therefore not be valid for another manufacturer Of the many reported CAD systems only few have shown robust results at cross-validation in datasets from different manufacturers
We developed in Lyon a mpMRI CAD system for discriminating Gleason 7 cancers in the peripheral zone PZ That CAD system was trained using mpMRI from patients treated by radical prostatectomy It combines the 10th percentile of the apparent diffusion coefficient ADC_10th and the time to the peak of enhancement TTP at dynamic contrast-enhanced DCE imaging It provided good results when cross-validated in two datasets from two different manufacturers General Electric and Philips We then tested the CAD on a cohort of 130 patients who underwent mpMRI General Electric or Philips MR unit before prostate biopsy Each MR lesion targeted at biopsy had prospectively received a Likert score of likelihood of malignancy at the time of the biopsy Retrospective analysis of these MR lesions with the CAD showed that the stand-alone CAD outperformed the Likert score in predicting the presence of Gleason 7 cancer at biopsy Area under the receiver operating characteristic curve AUC 094 95 confidence interval 95CI 090-098 versus 081 95CI 075-088 p00002 These good results encourage us to perform an external validation of the CAD testing its performance on mpMRI from another manufacturer Siemens and another institution
The principal objective of the DIJON-CAD study is to evaluate the performances of the QCAD developed in Lyon QCADLyon in a cohort of consecutive patients treated by prostatectomy and who underwent preoperative mpMRI on a Siemens 3 Tesla MR imager at the Dijon University Hospital center or at the Dijon Cancer Center both institutions share the same MR unit This study is the first step of the external validation of the QCADLyon system It is only aimed at verifying that the diagnostic performance of the system is not very poor on external mpMRI which is a substantial risk If the results are good a proper multicentric prospective validation study will be planned
Detailed Description:
None
Study Oversight
Has Oversight DMC:
None
Is a FDA Regulated Drug?:
False
Is a FDA Regulated Device?:
False
Is an Unapproved Device?:
None
Is a PPSD?:
None
Is a US Export?:
None
Is an FDA AA801 Violation?:
None