Clinical map document based on XML (cMDX): document architecture with mapping feature for reporting and analysing prostate cancer in radical prostatectomy specimens

Abstract

BackgroundThe pathology report of radical prostatectomy specimens plays an important role in clinical decisions and the prognostic evaluation in Prostate Cancer (PCa). The anatomical schema is a helpful tool to document PCa extension for clinical and research purposes. To achieve electronic documentation and analysis, an appropriate documentation model for anatomical schemas is needed. For this purpose we developed cMDX.MethodsThe document architecture of cMDX was designed according to Open Packaging Conventions by separating the whole data into template data and patient data. Analogue custom XML elements were considered to harmonize the graphical representation (e.g. tumour extension) with the textual data (e.g. histological patterns). The graphical documentation was based on the four-layer visualization model that forms the interaction between different custom XML elements. Sensible personal data were encrypted with a 256-bit cryptographic algorithm to avoid misuse. In order to assess the clinical value, we retrospectively analysed the tumour extension in 255 patients after radical prostatectomy.ResultsThe pathology report with cMDX can represent pathological findings of the prostate in schematic styles. Such reports can be integrated into the hospital information system. "cMDX" documents can be converted into different data formats like text, graphics and PDF. Supplementary tools like cMDX Editor and an analyser tool were implemented. The graphical analysis of 255 prostatectomy specimens showed that PCa were mostly localized in the peripheral zone (Mean: 73% ± 25). 54% of PCa showed a multifocal growth pattern.ConclusionscMDX can be used for routine histopathological reporting of radical prostatectomy specimens and provide data for scientific analysis.

Correlation of Intraprostatic Tumor Extent with 68Ga-PSMA Distribution in Patients with Prostate Cancer

“…The extent of cancer within the specimen was mapped according to the method Bettendorf et al (13) and Eminaga et al (17). The map consists of 22 segments, including 2 segments for the seminal vesicles.…”

Preoperative Serum Prostate-Specific Antigen Levels Vary According to the Topographical Distribution of Prostate Cancer in Prostatectomy Specimens

“…The cancer volume was computationally calculated based on this schematic M A N U S C R I P T A C C E P T E D ACCEPTED MANUSCRIPT 3 diagram as discussed in our recent study 13 . The cMDX© tool analyses and visualises the topographical distribution of PCa foci in the prostate 13 . The topographical distribution of the PCa foci was visualised in a heat map.…”

“…The tumour extension and its relationship to the prostatic capsule were transferred from the representative slides into a diagram of the prostate as previously described by Bettendorf et al 9 and Eminaga et al 13 . The transformation of topographical information into a schematic diagram was performed using a microscopic grid method and a cMDX-based documentation system.…”

“…The transformation of topographical information into a schematic diagram was performed using a microscopic grid method and a cMDX-based documentation system. The topographical and histopathological information were stored in an electronic format based on cMDX© (Clinical map document based on XML), which was introduced by Eminaga et al 13 . The cancer volume was computationally calculated based on this schematic M A N U S C R I P T A C C E P T E D ACCEPTED MANUSCRIPT 3 diagram as discussed in our recent study 13 .…”

“…The topographical and histopathological information were stored in an electronic format based on cMDX© (Clinical map document based on XML), which was introduced by Eminaga et al 13 . The cancer volume was computationally calculated based on this schematic M A N U S C R I P T A C C E P T E D ACCEPTED MANUSCRIPT 3 diagram as discussed in our recent study 13 . The cMDX© tool analyses and visualises the topographical distribution of PCa foci in the prostate 13 .…”