Clinical utility of MRI in the decision-making process before radical prostatectomy: Systematic review and meta-analysis

Kozikowski, Mieszko; Malewski, Wojciech; Michalak, Wojciech; Dobruch, Jakub

doi:10.1371/journal.pone.0210194

Cited by 45 publications

(26 citation statements)

References 40 publications

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“…Furthermore, they showed that the appropriateness of the surgical decision modification based on the MRI findings was 77%. 71 Similarly, Druskin et al 70 showed that the use of preoperative MRI in patients undergoing RP resulted in a 5.6% decrease in the PSM rate.…”

Section: Mrimentioning

confidence: 97%

“…Several authors studied the clinical value of preoperative MRI on surgical planning and PSM rates showing that it may influence the surgical decision in 26% to 59% of patients. [65][66][67][68][69][70] Recently, Kozikowski et al 71 reported, in their systematic review and meta-analysis, that MRI modified the NVB dissection on 1 or both sides in 35% of patients, of which 63% performed a more aggressive resection of the bundle and 37% had more preservation of the bundle. Furthermore, they showed that the appropriateness of the surgical decision modification based on the MRI findings was 77%.…”

Section: Mrimentioning

confidence: 99%

See 1 more Smart Citation

“Real-time” Assessment of Surgical Margins During Radical Prostatectomy: State-of-the-Art

Eissa

Zoeir

Sighinolfi

et al. 2020

Clinical Genitourinary Cancer

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Histopathologic examination of the pathologic specimens using hematoxylin & eosin stains represents the backbone of the modern pathology. It is time-consuming; thus, "real-time" assessment of prostatic and periprostatic tissue has gained special interest in the diagnosis and management of prostate cancer. The current study focuses on the review of the different available techniques for "real-time" evaluation of surgical margins during radical prostatectomy (RP). We performed a comprehensive search of the Medline database to identify all the articles discussing "real-time" or intraoperative assessment of surgical margins during RP. Several filters were applied to the search to include only English articles performed on human subjects and published between January 2000 and March 2019. The search revealed several options for pathologic assessment of surgical margins including intraoperative frozen sections, confocal laser endomicroscopy, optical spectroscopy, photodynamic diagnosis, optical coherence tomography, multiphoton microscopy, structured illumination microscopy, 3D augmented reality, and ex vivo fluorescence confocal microscope. Frozen section represents the gold standard technique for real-time pathologic examinations of surgical margins during RP; however, several other options showed promising results in the initial clinical trials, and considering the rapid development in the field of molecular and cellular imaging, some of these options may serve as an alternative to frozen section.

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Section: Mrimentioning

confidence: 97%

Section: Mrimentioning

confidence: 99%

“Real-time” Assessment of Surgical Margins During Radical Prostatectomy: State-of-the-Art

Eissa

Zoeir

Sighinolfi

et al. 2020

Clinical Genitourinary Cancer

View full text Add to dashboard Cite

show abstract

“…In contrast, the results of the systematic review and meta-analysis showed that the preoperative MRI altered the initial surgical plane in only one-third cases, but increased with the increasing PCa risk category. Also, modification based on MRI did not affect the PSM rate [ 33 ].…”

Section: Recent Innovations In Ns-rarpmentioning

confidence: 99%

Nerve-sparing robot-assisted radical prostatectomy: Current perspectives

Kumar

Patel

Panaiyadiyan

et al. 2021

Asian Journal of Urology

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Robotic-assisted radical prostatectomy (RARP) is the current standard of care with long term cure in organ-confined disease. The introduction of nerve-sparing (NS) to standard RARP has shown positive results in terms of functional outcomes in addition to the oncological outcomes. This article reviews the current perspectives of NS-RARP in terms of applied anatomy of the prostatic fascial planes, the neurovascular bundle (NVB), various NS techniques and postoperative functional outcomes. A non-systematic review was done using PubMed, Embase and Medline databases to retrieve and analyse articles in English, with following keywords “prostate cancer”, “robotic radical prostatectomy”, “nerve-sparing”. The Delphi method was used with an expert panel of robotic surgeons in urology to analyse the potency outcomes of various published comparative and non-comparative studies. The literature has shown that NS-RARP involves various techniques and approaches while there is a lack of randomized studies to suggest the superiority of one over the other. Variables such as preoperative risk assessments, baseline potency, surgical anatomy of individual patients and surgeons’ expertise play a major role in the outcomes. A tailored approach for each patient is required for applying the NS approach during RARP.

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“…With the widespread use of advanced MRI techniques and robot-assisted laparoscopic prostatectomy (RALP), it has become possible to evaluate the involvement of these critical structures in the tumor prior to surgery and spare them to reduce the risk of complications and recovery time 5 , 6 .…”

Section: Introductionmentioning

confidence: 99%

Domain adaptation for segmentation of critical structures for prostate cancer therapy

Meyer

Mehrtash

Rak

et al. 2021

Sci Rep

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Preoperative assessment of the proximity of critical structures to the tumors is crucial in avoiding unnecessary damage during prostate cancer treatment. A patient-specific 3D anatomical model of those structures, namely the neurovascular bundles (NVB) and the external urethral sphincters (EUS), can enable physicians to perform such assessments intuitively. As a crucial step to generate a patient-specific anatomical model from preoperative MRI in a clinical routine, we propose a multi-class automatic segmentation based on an anisotropic convolutional network. Our specific challenge is to train the network model on a unique source dataset only available at a single clinical site and deploy it to another target site without sharing the original images or labels. As network models trained on data from a single source suffer from quality loss due to the domain shift, we propose a semi-supervised domain adaptation (DA) method to refine the model’s performance in the target domain. Our DA method combines transfer learning and uncertainty guided self-learning based on deep ensembles. Experiments on the segmentation of the prostate, NVB, and EUS, show significant performance gain with the combination of those techniques compared to pure TL and the combination of TL with simple self-learning ($${p}<0.005$$ p < 0.005 for all structures using a Wilcoxon’s signed-rank test). Results on a different task and data (Pancreas CT segmentation) demonstrate our method’s generic application capabilities. Our method has the advantage that it does not require any further data from the source domain, unlike the majority of recent domain adaptation strategies. This makes our method suitable for clinical applications, where the sharing of patient data is restricted.

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Clinical utility of MRI in the decision-making process before radical prostatectomy: Systematic review and meta-analysis

Cited by 45 publications

References 40 publications

“Real-time” Assessment of Surgical Margins During Radical Prostatectomy: State-of-the-Art

“Real-time” Assessment of Surgical Margins During Radical Prostatectomy: State-of-the-Art

Nerve-sparing robot-assisted radical prostatectomy: Current perspectives

Domain adaptation for segmentation of critical structures for prostate cancer therapy

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