Lahiji, R, Ramacciotti, LS, Morton, E, Nicaise, EH, Braunschweig, A, Palmateer, G, Schmeusser, B, Patil, D, Richardson, M, Glover, F, Kearns, E, Lay, A, Hajiha, M, Master, VA, Ogan, K. Computerized tomography-derived body composition metrics are associated with 24-h urine lithogenic parameters. BJUI Compass.2026; 7(1): e70152. https://doi.org/10.1002/bco2.70152
In Table 1, we noticed an error in the placement of a superscript ‘a’ or ‘b’ in the first column. The corrected table is presented below.
We apologize for this error.
[这更正了文章DOI: 10.1002/bco2.70152.]。
{"title":"Correction to ‘computerized tomography-derived body composition metrics are associated with 24-h urine lithogenic parameters’","authors":"","doi":"10.1002/bco2.70174","DOIUrl":"10.1002/bco2.70174","url":null,"abstract":"<p>\u0000 <span>Lahiji, R</span>, <span>Ramacciotti, LS</span>, <span>Morton, E</span>, <span>Nicaise, EH</span>, <span>Braunschweig, A</span>, <span>Palmateer, G</span>, <span>Schmeusser, B</span>, <span>Patil, D</span>, <span>Richardson, M</span>, <span>Glover, F</span>, <span>Kearns, E</span>, <span>Lay, A</span>, <span>Hajiha, M</span>, <span>Master, VA</span>, <span>Ogan, K</span>. <span>Computerized tomography-derived body composition metrics are associated with 24-h urine lithogenic parameters</span>. <i>BJUI Compass.</i> <span>2026</span>; <span>7</span>(<span>1</span>): e70152. https://doi.org/10.1002/bco2.70152\u0000 </p><p>In Table 1, we noticed an error in the placement of a superscript ‘a’ or ‘b’ in the first column. The corrected table is presented below.</p><p>We apologize for this error.</p>","PeriodicalId":72420,"journal":{"name":"BJUI compass","volume":"7 2","pages":""},"PeriodicalIF":1.9,"publicationDate":"2026-02-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12908488/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146214863","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Hjalmar Svensson, Lars Grenabo, Klas Lindqvist, Erik Sörstedt, Jonas Hugosson
Objective
The study's aim is to provide a population-based description of the incidence, epidemiology, and clinical course of urinary tract infection or sepsis caused by ureteric stone obstruction. Although being a life-threatening condition, there have been few epidemiological reports on this disease.
Patients and Methods
The Swedish National Patient Register and local hospital databases were used to identify all adults discharged from inpatient care, with a combination of the International Classification of Disease 10th revision codes for urolithiasis and urinary tract infection in the Region Västra Götaland in Sweden for 2 years. Exclusion criteria were ongoing treatment for a urinary stone, nonsignificant infection and no obstruction from the stone. Medical records were reviewed to collect descriptive statistics on patient characteristics and clinical outcomes until stone-free.
Results
The register and local hospital search identified 702 patients with a predefined combination of diagnostic codes; 387 were excluded, leaving 315 for analysis. The incidence of acute obstructive urinary tract infection was 11.8 per 100 000 inhabitants per year. The median age was 68 years, and 176 (56%) were women. Fifty patients (16%) required intensive care unit admission and eight (3%) died. Four of these deaths were from acute septic complications, while the others died waiting for definitive stone treatment.
Conclusion
Acute obstructive urinary tract infection mainly affects elderly patients and has a variable clinical course, which in severe cases demands intensive care and may even be fatal.
{"title":"Urosepsis due to obstructive stones: Epidemiological data from a population-based study in Sweden","authors":"Hjalmar Svensson, Lars Grenabo, Klas Lindqvist, Erik Sörstedt, Jonas Hugosson","doi":"10.1002/bco2.70158","DOIUrl":"10.1002/bco2.70158","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Objective</h3>\u0000 \u0000 <p>The study's aim is to provide a population-based description of the incidence, epidemiology, and clinical course of urinary tract infection or sepsis caused by ureteric stone obstruction. Although being a life-threatening condition, there have been few epidemiological reports on this disease.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Patients and Methods</h3>\u0000 \u0000 <p>The Swedish National Patient Register and local hospital databases were used to identify all adults discharged from inpatient care, with a combination of the International Classification of Disease 10th revision codes for urolithiasis and urinary tract infection in the Region Västra Götaland in Sweden for 2 years. Exclusion criteria were ongoing treatment for a urinary stone, nonsignificant infection and no obstruction from the stone. Medical records were reviewed to collect descriptive statistics on patient characteristics and clinical outcomes until stone-free.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>The register and local hospital search identified 702 patients with a predefined combination of diagnostic codes; 387 were excluded, leaving 315 for analysis. The incidence of acute obstructive urinary tract infection was 11.8 per 100 000 inhabitants per year. The median age was 68 years, and 176 (56%) were women. Fifty patients (16%) required intensive care unit admission and eight (3%) died. Four of these deaths were from acute septic complications, while the others died waiting for definitive stone treatment.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>Acute obstructive urinary tract infection mainly affects elderly patients and has a variable clinical course, which in severe cases demands intensive care and may even be fatal.</p>\u0000 </section>\u0000 </div>","PeriodicalId":72420,"journal":{"name":"BJUI compass","volume":"7 2","pages":""},"PeriodicalIF":1.9,"publicationDate":"2026-02-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12908422/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146215075","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
To evaluate the treatment outcomes of 5-aminolevulinic acid hydrochloride (5-ALA) photodynamic diagnosis (PDD)-assisted transurethral resection of bladder tumour (TURBT) (ALA PDD-TURBT, hereinafter referred to as ‘ALA-PDD’) exceeding 4 h after ALA administration for non–muscle-invasive bladder cancer (NMIBC).
Patients and methods
This retrospective single-centre study included 386 patients who had undergone TURBT with or without 5-ALA for NMIBC between January 2018 and December 2024. Patients who received 5-ALA were divided into two groups based on 5-ALA exposure times before TURBT: 2–4 h and 4–8 h groups. The diagnostic sensitivity and specificity of procedures performed after the two exposure times were calculated by comparing cystoscopy findings with pathological findings in the ALA-PDD group. Recurrence-free survival (RFS) and progression-free survival (PFS) rates of NMIBC patients in the white-light (WL) and ALA-PDD groups were examined using Kaplan–Meier curves.
Results
When the same lesion was evaluated using WL and fluorescent light (FL) modes, the sensitivity was 62.6% for the former and 93.2% for the latter. Furthermore, when the FL mode was divided into two ALA-PDD groups, the sensitivity was 93.9% in the 2–4 h group and 91.3% in the 4–8 h group (p = 0.29). On the other hand, RFS was significantly longer in both the 2–4 h and 4–8 h ALA-PDD groups than in the WL group (p < 0.05), with no significant difference in RFS between the 2–4 h and 4–8 h ALA-PDD groups (p = 0.105).
Conclusion
The clinical efficacy of ALA-PDD, in terms of sensitivity and recurrence, was maintained even when the 5-ALA administration time was extended from 2 to 4 h to 2–8 h prior to TURBT.
{"title":"Effect of extending the oral administration period of 5-aminolevulinic acid on diagnostic accuracy and treatment outcomes for non–muscle-invasive bladder cancer","authors":"Hideo Fukuhara, Ryu Shigehisa, Shinkuro Yamamoto, Satoshi Fukata, Kenta Saito, Yasuhiko Shibanaka, Keiji Inoue","doi":"10.1002/bco2.70173","DOIUrl":"10.1002/bco2.70173","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Objectives</h3>\u0000 \u0000 <p>To evaluate the treatment outcomes of 5-aminolevulinic acid hydrochloride (5-ALA) photodynamic diagnosis (PDD)-assisted transurethral resection of bladder tumour (TURBT) (ALA PDD-TURBT, hereinafter referred to as ‘ALA-PDD’) exceeding 4 h after ALA administration for non–muscle-invasive bladder cancer (NMIBC).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Patients and methods</h3>\u0000 \u0000 <p>This retrospective single-centre study included 386 patients who had undergone TURBT with or without 5-ALA for NMIBC between January 2018 and December 2024. Patients who received 5-ALA were divided into two groups based on 5-ALA exposure times before TURBT: 2–4 h and 4–8 h groups. The diagnostic sensitivity and specificity of procedures performed after the two exposure times were calculated by comparing cystoscopy findings with pathological findings in the ALA-PDD group. Recurrence-free survival (RFS) and progression-free survival (PFS) rates of NMIBC patients in the white-light (WL) and ALA-PDD groups were examined using Kaplan–Meier curves.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>When the same lesion was evaluated using WL and fluorescent light (FL) modes, the sensitivity was 62.6% for the former and 93.2% for the latter. Furthermore, when the FL mode was divided into two ALA-PDD groups, the sensitivity was 93.9% in the 2–4 h group and 91.3% in the 4–8 h group (<i>p</i> = 0.29). On the other hand, RFS was significantly longer in both the 2–4 h and 4–8 h ALA-PDD groups than in the WL group (<i>p</i> < 0.05), with no significant difference in RFS between the 2–4 h and 4–8 h ALA-PDD groups (<i>p</i> = 0.105).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>The clinical efficacy of ALA-PDD, in terms of sensitivity and recurrence, was maintained even when the 5-ALA administration time was extended from 2 to 4 h to 2–8 h prior to TURBT.</p>\u0000 </section>\u0000 </div>","PeriodicalId":72420,"journal":{"name":"BJUI compass","volume":"7 2","pages":""},"PeriodicalIF":1.9,"publicationDate":"2026-02-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12895472/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146204154","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Ari Luder, Asaf Shvero, Roey Mashiach, Zohar A. Dotan, Nir Kleinmann
Introduction
Ureteral injuries during gynecologic surgery are uncommon (0.1%–2.5%) but may result in significant morbidity, including strictures, hydronephrosis and the need for additional interventions. This study evaluates the effectiveness of retrograde endoscopic management in treating iatrogenic ureteral injuries.
Materials and Methods
A retrospective review was conducted on women diagnosed with ureteral injury post-gynecologic surgery between 2010 and 2024 at a single institution. Patients were categorized into two groups: those treated with retrograde endoscopic interventions and those managed with non-endoscopic approaches (percutaneous nephrostomy and/or surgical reconstruction). The endoscopic group was further divided into early (<3 months post-injury) and late interventions. Outcomes assessed at ≥3 months of follow-up included treatment success, long-term complications and the need for further interventions.
Results
Of 42 patients, 29 (69%) underwent endoscopic treatment and 13 (31%) received non-endoscopic management. Among endoscopically treated patients, early intervention achieved an 80% success rate, significantly higher than the 33% observed with late intervention (p = 0.03). All non-endoscopic patients initially received percutaneous nephrostomy, and 12 (92.3%) required definitive surgical repair. Endoscopic treatment was associated with reduced operative time and shorter hospital stays. Given the rarity of ureteral injuries, the cohort represents one of the largest single-centre experiences focused on this specific population.
Conclusions
Early retrograde endoscopic management is a safe and effective approach for treating ureteral injuries after gynecologic surgery. Timely diagnosis and intervention significantly improve outcomes. Non-endoscopic patients were more complex cases, often unsuitable for endoscopy, which may account for outcome differences. Intraoperative retrograde ureterography and stenting should be considered whenever there is suspicion of ureteric injury, whereas postoperative endoscopic realignment or endoscopic management of ureteric strictures should be performed by appropriately trained urologists. Further prospective studies with larger cohorts and longer follow-up are warranted to refine optimal clinical pathways and long-term management strategies.
{"title":"Endoscopic management of ureteral injuries arising from gynecologic procedures","authors":"Ari Luder, Asaf Shvero, Roey Mashiach, Zohar A. Dotan, Nir Kleinmann","doi":"10.1002/bco2.70160","DOIUrl":"10.1002/bco2.70160","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Introduction</h3>\u0000 \u0000 <p>Ureteral injuries during gynecologic surgery are uncommon (0.1%–2.5%) but may result in significant morbidity, including strictures, hydronephrosis and the need for additional interventions. This study evaluates the effectiveness of retrograde endoscopic management in treating iatrogenic ureteral injuries.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Materials and Methods</h3>\u0000 \u0000 <p>A retrospective review was conducted on women diagnosed with ureteral injury post-gynecologic surgery between 2010 and 2024 at a single institution. Patients were categorized into two groups: those treated with retrograde endoscopic interventions and those managed with non-endoscopic approaches (percutaneous nephrostomy and/or surgical reconstruction). The endoscopic group was further divided into early (<3 months post-injury) and late interventions. Outcomes assessed at ≥3 months of follow-up included treatment success, long-term complications and the need for further interventions.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Of 42 patients, 29 (69%) underwent endoscopic treatment and 13 (31%) received non-endoscopic management. Among endoscopically treated patients, early intervention achieved an 80% success rate, significantly higher than the 33% observed with late intervention (<i>p</i> = 0.03). All non-endoscopic patients initially received percutaneous nephrostomy, and 12 (92.3%) required definitive surgical repair. Endoscopic treatment was associated with reduced operative time and shorter hospital stays. Given the rarity of ureteral injuries, the cohort represents one of the largest single-centre experiences focused on this specific population.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>Early retrograde endoscopic management is a safe and effective approach for treating ureteral injuries after gynecologic surgery. Timely diagnosis and intervention significantly improve outcomes. Non-endoscopic patients were more complex cases, often unsuitable for endoscopy, which may account for outcome differences. Intraoperative retrograde ureterography and stenting should be considered whenever there is suspicion of ureteric injury, whereas postoperative endoscopic realignment or endoscopic management of ureteric strictures should be performed by appropriately trained urologists. Further prospective studies with larger cohorts and longer follow-up are warranted to refine optimal clinical pathways and long-term management strategies.</p>\u0000 </section>\u0000 </div>","PeriodicalId":72420,"journal":{"name":"BJUI compass","volume":"7 2","pages":""},"PeriodicalIF":1.9,"publicationDate":"2026-02-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12894419/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146204191","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Katherina Y. Chen, Marieke K. Jones, Soutik Ghosal, Grace P. Ignozzi, Stephen H. Culp, Tracey L. Krupski, Jennifer M. Lobo
Objective
To identify factors associated with decreased adherence to the national risk-stratified surveillance cystoscopy schedule for non-muscle invasive bladder cancer (NMIBC).
Patients and methods
A retrospective, IRB-approved review was conducted at a single academic institution to identify patients diagnosed with NMIBC who underwent cystoscopy. Patient demographics were collected and driving distance to the urology clinic was calculated. Area Deprivation Index (ADI) and Distressed Communities Index (DCI) were used as proxies for socio-economic status (SES). Clinical data included year of diagnosis, cancer stage, risk stratification per national guidelines, pathology results and surveillance cystoscopy dates. The primary outcome was 12-month adherence to surveillance cystoscopy. Stepwise model selection using logistic regression identified factors associated with adherence.
Results
Of 591 patients identified, 351 had a confirmed pathological diagnosis and complete follow-up data. After excluding 57 patients who experienced recurrence, 112/294 (38.1%) were found to be compliant with the one-year surveillance schedule. Adherence was inversely associated with travel time to the clinic (OR 0.99, 95% CI 0.99–1.00; p = 0.015), while ADI and DCI were not statistically significant in relation to adherence. Other significant predictors included diagnosis before the 2016 guideline update where patients diagnosed pre-2016 were much more likely to adhere (OR 4.36, 95% CI 2.32–8.55; p < 0.001), risk stratification where patients of intermediate- and high-risk were much less likely to adhere than those of low-risk (intermediate: OR 0.48, CI 0.26–0.88; p = 0.018, high risk: OR 0.14, CI 0.04–0.40; p < 0.001), and smokers were much more likely to adhere than non-smokers (OR 1.91, CI 1.08–3.43; p = 0.028).
Conclusions
Travel time emerged as a significant barrier to adherence to NMIBC surveillance guidelines, whereas patients' SES did not appear to influence compliance. These findings suggest that logistical obstacles may play a more prominent role than socio-economic factors. Incorporating telehealth solutions and local partnerships may improve adherence and outcomes for NMIBC patients.
目的：确定非肌肉浸润性膀胱癌（NMIBC）国家风险分层监测膀胱镜检查计划依从性下降的相关因素。患者和方法：在一个学术机构进行了一项回顾性的、经irb批准的审查，以确定诊断为NMIBC并接受膀胱镜检查的患者。收集患者的人口统计数据，并计算到泌尿外科诊所的车程。区域剥夺指数（ADI）和贫困社区指数（DCI）作为社会经济地位（SES）的代理指标。临床数据包括诊断年份、癌症分期、根据国家指南的风险分层、病理结果和膀胱镜检查监测日期。主要结果是12个月的膀胱镜检查依从性。采用逻辑回归的逐步模型选择确定了与依从性相关的因素。结果：591例患者中，351例病理诊断明确，随访资料完整。在排除57例复发患者后，发现112/294（38.1%）符合为期一年的监测计划。依从性与到诊所的旅行时间呈负相关（OR 0.99, 95% CI 0.99-1.00; p = 0.015），而ADI和DCI与依从性的关系无统计学意义。其他重要的预测因素包括2016年指南更新之前的诊断，其中2016年之前诊断的患者更有可能坚持（OR 4.36, 95% CI 2.32-8.55; p p = 0.018，高风险：OR 0.14, CI 0.04-0.40; p p = 0.028）。结论：旅行时间成为遵守NMIBC监测指南的一个重要障碍，而患者的SES似乎并不影响依从性。这些发现表明，后勤障碍可能比社会经济因素发挥更突出的作用。结合远程医疗解决方案和地方伙伴关系可以改善NMIBC患者的依从性和结果。
{"title":"Predictors of adherence to surveillance cystoscopy for patients with non-muscle invasive bladder cancer","authors":"Katherina Y. Chen, Marieke K. Jones, Soutik Ghosal, Grace P. Ignozzi, Stephen H. Culp, Tracey L. Krupski, Jennifer M. Lobo","doi":"10.1002/bco2.70135","DOIUrl":"10.1002/bco2.70135","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Objective</h3>\u0000 \u0000 <p>To identify factors associated with decreased adherence to the national risk-stratified surveillance cystoscopy schedule for non-muscle invasive bladder cancer (NMIBC).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Patients and methods</h3>\u0000 \u0000 <p>A retrospective, IRB-approved review was conducted at a single academic institution to identify patients diagnosed with NMIBC who underwent cystoscopy. Patient demographics were collected and driving distance to the urology clinic was calculated. Area Deprivation Index (ADI) and Distressed Communities Index (DCI) were used as proxies for socio-economic status (SES). Clinical data included year of diagnosis, cancer stage, risk stratification per national guidelines, pathology results and surveillance cystoscopy dates. The primary outcome was 12-month adherence to surveillance cystoscopy. Stepwise model selection using logistic regression identified factors associated with adherence.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Of 591 patients identified, 351 had a confirmed pathological diagnosis and complete follow-up data. After excluding 57 patients who experienced recurrence, 112/294 (38.1%) were found to be compliant with the one-year surveillance schedule. Adherence was inversely associated with travel time to the clinic (OR 0.99, 95% CI 0.99–1.00; <i>p</i> = 0.015), while ADI and DCI were not statistically significant in relation to adherence. Other significant predictors included diagnosis before the 2016 guideline update where patients diagnosed pre-2016 were much more likely to adhere (OR 4.36, 95% CI 2.32–8.55; <i>p</i> < 0.001), risk stratification where patients of intermediate- and high-risk were much less likely to adhere than those of low-risk (intermediate: OR 0.48, CI 0.26–0.88; <i>p</i> = 0.018, high risk: OR 0.14, CI 0.04–0.40; <i>p</i> < 0.001), and smokers were much more likely to adhere than non-smokers (OR 1.91, CI 1.08–3.43; <i>p</i> = 0.028).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>Travel time emerged as a significant barrier to adherence to NMIBC surveillance guidelines, whereas patients' SES did not appear to influence compliance. These findings suggest that logistical obstacles may play a more prominent role than socio-economic factors. Incorporating telehealth solutions and local partnerships may improve adherence and outcomes for NMIBC patients.</p>\u0000 </section>\u0000 </div>","PeriodicalId":72420,"journal":{"name":"BJUI compass","volume":"7 2","pages":""},"PeriodicalIF":1.9,"publicationDate":"2026-02-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12894418/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146204167","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Mohammadmehdi Adhami, Jeremy Cheng, Elliot Anderson, Lloyd Smyth, Cate Davey, Thang Nguyen, Richard O'Sullivan, Andrew Ryan, Nathan Lawrentschuk, Jeremy Grummet, Andrew See
Objectives
We aim to prospectively evaluate functional outcomes and toxicity following focal low-dose-rate (LDR) brachytherapy for low–intermediate risk prostate cancer (PCa).
Patients and Methods
LIBERATE is a clinical registry of men treated with focal LDR brachytherapy for low–intermediate risk PCa since September 2019. Follow-up occurred at 6 weeks and every 3 months thereafter. Outcomes were assessed using validated patient-reported outcome measures (PROMs): IPSS, Expanded PCa Index Composite (EPIC) Bowel Assessment, and International Index of Erectile Function (IIEF-5). Adverse events (AEs) were clinically graded per Common Terminology Criteria for Adverse Events v5.0. Minimal important differences (MIDs) were defined as ±3.1 for IPSS, ±5 for EPIC bowel domain, and ±4 for IIEF-5.
Results
Of 120 patients enrolled, 88/120 (73.3%) had ≥12 months follow-up, and 79/88 (89.7%) completed PROMs with a median (IQR) follow-up of 33 (26–41) months. At 6 weeks, a transient, statistically and clinically significant increase in IPSS was observed, which returned to baseline by 12 months (median IPSS: 6 at baseline, 12 at 6 weeks, 6 at 12 months). EPIC bowel scores showed no significant changes, with 72 (91.1%) patients having rectal spacer. Among 66 sexually active men, 40 (60.6%) had no or mild erectile dysfunction (ED) at baseline, with a median IIEF-5 score of 22.5, decreasing to 22 at 6 weeks and plateauing at 21 at 6 months, none meeting MID criteria. For the 26 patients with mild to severe ED at baseline, the median IIEF-5 score declined from 10 at baseline to 5 at 6 months, with partial recovery followed by a drop to 5.5 at 2.5 and 3 years. Declines at 6 months and beyond 2 years were both statistically and clinically significant. No Grade ≥3 AEs were reported.
Conclusion
Focal LDR brachytherapy is associated with favorable functional outcomes and minimal toxicity. Further studies are required to evaluate long-term results.
{"title":"Functional outcomes and toxicity following focal low-dose-rate brachytherapy for low–intermediate risk prostate cancer","authors":"Mohammadmehdi Adhami, Jeremy Cheng, Elliot Anderson, Lloyd Smyth, Cate Davey, Thang Nguyen, Richard O'Sullivan, Andrew Ryan, Nathan Lawrentschuk, Jeremy Grummet, Andrew See","doi":"10.1002/bco2.70119","DOIUrl":"10.1002/bco2.70119","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Objectives</h3>\u0000 \u0000 <p>We aim to prospectively evaluate functional outcomes and toxicity following focal low-dose-rate (LDR) brachytherapy for low–intermediate risk prostate cancer (PCa).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Patients and Methods</h3>\u0000 \u0000 <p>LIBERATE is a clinical registry of men treated with focal LDR brachytherapy for low–intermediate risk PCa since September 2019. Follow-up occurred at 6 weeks and every 3 months thereafter. Outcomes were assessed using validated patient-reported outcome measures (PROMs): IPSS, Expanded PCa Index Composite (EPIC) Bowel Assessment, and International Index of Erectile Function (IIEF-5). Adverse events (AEs) were clinically graded per Common Terminology Criteria for Adverse Events v5.0. Minimal important differences (MIDs) were defined as ±3.1 for IPSS, ±5 for EPIC bowel domain, and ±4 for IIEF-5.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Of 120 patients enrolled, 88/120 (73.3%) had ≥12 months follow-up, and 79/88 (89.7%) completed PROMs with a median (IQR) follow-up of 33 (26–41) months. At 6 weeks, a transient, statistically and clinically significant increase in IPSS was observed, which returned to baseline by 12 months (median IPSS: 6 at baseline, 12 at 6 weeks, 6 at 12 months). EPIC bowel scores showed no significant changes, with 72 (91.1%) patients having rectal spacer. Among 66 sexually active men, 40 (60.6%) had no or mild erectile dysfunction (ED) at baseline, with a median IIEF-5 score of 22.5, decreasing to 22 at 6 weeks and plateauing at 21 at 6 months, none meeting MID criteria. For the 26 patients with mild to severe ED at baseline, the median IIEF-5 score declined from 10 at baseline to 5 at 6 months, with partial recovery followed by a drop to 5.5 at 2.5 and 3 years. Declines at 6 months and beyond 2 years were both statistically and clinically significant. No Grade ≥3 AEs were reported.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>Focal LDR brachytherapy is associated with favorable functional outcomes and minimal toxicity. Further studies are required to evaluate long-term results.</p>\u0000 </section>\u0000 </div>","PeriodicalId":72420,"journal":{"name":"BJUI compass","volume":"7 2","pages":""},"PeriodicalIF":1.9,"publicationDate":"2026-02-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12893820/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146183634","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Mohammadmehdi Adhami, Jeremy Cheng, Elliot Anderson, Lloyd Smyth, Cate Davey, Thang Nguyen, Richard O'Sullivan, Andrew Ryan, Nathan Lawrentschuk, Jeremy Grummet, Andrew See
Objectives
To prospectively evaluate oncological control, pathological progression, and its predictors following focal low-dose-rate (LDR) brachytherapy for low-intermediate risk prostate cancer (PCa).
Patients and methods
LIBERATE is a prospective, multi-centre clinical registry of patients who have undergone focal LDR brachytherapy for low-intermediate risk PCa since September 2019 (ACTRN:12619001669189). Unifocal ISUP GG1 (≥10 mm in ≥1 core), GG2 (any length) or GG3 (longest core<10 mm) were included. Follow-up entailed serial PSA measurements, and surveillance mpMRI and repeat transperineal prostate biopsy at 18–24 months post-treatment. Pathological control was achieved on repeat biopsy if there was no cancer or ISUP GG1 in <10 mm of core or GG2–3 grade cancer with radiation treatment effect. Progression was defined as no pathological changes from baseline or tumour upgrading.
Results
Of 120 men enrolled, 55 (45.8%) have completed repeat histopathological assessments with a median (IQR) follow-up of 38 (33–45) months. Pathological control was reported in 42 (76.4%) patients, including 25 negative biopsies, 12 clinically insignificant disease, and five in-field ISUP GG2–3 with radiation treatment effect. Pathological progression was observed in 13 patients (23.6%), with concurrent clinically significant in- and out-of-field progression in three cases (5.5%) and isolated clinically significant out-of-field progression in 10 cases (18.2%). Five (9.1%) patients underwent salvage treatment, including three robotic-assisted radical prostatectomies, one contralateral lobe LDR brachytherapy and one external beam radiation therapy. The salvage-free survival at 1, 2, 3 and 4 years were 98.2%, 96.4%, 94.2% and 87.0%, respectively. Mean PSA velocity >0.55 ng/mL/year was a strong predictor of pathological progression (OR 23.54, 95% CI 4.28–129.35, p = 0.001), with a sensitivity of 76.9% and specificity of 90.5%.
Conclusion
With a median follow-up of 38 months, these early results suggest that focal LDR brachytherapy for low-intermediate risk, single-lesion, imaging-visible PCa demonstrates satisfactory oncological control. However, further follow-up is needed to assess long-term oncological outcomes.
目的：前瞻性评价低剂量率（LDR）局灶性近距离前列腺癌（PCa）治疗后的肿瘤控制、病理进展及其预测因素。患者和方法：LIBERATE是一项前瞻性、多中心临床注册研究，研究对象是自2019年9月以来接受局点LDR近距离治疗的中低危PCa患者（ACTRN:12619001669189）。单焦点ISUP GG1（≥10 mm，≥1个核）、GG2（任何长度）或GG3（最长核）结果：在120名入组男性中，55名（45.8%）完成了重复组织病理学评估，中位（IQR）随访时间为38（33-45）个月。病理对照42例（76.4%），其中活检阴性25例，临床不明显疾病12例，现场ISUP GG2-3 5例，有放射治疗效果。13例（23.6%）出现病理进展，3例（5.5%）同时出现临床显著的野内和野外进展，10例（18.2%）单独出现临床显著的野外进展。5例（9.1%）患者接受了挽救性治疗，包括3例机器人辅助根治性前列腺切除术，1例对侧LDR近距离治疗和1例外束放射治疗。1年、2年、3年和4年无打捞生存率分别为98.2%、96.4%、94.2%和87.0%。平均PSA速度>0.55 ng/mL/年是病理进展的有力预测因子（OR 23.54, 95% CI 4.28-129.35, p = 0.001），敏感性为76.9%，特异性为90.5%。结论：中位随访38个月，这些早期结果表明，局灶LDR近距离治疗中低风险、单病灶、成像可见的前列腺癌显示出令人满意的肿瘤控制。然而，需要进一步的随访来评估长期的肿瘤预后。
{"title":"Oncological outcomes post focal low-dose-rate brachytherapy in low-intermediate risk prostate cancer","authors":"Mohammadmehdi Adhami, Jeremy Cheng, Elliot Anderson, Lloyd Smyth, Cate Davey, Thang Nguyen, Richard O'Sullivan, Andrew Ryan, Nathan Lawrentschuk, Jeremy Grummet, Andrew See","doi":"10.1002/bco2.70129","DOIUrl":"10.1002/bco2.70129","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Objectives</h3>\u0000 \u0000 <p>To prospectively evaluate oncological control, pathological progression, and its predictors following focal low-dose-rate (LDR) brachytherapy for low-intermediate risk prostate cancer (PCa).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Patients and methods</h3>\u0000 \u0000 <p>LIBERATE is a prospective, multi-centre clinical registry of patients who have undergone focal LDR brachytherapy for low-intermediate risk PCa since September 2019 (ACTRN:12619001669189). Unifocal ISUP GG1 (≥10 mm in ≥1 core), GG2 (any length) or GG3 (longest core<10 mm) were included. Follow-up entailed serial PSA measurements, and surveillance mpMRI and repeat transperineal prostate biopsy at 18–24 months post-treatment. Pathological control was achieved on repeat biopsy if there was no cancer or ISUP GG1 in <10 mm of core or GG2–3 grade cancer with radiation treatment effect. Progression was defined as no pathological changes from baseline or tumour upgrading.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Of 120 men enrolled, 55 (45.8%) have completed repeat histopathological assessments with a median (IQR) follow-up of 38 (33–45) months. Pathological control was reported in 42 (76.4%) patients, including 25 negative biopsies, 12 clinically insignificant disease, and five in-field ISUP GG2–3 with radiation treatment effect. Pathological progression was observed in 13 patients (23.6%), with concurrent clinically significant in- and out-of-field progression in three cases (5.5%) and isolated clinically significant out-of-field progression in 10 cases (18.2%). Five (9.1%) patients underwent salvage treatment, including three robotic-assisted radical prostatectomies, one contralateral lobe LDR brachytherapy and one external beam radiation therapy. The salvage-free survival at 1, 2, 3 and 4 years were 98.2%, 96.4%, 94.2% and 87.0%, respectively. Mean PSA velocity >0.55 ng/mL/year was a strong predictor of pathological progression (OR 23.54, 95% CI 4.28–129.35, <i>p</i> = 0.001), with a sensitivity of 76.9% and specificity of 90.5%.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>With a median follow-up of 38 months, these early results suggest that focal LDR brachytherapy for low-intermediate risk, single-lesion, imaging-visible PCa demonstrates satisfactory oncological control. However, further follow-up is needed to assess long-term oncological outcomes.</p>\u0000 </section>\u0000 </div>","PeriodicalId":72420,"journal":{"name":"BJUI compass","volume":"7 2","pages":""},"PeriodicalIF":1.9,"publicationDate":"2026-02-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12893819/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146183666","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
<div> <section> <h3> Background</h3> <p>Prostate cancer is an emerging public health concern in India, with rising incidence and varying survival outcomes. This study aimed to evaluate 5-year overall survival and identify prognostic factors among prostate cancer patients treated at Tata Memorial Hospital (TMH), Mumbai.</p> </section> <section> <h3> Methods</h3> <p>This retrospective study included all patients newly diagnosed with prostate cancer between January and December 2017 who received cancer-directed treatment at TMH. Patients were followed through 2022. Clinico-epidemiological variables including age, PSA levels, Gleason grade, clinical extent (EAU risk group classification), intent, completion status and treatment modality were analysed. Kaplan–Meier survival curves and Cox proportional hazards models were used to assess survival outcomes.</p> </section> <section> <h3> Results</h3> <p>A total of 421 patients were included, with a mean (SD) age of 66 ± (8.39) years and a median (IQR) PSA of 45.9 (17–154) ng/ml. All patients were symptomatic at presentation, predominantly with urinary complaints (90.5%), followed by bone pain (3.6%) or both (5.9%). At diagnosis, 15.2% had localized disease, 25.8% had locally advanced disease, and 58.4% had metastatic cancer. The overall 5-year survival rate was 61%. Prognostic factors significantly associated with survival included age, PSA, Gleason grade and disease extent. Patients with PSA > 1000 ng/ml had the poorest prognosis (33% 5-year survival). Survival varied by age group, declining from 66% in those aged 66–75 years to 45% in patients >75 years, although this trend was not statistically significant in adjusted analysis (<i>p</i> = 0.46). Disease extent demonstrated a strong survival gradient: 89% in localized disease, 79% in locally advanced and 41% in metastatic cancer, with metastatic disease showing a significantly increased adjusted mortality risk (HR: 4.59; <i>p</i> 0.004). Curative treatment intent was associated with markedly better outcomes, with a 5-year survival of 81% compared to 40% among those receiving palliative care. Similarly, treatment adherence had a substantial impact on prognosis, with patients completing therapy achieving a 65% 5-year survival rate, in contrast to only 12% among those with incomplete treatment (adjusted HR: 3.62; <i>p</i> < 0.001). Treatment modality also influenced survival: patients treated with ADT alone had the lowest 5-year survival (35%) and a significantly higher mortality risk (adjusted HR:1.65; <i>p</i> 0.01), whereas outcomes were more favourable with radical prostatectomy with adjuvant therapy (75%; adjusted HR: 1.21 <i>p</i> 0.80).</p>
前列腺癌在印度是一个新兴的公共卫生问题，发病率不断上升，生存结果也各不相同。本研究旨在评估在孟买塔塔纪念医院（TMH）治疗的前列腺癌患者的5年总生存率和确定预后因素。方法回顾性研究纳入2017年1月至12月在TMH接受癌症定向治疗的所有新诊断前列腺癌患者。这些患者被跟踪到2022年。分析临床流行病学变量包括年龄、PSA水平、Gleason分级、临床程度（EAU危险组分类）、意图、完成情况和治疗方式。Kaplan-Meier生存曲线和Cox比例风险模型用于评估生存结果。结果共纳入421例患者，平均（SD）年龄66±（8.39）岁，中位（IQR） PSA为45.9 (17-154)ng/ml。所有患者在就诊时均有症状，主要是泌尿系统疾病（90.5%），其次是骨痛（3.6%）或两者兼有（5.9%）。诊断时，15.2%为局限性疾病，25.8%为局部晚期疾病，58.4%为转移性癌症。总体5年生存率为61%。与生存显著相关的预后因素包括年龄、PSA、Gleason分级和疾病程度。PSA≤1000 ng/ml的患者预后最差（5年生存率33%）。生存率因年龄组而异，从66-75岁患者的66%下降到75岁患者的45%，尽管这一趋势在校正分析中没有统计学意义（p = 0.46）。疾病程度表现出很强的生存梯度：局部疾病89%，局部晚期79%，转移性癌症41%，转移性癌症显示出显著增加的调整死亡率风险（HR: 4.59; p 0.004）。治疗意图与明显更好的结果相关，接受姑息治疗的5年生存率为81%，而接受姑息治疗的5年生存率为40%。同样，治疗依从性对预后有重大影响，完成治疗的患者达到65%的5年生存率，而不完全治疗的患者只有12%的5年生存率（调整后比差：3.62;p < 0.001）。治疗方式也影响生存率：单独接受ADT治疗的患者5年生存率最低（35%），死亡风险显著较高（校正后比：1.65;p 0.01），而根治性前列腺切除术加辅助治疗的结果更有利（校正后比：75%；校正后比：1.21 p 0.80）。结论前列腺癌的临床诊断程度、PSA、Gleason分级及治疗对患者的生存有重要影响。改善早期发现、扩大多模式治疗战略和确保治疗完成对提高印度的结果至关重要。
{"title":"Survival outcomes in prostate cancer patients treated at an Indian tertiary care centre","authors":"Aswathy P, Sivaranjini Kannusamy, Amey Oak, Gagan Prakash, Amit Joshi, Vedang Murthy, Santosh Menon, Sandhya Cheulkar, Monika Lokhande, Ganesh Balasubramaniam, Rajesh Dikshit, Pankaj Chaturvedi, Sudeep Gupta","doi":"10.1002/bco2.70155","DOIUrl":"10.1002/bco2.70155","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>Prostate cancer is an emerging public health concern in India, with rising incidence and varying survival outcomes. This study aimed to evaluate 5-year overall survival and identify prognostic factors among prostate cancer patients treated at Tata Memorial Hospital (TMH), Mumbai.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>This retrospective study included all patients newly diagnosed with prostate cancer between January and December 2017 who received cancer-directed treatment at TMH. Patients were followed through 2022. Clinico-epidemiological variables including age, PSA levels, Gleason grade, clinical extent (EAU risk group classification), intent, completion status and treatment modality were analysed. Kaplan–Meier survival curves and Cox proportional hazards models were used to assess survival outcomes.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>A total of 421 patients were included, with a mean (SD) age of 66 ± (8.39) years and a median (IQR) PSA of 45.9 (17–154) ng/ml. All patients were symptomatic at presentation, predominantly with urinary complaints (90.5%), followed by bone pain (3.6%) or both (5.9%). At diagnosis, 15.2% had localized disease, 25.8% had locally advanced disease, and 58.4% had metastatic cancer. The overall 5-year survival rate was 61%. Prognostic factors significantly associated with survival included age, PSA, Gleason grade and disease extent. Patients with PSA > 1000 ng/ml had the poorest prognosis (33% 5-year survival). Survival varied by age group, declining from 66% in those aged 66–75 years to 45% in patients >75 years, although this trend was not statistically significant in adjusted analysis (<i>p</i> = 0.46). Disease extent demonstrated a strong survival gradient: 89% in localized disease, 79% in locally advanced and 41% in metastatic cancer, with metastatic disease showing a significantly increased adjusted mortality risk (HR: 4.59; <i>p</i> 0.004). Curative treatment intent was associated with markedly better outcomes, with a 5-year survival of 81% compared to 40% among those receiving palliative care. Similarly, treatment adherence had a substantial impact on prognosis, with patients completing therapy achieving a 65% 5-year survival rate, in contrast to only 12% among those with incomplete treatment (adjusted HR: 3.62; <i>p</i> < 0.001). Treatment modality also influenced survival: patients treated with ADT alone had the lowest 5-year survival (35%) and a significantly higher mortality risk (adjusted HR:1.65; <i>p</i> 0.01), whereas outcomes were more favourable with radical prostatectomy with adjuvant therapy (75%; adjusted HR: 1.21 <i>p</i> 0.80).</p>\u0000 ","PeriodicalId":72420,"journal":{"name":"BJUI compass","volume":"7 2","pages":""},"PeriodicalIF":1.9,"publicationDate":"2026-02-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://bjui-journals.onlinelibrary.wiley.com/doi/epdf/10.1002/bco2.70155","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146129786","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Muhammad Imran, Wayne G. Brisbane, Li-Ming Su, Jason P. Joseph, Wei Shao
Objective
This study aimed to evaluate the diagnostic accuracy of artificial intelligence (AI)–enhanced micro-ultrasound (micro-US) for detecting clinically significant prostate cancer (csPCa) in men referred for prostate biopsy.
Patients and Methods
We retrospectively analysed 145 men undergoing micro-US-guided biopsy (79 with csPCa, 66 without). Deep features were extracted from 2D micro-US slices using a self-supervised convolutional autoencoder and classified with a random forest model under fivefold cross-validation. Patients were considered csPCa-positive if ≥8 consecutive slices were predicted positive. Diagnostic performance was assessed against biopsy pathology using receiver operating characteristic (ROC) analysis.
Results
The AI–micro-US model achieved an area under the ROC curve (AUC) of 0.871. At a fixed threshold, sensitivity was 92.5% and specificity 68.1%, outperforming a clinical model based on prostate-specific antigen (PSA), digital rectal examination (DRE), age, and prostate volume (AUC 0.753; sensitivity 96.2%, specificity 27.3%).
Conclusion
AI-enhanced micro-US reduces false positives from conventional screening tools while preserving high sensitivity. It shows promise as a point-of-care alternative to MRI, integrating risk stratification and biopsy guidance into a single platform.
{"title":"AI-enhanced micro-ultrasound improves detection of clinically significant prostate cancer at biopsy","authors":"Muhammad Imran, Wayne G. Brisbane, Li-Ming Su, Jason P. Joseph, Wei Shao","doi":"10.1002/bco2.70133","DOIUrl":"https://doi.org/10.1002/bco2.70133","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Objective</h3>\u0000 \u0000 <p>This study aimed to evaluate the diagnostic accuracy of artificial intelligence (AI)–enhanced micro-ultrasound (micro-US) for detecting clinically significant prostate cancer (csPCa) in men referred for prostate biopsy.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Patients and Methods</h3>\u0000 \u0000 <p>We retrospectively analysed 145 men undergoing micro-US-guided biopsy (79 with csPCa, 66 without). Deep features were extracted from 2D micro-US slices using a self-supervised convolutional autoencoder and classified with a random forest model under fivefold cross-validation. Patients were considered csPCa-positive if ≥8 consecutive slices were predicted positive. Diagnostic performance was assessed against biopsy pathology using receiver operating characteristic (ROC) analysis.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>The AI–micro-US model achieved an area under the ROC curve (AUC) of 0.871. At a fixed threshold, sensitivity was 92.5% and specificity 68.1%, outperforming a clinical model based on prostate-specific antigen (PSA), digital rectal examination (DRE), age, and prostate volume (AUC 0.753; sensitivity 96.2%, specificity 27.3%).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>AI-enhanced micro-US reduces false positives from conventional screening tools while preserving high sensitivity. It shows promise as a point-of-care alternative to MRI, integrating risk stratification and biopsy guidance into a single platform.</p>\u0000 </section>\u0000 </div>","PeriodicalId":72420,"journal":{"name":"BJUI compass","volume":"7 2","pages":""},"PeriodicalIF":1.9,"publicationDate":"2026-02-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://bjui-journals.onlinelibrary.wiley.com/doi/epdf/10.1002/bco2.70133","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146135795","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
This work aimed to evaluate the implementation and impact of a pre-multidisciplinary team (MDT) triage model using Standards of Care (SoC) for streamlining in a urology cancer service.
Materials and Methods
An SoC framework was developed by the cancer lead in line with national guidance. Using this, the Urology MDT at Dartford and Gravesham NHS Trust (DGT) introduced a pre-MDT triage model. Each week, a consultant urologist, clinical nurse specialist, and MDT coordinator reviewed referrals and allocated them for either full MDT discussion or protocolised management. Data were collected over 50 weeks, including meeting duration, case numbers, plan changes, and a clinician survey.
Results
Average MDT duration reduced from 158 to 135 min (p < 0.001), allowing more focused discussion of complex cases. Of 50 MDT members invited, 25 responded to the survey (50%): 79% were confident that SoC-aligned cases received appropriate management without full discussion, 84% supported ongoing streamlining, and most reported time savings. Suggested improvements included artificial intelligence (AI) decision-support and clearer timelines. Overall, streamlining improved both the operational efficiency and clinician satisfaction.
Conclusion
The initiative enhanced MDT efficiency, maintained oversight, and strengthened clinician confidence in protocolised care pathways. Challenges remain, including reliance on a single consultant for triage and occasional gaps in the availability of radiology or histopathology reports, which may affect sustainability. Overall, these findings support wider adoption of pre-MDT streamlining in cancer services.
{"title":"Streamlining urology cancer multidisciplinary team meetings: Implementation and outcomes","authors":"Hossein Arang, Adeyinka Pratt, Muhammed Rashim Parappan, Mutahhar Nabeel Syed, Jayasimha Abbaraju, Srijit Banerjee, Sanjeev Madaan","doi":"10.1002/bco2.70167","DOIUrl":"10.1002/bco2.70167","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Objectives</h3>\u0000 \u0000 <p>This work aimed to evaluate the implementation and impact of a pre-multidisciplinary team (MDT) triage model using Standards of Care (SoC) for streamlining in a urology cancer service.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Materials and Methods</h3>\u0000 \u0000 <p>An SoC framework was developed by the cancer lead in line with national guidance. Using this, the Urology MDT at Dartford and Gravesham NHS Trust (DGT) introduced a pre-MDT triage model. Each week, a consultant urologist, clinical nurse specialist, and MDT coordinator reviewed referrals and allocated them for either full MDT discussion or protocolised management. Data were collected over 50 weeks, including meeting duration, case numbers, plan changes, and a clinician survey.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Average MDT duration reduced from 158 to 135 min (<i>p</i> < 0.001), allowing more focused discussion of complex cases. Of 50 MDT members invited, 25 responded to the survey (50%): 79% were confident that SoC-aligned cases received appropriate management without full discussion, 84% supported ongoing streamlining, and most reported time savings. Suggested improvements included artificial intelligence (AI) decision-support and clearer timelines. Overall, streamlining improved both the operational efficiency and clinician satisfaction.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>The initiative enhanced MDT efficiency, maintained oversight, and strengthened clinician confidence in protocolised care pathways. Challenges remain, including reliance on a single consultant for triage and occasional gaps in the availability of radiology or histopathology reports, which may affect sustainability. Overall, these findings support wider adoption of pre-MDT streamlining in cancer services.</p>\u0000 </section>\u0000 </div>","PeriodicalId":72420,"journal":{"name":"BJUI compass","volume":"7 2","pages":""},"PeriodicalIF":1.9,"publicationDate":"2026-02-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://bjui-journals.onlinelibrary.wiley.com/doi/epdf/10.1002/bco2.70167","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146129785","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
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