- ICH GCP
- USA klinikai vizsgálatok nyilvántartása
- Klinikai vizsgálat NCT07647445
Prostate MRI Analysis by Radiologists and Artificial Intelligence - Disease Identification and Guided Management (PARADIGM)
A Study Assessing Whether Artificial Intelligence is Non-inferior to Radiologists in the Diagnosis of Clinically Significant Prostate Cancer.
Prostate cancer is the most common male cancer in 112 countries and makes up 7% of global cancer cases, and is the second leading cause of cancer-related deaths in men.
Normally, men with suspected prostate cancer undergo a prostate MRI, and then a Radiologist would review this scan to identify any suspicious areas for cancer within the prostate. Prostate MRI interpretation, however, is an expert skill with a steep learning curve, and internationally, there is a growing shortage of Radiologists.
The PARADIGM trial aims to assess if AI can perform just as well as Radiologists in interpreting prostate MRI scans to identify prostate cancer. Enrolled participants will undergo a prostate MRI, which is the normal method used for investigating suspected prostate cancer. AI and a Radiologist will both interpret the MRI, without knowledge of each other's interpretation. Once both reports have been made, the Radiologist will be asked to produce a third, combined report.
If there is a suspicious area in the prostate identified either by AI or the Radiologist, targeted biopsies will be performed. If there are no suspicious areas on the MRI and if you are at low risk of harbouring cancer, which occurs in about 30% of men, then no biopsy will be taken at all.
A tanulmány áttekintése
Állapot
Körülmények
Részletes leírás
Aim: To assess whether artificial intelligence is non-inferior to radiologists in the diagnosis of clinically significant prostate cancer on MRI.
Objectives
Primary
1. To compare the proportion of men who have clinically significant prostate cancer detected on MRI using AI ± targeted biopsy with radiologists ± targeted biopsy.
Secondary
- To compare the proportion of men who have clinically insignificant prostate cancer detected on MRI using AI ± targeted biopsy with radiologists ± targeted biopsy.
- To compare the proportion of men with non-suspicious MRIs for AI vs radiologists.
- To compare the proportion of men with indeterminately scored MRI as reported by AI vs radiologists.
- To compare the diagnostic test performance of AI vs radiologist.
- To compare the additive value of AI when used together with a radiologist interpretation (summative of all identified lesions) compared to a radiologist alone.
- To compare the additive value of AI when used together with a radiologist interpretation (where the radiologist can interact with the AI system by accepting or rejecting AI-identified lesions) compared to a radiologist alone.
- To determine the frequency of AI failures.
- To compare treatment eligibility decisions between AI and Radiologist.
- To compare the cost-effectiveness of unblinded AI interpreted by the radiologist compared to radiologist alone for prostate cancer detection, and AI alone vs. radiologist alone, and a 3-arm analysis considering all three.
Design:
Prospective, international, within-patient, multi-centre, level-1 evidence trial in participants referred to hospital with a clinical suspicion of prostate cancer.
Tanulmány típusa
Beiratkozás (Becsült)
Fázis
- Nem alkalmazható
Kapcsolatok és helyek
Tanulmányi kapcsolat
- Név: Ng Alexander, MBBS BSc (Hons)
- Telefonszám: +44 0207 679 5057
- E-mail: alexander.ng@ucl.ac.uk
Tanulmányozza a kapcsolattartók biztonsági mentését
- Név: PARADIGM Study Team
- E-mail: med.paradigm@ucl.ac.uk
Részvételi kritériumok
Jogosultsági kritériumok
Tanulmányozható életkorok
- Felnőtt
- Idősebb felnőtt
Egészséges önkénteseket fogad
Leírás
Inclusion Criteria:
- Men at least 18 years of age referred with clinical suspicion of prostate cancer
- Serum PSA ≤ 20 ng/mL
- Fit to undergo all procedures listed in the protocol
- Able to provide written informed consent
Exclusion Criteria:
- Prior prostate biopsy
- Prior prostate MRI on a previous encounter*
- Prior treatment for prostate cancer
- Contraindication to MRI (e.g. claustrophobia, pacemaker)
- Metalwork that would give rise to artefact on MRI (e.g. hip prosthesis, pelvic/spinal metalwork)
- Contraindication to prostate biopsy
Unfit to undergo any procedures listed in protocol
- An MRI on a previous encounter means a previous prostate MRI which has been seen by a doctor and has been used to inform patient management at the time of the original MRI.
Tanulási terv
Hogyan készül a tanulmány?
Tervezési részletek
- Elsődleges cél: Diagnosztikai
- Kiosztás: N/A
- Beavatkozó modell: Egyetlen csoportos hozzárendelés
- Maszkolás: Egyetlen
Fegyverek és beavatkozások
Résztvevő csoport / kar |
Beavatkozás / kezelés |
|---|---|
|
Aktív összehasonlító: Radiologist interpretation of MRI +/- prostate biopsy
Radiologist Interpretation
|
Radiologist will interpret the prostate MRI (as per standard of care)
|
|
Kísérleti: AI interpretation of MRI +/- prostate biopsy
AI Interpretation
|
AI algorithm that will interpretate the prostate MRI
|
Mit mér a tanulmány?
Elsődleges eredményintézkedések
Eredménymérő |
Intézkedés leírása |
Időkeret |
|---|---|---|
|
Proportion of men with clinically significant cancer
Időkeret: When biopsy results available, at an expected average of 30 days post-biopsy
|
Proportion of men with clinically significant cancer detected (any pattern 4 disease on any core (i.e.
Gleason Grade ≥ 3+4/Gleason grade group ≥2).
|
When biopsy results available, at an expected average of 30 days post-biopsy
|
Másodlagos eredményintézkedések
Eredménymérő |
Intézkedés leírása |
Időkeret |
|---|---|---|
|
Proportion of men with clinically insignificant cancer
Időkeret: When biopsy results available, at an expected average of 30 days post-biopsy
|
Proportion of men with clinically insignificant cancer detected (Gleason grade 3+3/Gleason grade group 1).
|
When biopsy results available, at an expected average of 30 days post-biopsy
|
|
Proportion of men with non-suspicious MRIs
Időkeret: When MRI results available, at an expected average of 30 days post-MRI
|
Proportion of men with non-suspicious MRIs for AI vs Radiologists
|
When MRI results available, at an expected average of 30 days post-MRI
|
|
Proportion of MRIs with indeterminate scores.
Időkeret: When MRI results available, at an expected average of 30 days post-MRI
|
Proportion of men with indeterminately scored MRI as reported by AI vs radiologists
|
When MRI results available, at an expected average of 30 days post-MRI
|
|
Agreement between AI and Radiologist in score of suspicion
Időkeret: When MRI results available, at an expected average of 30 days post-MRI
|
Compare the proportion of MRIs with concordant scores between AI and Radiologist in score of suspicion
|
When MRI results available, at an expected average of 30 days post-MRI
|
|
Diagnostic test performance characteristics (AI versus Radiologist)
Időkeret: When biopsy results available, at an expected average of 30 days post-biopsy
|
Test performance characteristics for AI and Radiologists, including sensitivity, specificity, area under the receive operating characteristic curve, positive predictive value and negative predictive value.
|
When biopsy results available, at an expected average of 30 days post-biopsy
|
|
Diagnostic test performance characteristics (AI plus Radiologist)
Időkeret: When biopsy results available, at an expected average of 30 days post-biopsy
|
Test performance characteristics of AI in combination with Radiologist (summative of all identified lesions) compared to a radiologist alone, including sensitivity, specificity, area under the receive operating characteristic curve, positive predictive value and negative predictive value.
|
When biopsy results available, at an expected average of 30 days post-biopsy
|
|
Diagnostic test performance characteristics (AI-assisted Radiologist)
Időkeret: When biopsy results available, at an expected average of 30 days post-biopsy
|
Test performance characteristics of AI in combination with Radiologist (where the radiologist can interact with the AI system by accepting or rejecting AI-identified lesions) compared to a radiologist alone, including sensitivity, specificity, area under the receive operating characteristic curve, positive predictive value and negative predictive value.
|
When biopsy results available, at an expected average of 30 days post-biopsy
|
|
Significant cancer detected by peri-lesional biopsies
Időkeret: When biopsy results available, at an expected average of 30 days post-biopsy
|
Proportion of patients with significant cancer detected taking into account peri-lesional biopsies of AI and Radiologist declared lesions.
|
When biopsy results available, at an expected average of 30 days post-biopsy
|
|
Significant cancer detected by systematic biopsies
Időkeret: When biopsy results available, at an expected average of 30 days post-biopsy
|
Proportion of patients with significant cancer detected by systematic biopsies
|
When biopsy results available, at an expected average of 30 days post-biopsy
|
|
Frequency of AI failures
Időkeret: When MRI results available, at an expected average of 30 days post-MRI
|
Proportion of patients where AI was unable to interpret the MRI scan
|
When MRI results available, at an expected average of 30 days post-MRI
|
|
Treatment eligibility decisions
Időkeret: When biopsy results available, at an expected average of 30 days post-biopsy
|
Proportion of patients where treatment eligibility changed between AI and Radiologist
|
When biopsy results available, at an expected average of 30 days post-biopsy
|
|
Cost-efffectiveness
Időkeret: At an expected average of 30 days post-intervention
|
Cost-effectiveness of unblinded AI interpreted by the radiologist compared to radiologist alone in detecting significant prostate cancer, and AI alone vs. radiologist alone, and a 3-arm analysis considering all three.
|
At an expected average of 30 days post-intervention
|
Együttműködők és nyomozók
Szponzor
Együttműködők
Nyomozók
- Tanulmányi szék: Veeru Kasivisvanathan, MBBS BSc FRCS MSc PGCert PhD, Division of Surgery and Interventional Science, University College London, UK
- Tanulmányi szék: Doug Pendse, MB ChB MD (Res) MRCS FRCR, Department of Radiology, Universiy College London Hospitals NHS Foundation Trust, UK
Tanulmányi rekorddátumok
Tanulmány főbb dátumok
Tanulmány kezdete (Becsült)
Elsődleges befejezés (Becsült)
A tanulmány befejezése (Becsült)
Tanulmányi regisztráció dátumai
Először benyújtva
Először nyújtották be, amely megfelel a minőségbiztosítási kritériumoknak
Első közzététel (Tényleges)
Tanulmányi rekordok frissítései
Utolsó frissítés közzétéve (Tényleges)
Az utolsó frissítés elküldve, amely megfelel a minőségbiztosítási kritériumoknak
Utolsó ellenőrzés
Több információ
A tanulmányhoz kapcsolódó kifejezések
Kulcsszavak
További vonatkozó MeSH feltételek
Egyéb vizsgálati azonosító számok
- 338739
Terv az egyéni résztvevői adatokhoz (IPD)
Tervezi megosztani az egyéni résztvevői adatokat (IPD)?
IPD terv leírása
IPD megosztási időkeret
IPD-megosztási hozzáférési feltételek
Az IPD megosztását támogató információ típusa
- STUDY_PROTOCOL
- NEDV
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