- ICH GCP
- Rejestr badań klinicznych w USA
- Badanie kliniczne 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 interpretating 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. f 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.
Przegląd badań
Status
Warunki
Interwencja / Leczenie
Szczegółowy opis
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 evidnece trial in participants referred to hospital with a clinical suspicion of prostate cancer.
Typ studiów
Zapisy (Szacowany)
Faza
- Nie dotyczy
Kontakty i lokalizacje
Kontakt w sprawie studiów
- Nazwa: Ng Alexander, MBBS BSc (Hons)
- Numer telefonu: +44 0207 679 5057
- E-mail: alexander.ng@ucl.ac.uk
Kopia zapasowa kontaktu do badania
- Nazwa: PARADIGM Study Team
- E-mail: med.paradigm@ucl.ac.uk
Kryteria uczestnictwa
Kryteria kwalifikacji
Wiek uprawniający do nauki
- Dorosły
- Starszy dorosły
Akceptuje zdrowych ochotników
Opis
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.
Plan studiów
Jak projektuje się badanie?
Szczegóły projektu
- Główny cel: Diagnostyczny
- Przydział: Nielosowe
- Model interwencyjny: Zadanie dla jednej grupy
- Maskowanie: Pojedynczy
Broń i interwencje
Grupa uczestników / Arm |
Interwencja / Leczenie |
|---|---|
|
Aktywny komparator: Radiologist interpretation of MRI +/- prostate biopsy
Radiologist Interpretation
|
Radiologist will interpret the prostate MRI (as per standard of care)
|
|
Eksperymentalny: AI interpretation of MRI +/- prostate biopsy
AI Interpretation
|
AI algorithm that will interpretate the prostate MRI
|
Co mierzy badanie?
Podstawowe miary wyniku
Miara wyniku |
Opis środka |
Ramy czasowe |
|---|---|---|
|
Proportion of men with clinically significant cancer
Ramy czasowe: 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
|
Miary wyników drugorzędnych
Miara wyniku |
Opis środka |
Ramy czasowe |
|---|---|---|
|
Proportion of men with clinically insignificant cancer
Ramy czasowe: 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
Ramy czasowe: 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.
Ramy czasowe: 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
Ramy czasowe: 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)
Ramy czasowe: 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)
Ramy czasowe: 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)
Ramy czasowe: 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
Ramy czasowe: 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
Ramy czasowe: 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
Ramy czasowe: 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
Ramy czasowe: 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
Ramy czasowe: 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
|
Współpracownicy i badacze
Sponsor
Współpracownicy
Śledczy
- Krzesło do nauki: Veeru Kasivisvanathan, MBBS BSc FRCS MSc PGCert PhD, Division of Surgery and Interventional Science, University College London, UK
- Krzesło do nauki: Doug Pendse, MB ChB MD (Res) MRCS FRCR, Department of Radiology, Universiy College London Hospitals NHS Foundation Trust, UK
Daty zapisu na studia
Główne daty studiów
Rozpoczęcie studiów (Szacowany)
Zakończenie podstawowe (Szacowany)
Ukończenie studiów (Szacowany)
Daty rejestracji na studia
Pierwszy przesłany
Pierwszy przesłany, który spełnia kryteria kontroli jakości
Pierwszy wysłany (Rzeczywisty)
Aktualizacje rekordów badań
Ostatnia wysłana aktualizacja (Rzeczywisty)
Ostatnia przesłana aktualizacja, która spełniała kryteria kontroli jakości
Ostatnia weryfikacja
Więcej informacji
Terminy związane z tym badaniem
Słowa kluczowe
Dodatkowe istotne warunki MeSH
Inne numery identyfikacyjne badania
- 338739
Plan dla danych uczestnika indywidualnego (IPD)
Planujesz udostępniać dane poszczególnych uczestników (IPD)?
Opis planu IPD
Ramy czasowe udostępniania IPD
Kryteria dostępu do udostępniania IPD
Typ informacji pomocniczych dotyczących udostępniania IPD
- PROTOKÓŁ BADANIA
- SOK ROŚLINNY
Informacje o lekach i urządzeniach, dokumenty badawcze
Bada produkt leczniczy regulowany przez amerykańską FDA
Bada produkt urządzenia regulowany przez amerykańską FDA
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