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Prostate MRI Analysis by Radiologists and Artificial Intelligence - Disease Identification and Guided Management (PARADIGM)

2026年6月29日 更新者：University College, London

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.

研究概览

地位

尚未招聘

条件

干预/治疗

详细说明

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

  1. To compare the proportion of men who have clinically insignificant prostate cancer detected on MRI using AI ± targeted biopsy with radiologists ± targeted biopsy.
  2. To compare the proportion of men with non-suspicious MRIs for AI vs radiologists.
  3. To compare the proportion of men with indeterminately scored MRI as reported by AI vs radiologists.
  4. To compare the diagnostic test performance of AI vs radiologist.
  5. To compare the additive value of AI when used together with a radiologist interpretation (summative of all identified lesions) compared to a radiologist alone.
  6. 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.
  7. To determine the frequency of AI failures.
  8. To compare treatment eligibility decisions between AI and Radiologist.
  9. 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.

研究类型

介入性

注册 (估计的)

500

阶段

  • 不适用

联系人和位置

本节提供了进行研究的人员的详细联系信息，以及有关进行该研究的地点的信息。

学习联系方式

研究联系人备份

参与标准

研究人员寻找符合特定描述的人，称为资格标准。这些标准的一些例子是一个人的一般健康状况或先前的治疗。

资格标准

适合学习的年龄

  • 成人
  • 年长者

接受健康志愿者

不

描述

Inclusion Criteria:

  1. Men at least 18 years of age referred with clinical suspicion of prostate cancer
  2. Serum PSA ≤ 20 ng/mL
  3. Fit to undergo all procedures listed in the protocol
  4. Able to provide written informed consent

Exclusion Criteria:

  1. Prior prostate biopsy
  2. Prior prostate MRI on a previous encounter*
  3. Prior treatment for prostate cancer
  4. Contraindication to MRI (e.g. claustrophobia, pacemaker)
  5. Metalwork that would give rise to artefact on MRI (e.g. hip prosthesis, pelvic/spinal metalwork)
  6. Contraindication to prostate biopsy

  7. 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.

学习计划

本节提供研究计划的详细信息，包括研究的设计方式和研究的衡量标准。

研究是如何设计的？

设计细节

  • 主要用途：诊断
  • 分配：不适用
  • 介入模型：单组作业
  • 屏蔽：单身的

武器和干预

参与者组/臂
干预/治疗
有源比较器：Radiologist interpretation of MRI +/- prostate biopsy
Radiologist Interpretation
诊断测试：Radiologist interpretation
Radiologist will interpret the prostate MRI (as per standard of care)
实验性的：AI interpretation of MRI +/- prostate biopsy
AI Interpretation
诊断测试：AI (Lucida Pi) interpretation
AI algorithm that will interpretate the prostate MRI

研究衡量的是什么？

主要结果指标

结果测量
措施说明
大体时间
Proportion of men with clinically significant cancer
大体时间：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

次要结果测量

结果测量
措施说明
大体时间
Proportion of men with clinically insignificant cancer
大体时间：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
大体时间：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.
大体时间：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
大体时间：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)
大体时间：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)
大体时间：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)
大体时间：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
大体时间：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
大体时间：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
大体时间：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
大体时间：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
大体时间：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

合作者和调查者

在这里您可以找到参与这项研究的人员和组织。

赞助

University College, London

合作者

Lucida Medical Ltd

调查人员

  • 学习椅：Veeru Kasivisvanathan, MBBS BSc FRCS MSc PGCert PhD、Division of Surgery and Interventional Science, University College London, UK
  • 学习椅：Doug Pendse, MB ChB MD (Res) MRCS FRCR、Department of Radiology, Universiy College London Hospitals NHS Foundation Trust, UK

研究记录日期

这些日期跟踪向 ClinicalTrials.gov 提交研究记录和摘要结果的进度。研究记录和报告的结果由国家医学图书馆 (NLM) 审查，以确保它们在发布到公共网站之前符合特定的质量控制标准。

研究主要日期

学习开始 (估计的)

2026年10月1日

初级完成 (估计的)

2029年1月1日

研究完成 (估计的)

2029年1月1日

研究注册日期

首次提交

2026年6月9日

首先提交符合 QC 标准的

2026年6月9日

首次发布 (实际的)

2026年6月15日

研究记录更新

最后更新发布 (实际的)

2026年6月30日

上次提交的符合 QC 标准的更新

2026年6月29日

最后验证

2026年6月1日

更多信息

与本研究相关的术语

关键字

其他相关的 MeSH 术语

其他研究编号

  • 338739

计划个人参与者数据 (IPD)

计划共享个人参与者数据 (IPD)？

是的

IPD 计划说明

Anonymised data will be available at request for bona fide researchers with important research questions subject to approval by the study steering committee.

IPD 共享时间框架

Data will become available 1 year after publication of the main study results.

IPD 共享访问标准

A study steering committee will review all requests for access to the data and will make decisions on whether or not to grant access to bona fide researchers based on the importance of the research question being asked, ensuring analysis is non overlapping with existing analyses and planned analyses.

IPD 共享支持信息类型

  • 研究方案
  • 树液

药物和器械信息、研究文件

研究美国 FDA 监管的药品

不

研究美国 FDA 监管的设备产品

不

此信息直接从 clinicaltrials.gov 网站检索，没有任何更改。如果您有任何更改、删除或更新研究详细信息的请求，请联系 register@clinicaltrials.gov. clinicaltrials.gov 上实施更改，我们的网站上也会自动更新.

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