The National Cancer Imaging Translational Accelerator (NCITA) in partnership with the ReIMAGINE Consortium have announced the release of a unique clinical imaging dataset from the Prostate MRI Imaging Study (PROMIS)).  The imaging dataset can now be accessed by clinical researchers, initially on an application basis, for artificial intelligence (AI) research to speed up imaging diagnosis of clinically significant prostate cancer using novel machine learning tools.

About the PROMIS study

PROMIS was a landmark multi-centre study funded by the National Institute for Health and Care Research (NIHR) that has reshaped the prostate cancer diagnostic pathway.  The study assessed the accuracy of an imaging technique called multiparametric magnetic resonance imaging (mp-MRI) for diagnosing prostate cancer compared to a detailed biopsy procedure.  A total of 576 men underwent a mp-MRI scan, followed by a systematic transrectal ultrasound (TRUS)-guided biopsy and a 5 mm transperineal template mapping (TPM) biopsy across the entire prostate. As the MRI scans were reported independently to the biopsy, all participants, underwent a full prostate biopsy, irrespective of the MRI result.

The results published in the Lancet showed that mp-MRI scan was highly accurate in detecting 93% of prostate cancers compared to 43% for the TRUS biopsy test. The mp-MRI scan was also shown to accurately identify about 25% of men who did not have prostate cancer and who might safely avoid having a biopsy.

Changes in international guidelines

These landmark results from the PROMIS study and a number of other high-profile studies including PRECISION (PRostate Evaluation for Clinically Important disease, Sampling using Image-guidance Or Not?) published in the New England Journal of Medicine have led to changes in international guidelines for prostate cancer care to reduce the proportion of men having unnecessary biopsies and improve the detection of clinically significant prostate cancer.

The 2019 UK National Institute for Health and Care Excellence (NICE) guidelines and the 2019 European Association of Urology guidelines now recommend that all men with a suspicion of prostate cancer receive a mp-MRI scan as an initial test prior to prostate biopsy.  Both organisations also recommend considering avoiding a prostate biopsy in men with low clinical risk of prostate cancer who have a non-suspicious MRI, after an informed discussion with the patient.

Unique clinical imaging dataset for AI and machine learning research

The clinical imaging dataset from the PROMIS study includes data from 11 NHS hospital trusts across the UK, and comprises of over 500 consecutive pre-biopsy mp-MRI scans paired with comprehensive template mapped biopsies of the prostate.  This is an entirely unique dataset as it includes paired MRI scanning and template mapped biopsy of the entire prostate, including template biopsy validated negative MRI cases.

The dataset, which has been curated by the ReIMAGINE consortium at UCL, is now accessible to clinical researchers who are developing AI algorithms and machine learning tools for clinical application to speed up prostate cancer diagnosis.

Accessing the PROMIS study dataset

The curated PROMIS study imaging dataset is hosted by NCITA, a UK-wide clinical imaging research infrastructure funded by a 5-year Cancer Research UK Accelerator Award.  NCITA provides a federated digital infrastructure for the secure storage and sharing of imaging data as well as data integration and analysis services using AI and machine learning tools.

The curated imaging dataset is now accessible to clinical researchers on an application basis to The ReIMAGINE PCa Risk Trial Management Group. For further details, please contact by email: ncita.general@ucl.ac.uk).

Professor Hashim Ahmed, Chair of Urology at Imperial College London commented:

“PROMIS was a once-in-a-lifetime, never to be repeated, validation study in which all patients underwent a transperineal template mapping biopsy of the prostate. This gold standard reference test provides the highest accuracy and fidelity of cancer status and location for a population at risk.”

Professor Mark Emberton, Dean of Medical Sciences at UCL, who led the PROMIS study commented:

“PROMIS will never be repeated.  As such it offers a unique (and therefore priceless) data set for testing any prostate cancer diagnostic against as true a negative as it is possible to get in an individual at risk.”

Professor Shonit Punwani, Professor of Magnetic Resonance and Cancer Imaging and Consultant Radiologist at UCL and Chair of the NCITA governance group commented:

“NCITA are delighted to host this landmark dataset, that offers a unique and exciting opportunity. Template biopsy validated negative MRI cases are rarely available for AI development, and have the potential to improve the accuracy of machine learning models.“

About the National Cancer Imaging Translational Accelerator (NCITA)

NCITA is a national UK infrastructure consortium funded by a 5-year Cancer Research UK Accelerator Award to accelerate the standardisation and clinical translation of imaging biomarkers into clinical trials and the NHS.  NCITA brings together nine world-leading medical imaging centres from across the UK including University College London, University of Oxford, University of Manchester, Institute of Cancer Research London, King’s College London, Imperial College London, University of Cambridge, Newcastle University and University of Glasgow.  The NCITA infrastructure network provides clinical researchers with access to a specialised imaging clinical trials unit offering bespoke trial management and governance, quality assurance and control support and data repository services, including artificial intelligence tools and ongoing training opportunities.  For more information on the NCITA infrastructure support for clinical imaging research, please visit ncita.org.uk and view the NCITA Comment article published in the British Journal of Cancer in July 2021 (https://www.nature.com/articles/s41416-021-01497-5). Follow us on Twitter and LinkedIn.

About ReIMAGINE

ReIMAGINE is a UCL consortium funded by the Medical Research Council (MRC) and Cancer Research UK (CRUK), which was established in 2018 to test combining MRI with diagnostic molecular markers as a tool for precise baseline risk stratification of men being assessed for prostate cancer.  The ReIMAGINE studies will test for the first time if MRI scans can be used for population screening to detect prostate cancer more accurately. The current prostate-specific antigen (PSA) test is considered too unreliable for population screening, and the scientists will study if MRI could be used to screen men to pick up cancers earlier and more reliably, and help save lives.  For more information, please visit reimagine-pca.org.

About NIHR

The mission of the National Institute for Health and Care Research (NIHR) is to improve the health and wealth of the nation through research. We do this by:

Funding high quality, timely research that benefits the NHS, public health and social care;

Investing in world-class expertise, facilities and a skilled delivery workforce to translate discoveries into improved treatments and services;

Partnering with patients, service users, carers and communities, improving the relevance, quality and impact of our research;

Attracting, training and supporting the best researchers to tackle complex health and social care challenges;

Collaborating with other public funders, charities and industry to help shape a cohesive and globally competitive research system;

Funding applied global health research and training to meet the needs of the poorest people in low- and middle-income countries.

NIHR is funded by the Department of Health and Social Care. Its work in low- and middle-income countries is principally funded through UK Aid from the UK government. For more information, please visit https://www.nihr.ac.uk/.

About Cancer Research UK 

Cancer Research UK is the world’s leading cancer charity dedicated to saving lives through research, influence and information. 

Cancer Research UK’s pioneering work into the prevention, diagnosis and treatment of cancer has helped save millions of lives.  

Cancer Research UK has been at the heart of the progress that has already seen survival in the UK double in the last 40 years.  

Today, 2 in 4 people survive their cancer for at least 10 years. Cancer Research UK wants to accelerate progress and see 3 in 4 people surviving their cancer by 2034. 

Cancer Research UK supports research into the prevention and treatment of cancer through the work of over 4,000 scientists, doctors and nurses. 

Together with its partners and supporters, Cancer Research UK is working towards a world where people can live longer, better lives, free from the fear of cancer. 

For further information about Cancer Research UK's work or to find out how to support the charity, please call 0300 123 1022 or visit www.cancerresearchuk.org. Follow us on Twitter and Facebook.

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About MRC Clinical Trials Unit

The Medical Research Council (MRC) Clinical Trials Unit at University College London (MRC CTU at UCL) is a centre of excellence for clinical trials, meta-analyses and epidemiological studies. It specialises in cancer and HIV/AIDS, but also undertakes research in other areas, including rheumatoid arthritis, tuberculosis and mental health.  For more information visit https://www.mrcctu.ucl.ac.uk/.

Links

• Professor Hashim Ahmed
• Professor Mark Emberton
• Professor Shonit Punwani
• PROMIS trial
• NCITA
• ReIMAGINE
• PRECISION trial
• NICE

References

1.         Stavrinides V, Syer T, Hu Y, Giganti F, Freeman A, Karapanagiotis S, et al. False Positive Multiparametric Magnetic Resonance Imaging Phenotypes in the Biopsy-naive Prostate: Are They Distinct from Significant Cancer-associated Lesions? Lessons from PROMIS. Eur Urol. 2021;79(1):20-9.

2.         Norris JM, Carmona Echeverria LM, Bott SRJ, Brown LC, Burns-Cox N, Dudderidge T, et al. What Type of Prostate Cancer Is Systematically Overlooked by Multiparametric Magnetic Resonance Imaging? An Analysis from the PROMIS Cohort. Eur Urol. 2020;78(2):163-70.

3.         Bosaily AE, Frangou E, Ahmed HU, Emberton M, Punwani S, Kaplan R, et al. Additional Value of Dynamic Contrast-enhanced Sequences in Multiparametric Prostate Magnetic Resonance Imaging: Data from the PROMIS Study. Eur Urol. 2020;78(4):503-11.

4.         Ahmed HU, El-Shater Bosaily A, Brown LC, Gabe R, Kaplan R, Parmar MK, et al. Diagnostic accuracy of multi-parametric MRI and TRUS biopsy in prostate cancer (PROMIS): a paired validating confirmatory study. Lancet. 2017;389(10071):815-22.