Brief 🧵 1/

How common is *failure* of modern active surveillance (AS) for #ProstateCancer (PCa)?

Which patients are at higher risk?

Spoiler 🚨: it’s pretty simple

@EurUrolOncol @UroToday @OncoAlert @PCF_Science @gu_onc @AmerUrological @Uroweb 2/

Link to paper:

@ImagingProstate @jasonvassy @rtdess @a_dalpra @docpriyamvada @whallradonc @Xristodouleas @CZamboglou @SbrtSean @SeanMcGuireMD @Soum_Roy_RadOnc @BrandonMahal @LabBryantauthors.elsevier.com/sd/article/S25…

How do you know if #AI works in medicine⚕️?

🧑🏽‍⚕️👩🏻‍⚕️👨🏻‍⚕️must step up to define the reference standard and put 🤖 to the test

🧵on an example: precisely outlining the prostate on MRI

@EricTopol @PCF_Science @urotoday @OncoAlert
1/n Background: #radonc docs target radiation therapy using imaging

Traditionally, we used CT scans. But docs tend to draw the “prostate” 30% too big while still missing 16% of the actual organ 😬



2/n sciencedirect.com/science/articl…

PRIMARY: is Ga PSMA PET useful beyond mpMRI for diagnosis of #ProstateCancer?

MRI -> MRI+PSMA: avoid 22 unnecessary biopsies but add 17 false+, so only really spare 5/291 men by adding PSMA.

🧵1/ Really great study by @drlouiseemmett is worth a close read.

2/

sciencedirect.com/science/articl…

@EUplatinum

New #radonc attendings:

Your first cases will take a long time. That's normal. It means you understand how big #cancer care is and are doing your best by your patients. Be patient with yourself. It will get easier. You *do* know what you are doing.
(1/n) Also, don't forget:
1. Expert contours vary.
2. Imaging now is better than the old trials that often define care.
3. Dose has a gradient.
(2/n)