%0 Journal Article
%A Ortner, Gernot
%A Hoderlein, Xenia
%A Barbato, Francesco
%A Beyersdorff, Dirk
%A Budäus, Lars
%A Burger, Irene A
%A Eiber, Matthias
%A Graefen, Markus
%A Hadaschik, Boris
%A Haese, Alexander
%A Herrmann, Ken
%A Maack, Lennart
%A Maric, Ines
%A Mattei, Agostino
%A Rauscher, Isabel
%A Salomon, Georg
%A Sauer, Markus
%A Schimmöller, Lars
%A Schlaefer, Alexander
%A Schlemmer, Heinz-Peter
%A Spohn, Simon K B
%A Umutlu, Lale
%A Walz, Jochen
%A Würnschimmel, Christoph
%A Koehler, Daniel
%A Maurer, Tobias
%T The Pelvic Rosetta Classification Project: An Interdisciplinary Proposal for a Lymph Node Map of the Pelvis in Prostate Cancer.
%J Journal of nuclear medicine
%V nn
%@ 0097-9058
%C New York, NY
%I Soc.
%M DKFZ-2025-02292
%P nn
%D 2025
%Z epub
%X The Pelvic Rosetta Classification (PRC) project aimed to develop an interdisciplinary, landmark-based pelvic lymph node map for patients with prostate cancer to improve communication between imaging specialists and urologists. Methods: After an intense development phase, we conducted 3 evaluation rounds including 19 clinical experts having consensus meetings after each evaluation round. Experts contoured lymph node areas (LNA) for 2 patients with prostate cancer. Contours were assessed qualitatively and quantitatively. The PRC was further validated by assignment of 30 prostate-specific membrane antigen PET/CT-positive lesions to LNAs. The interrater reliability was calculated using Fleiss κ. Based on the final PRC, a complete contour and a 3-dimensional model were created. Results: Eight pelvic (external iliac, cranial/caudal obturator fossa, dorsal internal iliac, vesico-prostatic pedicle, mesorectal/perirectal, presacral, preprostatic/retropubic) and 4 extrapelvic (common iliac, intercommon, sigmoid, inguinal) LNAs were defined using anatomic landmarks which are consistently recognizable on imaging and intraoperatively. Strong consensus between experts existed for smaller, well-defined LNAs (e.g., preprostatic/retropubic, mesorectal/perirectal LNAs) compared with regions with proportionally large borders (e.g., obturator fossa, vesico-prostatic pedicle LNAs). Overall, moderate agreement (κ = 0.53) was observed during validation. Discrepancies were mostly encountered for lesions adjacent to borders between LNAs. The final contour and 3-dimensional model were approved by all experts. Conclusion: The PRC project showed fair reproducibility and validity. Further external validation is needed to assess its influence on interdisciplinary communication and treatment outcomes.
%K PSA (Other)
%K lymph node drainage (Other)
%K metastases (Other)
%K sentinel (Other)
%K standardization (Other)
%F PUB:(DE-HGF)16
%9 Journal Article
%$ pmid:41198239
%R 10.2967/jnumed.125.270667
%U https://inrepo02.dkfz.de/record/305662