TY  - JOUR
AU  - Ortner, Gernot
AU  - Hoderlein, Xenia
AU  - Barbato, Francesco
AU  - Beyersdorff, Dirk
AU  - Budäus, Lars
AU  - Burger, Irene A
AU  - Eiber, Matthias
AU  - Graefen, Markus
AU  - Hadaschik, Boris
AU  - Haese, Alexander
AU  - Herrmann, Ken
AU  - Maack, Lennart
AU  - Maric, Ines
AU  - Mattei, Agostino
AU  - Rauscher, Isabel
AU  - Salomon, Georg
AU  - Sauer, Markus
AU  - Schimmöller, Lars
AU  - Schlaefer, Alexander
AU  - Schlemmer, Heinz-Peter
AU  - Spohn, Simon K B
AU  - Umutlu, Lale
AU  - Walz, Jochen
AU  - Würnschimmel, Christoph
AU  - Koehler, Daniel
AU  - Maurer, Tobias
TI  - The Pelvic Rosetta Classification Project: An Interdisciplinary Proposal for a Lymph Node Map of the Pelvis in Prostate Cancer.
JO  - Journal of nuclear medicine
VL  - nn
SN  - 0097-9058
CY  - New York, NY
PB  - Soc.
M1  - DKFZ-2025-02292
SP  - nn
PY  - 2025
N1  - epub
AB  - 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.
KW  - PSA (Other)
KW  - lymph node drainage (Other)
KW  - metastases (Other)
KW  - sentinel (Other)
KW  - standardization (Other)
LB  - PUB:(DE-HGF)16
C6  - pmid:41198239
DO  - DOI:10.2967/jnumed.125.270667
UR  - https://inrepo02.dkfz.de/record/305662
ER  -