BJU International最新文献

{"title":"An artificial intelligence model combining MRI and ultrasound images (MRUSuNet) for prostate cancer detection outperforms radiologist MRI interpretation","authors":"Hassan Jahanandish, Shengtian Sang, Cynthia Xinran Li, Sulaiman Vesal, Indrani Bhattacharya, Jeong Hoon Lee, Rajesh Venkataraman, Richard E. Fan, Geoffrey A. Sonn, Mirabela Rusu","doi":"10.1111/bju.70491","DOIUrl":"https://doi.org/10.1111/bju.70491","url":null,"abstract":"Objectives To develop the magnetic resonance imaging (MRI)‐UltraSound UNet (MRUSuNet), a model that uses both MRI and transrectal ultrasonography (TRUS) as input to detect and localise the three‐dimensional spatial volume of clinically significant prostate cancer on TRUS images to allow better visualisation of cancer in the TRUS space. Patients and Methods Pre‐biopsy MRI is increasingly used to target suspicious prostate lesions. The lesions identified by radiologists are mapped onto TRUS images to enable real‐time targeting during the biopsy. Yet, the misalignment of MRI and TRUS results in sampling errors, and in some cases even missing the clinically significant cancers. This study included two MRI‐TRUS fusion biopsy cohorts (3000 patients) for model development, and one radical prostatectomy cohort (110 patients) used for independent validation and for the comparison with radiologist interpretation. A total of 1700 independent cases were reserved to compare the MRUSuNet with single‐modality MRI‐only and TRUS‐only models. Sensitivity and lesion‐level Dice similarity scores were computed using targeted biopsy pathology as the reference standard in the biopsy cohorts and whole‐mount prostatectomy pathology in the radical prostatectomy cohort. Result The MRUSuNet achieved significantly superior sensitivity (0.80) and lesion Dice score (0.42) across all test cohorts compared to the MRI‐only model (sensitivity: 0.73, <jats:italic>P</jats:italic> = 0.033; Dice score: 0.30, <jats:italic>P</jats:italic> &lt; 0.001) and the TRUS‐only model (sensitivity: 0.49, <jats:italic>P</jats:italic> &lt; 0.001; Dice score: 0.27, <jats:italic>P</jats:italic> &lt; 0.001). Compared to radiologists in the prostatectomy cohort, the MRUSuNet showed significantly higher specificity (0.88 vs 0.78; <jats:italic>P</jats:italic> = 0.004) and lesion Dice score (0.32 vs 0.27; <jats:italic>P</jats:italic> = 0.048), with no observed statistical difference in sensitivity (0.79; <jats:italic>P</jats:italic> = 1.000). Conclusion Our findings demonstrate the potential of combining MRI and TRUS in a multimodal artificial intelligence (AI) model to improve localisation of clinically significant prostate cancer on TRUS images relative to single‐modality models. These findings support further study of such multimodal AI models as an adjunct to MRI‐TRUS fusion workflows.","PeriodicalId":8985,"journal":{"name":"BJU International","volume":"13 1","pages":""},"PeriodicalIF":4.5,"publicationDate":"2026-10-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149226566","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"UK urology trainee interest in functional urology: a national survey","authors":"James Liston, Pragnitha Chitteti, Sanad Saad, Magda Kujawa, Arun Sahai, Suzanne Biers, Mehwash Nadeem","doi":"10.1111/bju.70485","DOIUrl":"https://doi.org/10.1111/bju.70485","url":null,"abstract":"","PeriodicalId":8985,"journal":{"name":"BJU International","volume":"5 1","pages":""},"PeriodicalIF":4.5,"publicationDate":"2026-10-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149226384","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"When surgery changes PSA : refining a cytoreductive prostatectomy trial endpoint","authors":"Ahmed M. Elalfy","doi":"10.1111/bju.70495","DOIUrl":"https://doi.org/10.1111/bju.70495","url":null,"abstract":"","PeriodicalId":8985,"journal":{"name":"BJU International","volume":"19 1","pages":""},"PeriodicalIF":4.5,"publicationDate":"2026-10-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149226385","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"First African city‐to‐city robot‐assisted radical prostatectomy: a feasibility experience toward a telesurgery programme","authors":"Adil Ouzzane, Adil Mellouki, Khalid Azizi, Mohammed Amine Lakmichi, Jaafar Zemrag, Rajaa Et‐Touzani, Maxime Odin, Redouane Rabii, Guillaume Ploussard, Younes Tibari, Nordine Deffar, Alae Touzani","doi":"10.1111/bju.70510","DOIUrl":"https://doi.org/10.1111/bju.70510","url":null,"abstract":"","PeriodicalId":8985,"journal":{"name":"BJU International","volume":"13 1","pages":""},"PeriodicalIF":4.5,"publicationDate":"2026-10-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149226383","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Reply to: When surgery changes PSA : refining a cytoreductive prostatectomy trial endpoint","authors":"Xiangwei Yang, Hanqi Lei, Binyuan Yan, Jun Pang","doi":"10.1111/bju.70496","DOIUrl":"https://doi.org/10.1111/bju.70496","url":null,"abstract":"","PeriodicalId":8985,"journal":{"name":"BJU International","volume":"32 1","pages":""},"PeriodicalIF":4.5,"publicationDate":"2026-10-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149221335","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Androgen driven organoids for the male urogenital system","authors":"Anlin Liu, Luchen Yang, Xin Yan, Zhenghuan Liu, Haiyun Qiu, Xiaoyang Liu, Kai Ma, Haolin Liu, Qiang Dong","doi":"10.1111/bju.70502","DOIUrl":"https://doi.org/10.1111/bju.70502","url":null,"abstract":"Androgen signalling plays a central role in the development and function of the male urogenital system, including the adrenal gland, prostate, and testis. Disruption of the androgen axis underlies diseases ranging from infertility to castration‐resistant prostate cancer, yet current models fail to fully display its multi‐organ and hormone‐driven complexity. Organoid systems provide a promising platform to model androgen‐responsive tissues while preserving three‐dimensional structure and cellular heterogeneity, with the ability for long‐term culture and cryopreservation. Recent advances have enabled the generation of prostate, testicular, and adrenocortical organoids, offering new opportunities to study androgen receptor signalling, steroidogenesis, and lineage plasticity. Here, we review androgen‐driven organoids across the male urogenital axis and discuss emerging strategies to recapitulate endocrine crosstalk. Despite these advances, current models remain reductionist and lack systemic integration. Future efforts toward multi‐organ platforms and engineered microenvironments may enable the elucidation of the role of androgen signalling in physiological conditions and disease development.","PeriodicalId":8985,"journal":{"name":"BJU International","volume":"73 1","pages":""},"PeriodicalIF":4.5,"publicationDate":"2026-10-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149221395","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Transient apnoea for motion control during flexible ureteroscopic lithotripsy: a randomised trial","authors":"Jiahuan Yu, Yi Zhou, Xiaolei Shi, Yi Liu, Ziyu Fang, Min Liu, Shaoxiong Ming, Hao Dong, Yonghan Peng, Yuanchang Xiong, Xiaofeng Gao, Linhui Wang, Ling Li","doi":"10.1111/bju.70505","DOIUrl":"https://doi.org/10.1111/bju.70505","url":null,"abstract":"Objectives To determine whether transient apnoea (TA) during flexible ureteroscopic laser lithotripsy improves active lithotripsy efficiency compared with regular mechanical ventilation (RMV) and small tidal‐volume ventilation (STVV). Patients and Methods In this single‐centre, three‐arm randomised trial, 150 adults with a single computed tomography (CT)‐confirmed renal, ureteropelvic, or proximal ureteric stone measuring 10–&lt;20 mm were assigned one‐to‐one‐to‐one to RMV, STVV, or TA. TA followed 5‐min 100% oxygen pre‐oxygenation, with 9‐min maximum and pre‐specified stopping criteria under continuous anaesthetic monitoring. The primary endpoint was active lithotripsy efficiency, defined as CT‐estimated stone volume divided by elapsed active lithotripsy time. Analyses followed the intention‐to‐treat principle. Results The mean (standard deviation) active lithotripsy efficiency was 27.8 (8.9), 26.6 (8.0), and 34.3 (10.0) mm <jats:sup>3</jats:sup> /min with RMV, STVV, and TA, respectively ( <jats:italic>P</jats:italic> &lt; 0.001). TA increased adjusted efficiency by 5.9 mm <jats:sup>3</jats:sup> /min vs RMV (95% confidence interval [CI] 2.2–9.6 mm <jats:sup>3</jats:sup> /min) and 6.8 mm <jats:sup>3</jats:sup> /min vs STVV (95% CI 3.3–10.2 mm <jats:sup>3</jats:sup> /min). The median active lithotripsy time was 27.5, 26.5, and 22.0 min ( <jats:italic>P</jats:italic> = 0.001); total operative time was 50.0, 50.0, and 43.0 min ( <jats:italic>P</jats:italic> = 0.002); and surgeon‐rated targeting stability scores were 7.0, 7.0, and 9.0 ( <jats:italic>P</jats:italic> &lt; 0.001), respectively. Postoperative Day 1/1‐month stone‐free rates were 88%/92%, 80%/96%, and 88%/90%, respectively, with no significant between‐group differences. The median (interquartile range) achieved apnoea duration was 5.0 (4.5–6.8) min; 46/50 resumed ventilation before the 9‐min maximum, most commonly for heart‐rate decline/bradycardia ( <jats:italic>n</jats:italic> = 27) or blood‐pressure decline/hypotension ( <jats:italic>n</jats:italic> = 20). No patient had a peripheral oxygen saturation &lt;90% or a Clavien–Dindo Grade ≥III complication; transient hypercapnia and respiratory acidosis improved after ventilation resumed. Conclusion Transient apnoea improved lithotripsy efficiency and shortened operative time compared with RMV and STVV, with higher surgeon‐rated targeting stability. The benefit was primarily intraoperative, without evidence of greater postoperative stone clearance. Protocolised TA may provide a brief intraoperative motion‐control option with pre‐oxygenation, continuous anaesthetic monitoring, and individualised termination.","PeriodicalId":8985,"journal":{"name":"BJU International","volume":"42 1","pages":""},"PeriodicalIF":4.5,"publicationDate":"2026-10-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149218576","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Validation of Cxbladder Triage Plus in Australian patients with haematuria: the AUSSIE study","authors":"Varun Buhariwalla, Kapil Sethi, Ian Vela, Dickon Hayne, Zahrah Atchia, Michel de Lange, Tony Lough, Alexis White, Weranja Ranasinghe","doi":"10.1111/bju.70504","DOIUrl":"https://doi.org/10.1111/bju.70504","url":null,"abstract":"Objectives To assess the clinical validity of Cxbladder Triage Plus (Pacific Edge Ltd., Dunedin, New Zealand), a non‐invasive urinary biomarker assay, for urothelial carcinoma (UC) risk stratification compared with standard‐of‐care evaluation (cystoscopy) in patients presenting with visible or non‐visible haematuria (VH or NVH) in routine practice in Australia. Patients and Methods A multicentre, prospective, observational study (AUSSIE; Australian and New Zealand Clinical Trial Registry identifier: ACTRN12622001127796) enrolled adults (aged ≥18 years) presenting with VH or NVH, no UC history and a cystoscopy referral between September 2023 and August 2025 across four Australian clinical sites. Midstream urine samples were tested with Cxbladder Triage Plus prior to cystoscopy. The primary outcome was diagnostic performance of Cxbladder Triage Plus (sensitivity, specificity, positive predictive value [PPV], negative PV [NPV], and test‐negative rate [TNR]) vs white light cystoscopy and histopathological UC confirmation. Results Of 691 patients with evaluable samples (424 with VH, 267 with NVH), 54 (7.8%) had histopathology‐confirmed tumours (44 with VH, 10 with NVH). Compared with cystoscopy, Cxbladder Triage Plus had sensitivity of 89%, specificity 79%, PPV 27%, NPV 99%, and TNR 74%. Six tumours were not detected (five low‐grade Ta, one T3b urachal adenocarcinoma). Compared with 2025 American Urological Association risk stratification criteria, Cxbladder Triage Plus provided a 3.3‐fold increase in PPV. Conclusion These findings provide clinical validation of Cxbladder Triage Plus for UC risk stratification in Australian patients presenting with VH or NVH in routine clinical practice.","PeriodicalId":8985,"journal":{"name":"BJU International","volume":"1 1","pages":""},"PeriodicalIF":4.5,"publicationDate":"2026-10-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149218788","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Comment on: Guideline of guidelines: management of small testicular masses","authors":"Michele Rizzo, Michele Bertolotto, Giovanni Liguori","doi":"10.1111/bju.70501","DOIUrl":"https://doi.org/10.1111/bju.70501","url":null,"abstract":"","PeriodicalId":8985,"journal":{"name":"BJU International","volume":"13 1","pages":""},"PeriodicalIF":4.5,"publicationDate":"2026-10-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149218578","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Segment‐based comparison of multiparametric MRI , Gallium‐68‐ PSMA ‐ PET / CT and combined imaging with histopathology in prostate cancer","authors":"Clarissa J. Schmidt, Marit Bernhardt, Glen Kristiansen, Florian C. Gaertner, Barbara Kreppel, Markus Essler, Julian A. Luetkens, Ulrike Attenberger, Michael Anspach, Carsten‐Henning Ohlmann, Stefan Hauser, Jörg Ellinger, Manuel Ritter, Philipp Krausewitz","doi":"10.1111/bju.70497","DOIUrl":"https://doi.org/10.1111/bju.70497","url":null,"abstract":"Objectives To compare the segment‐based diagnostic performance of multiparametric magnetic resonance imaging (mpMRI), Gallium‐68‐prostate‐specific membrane antigen‐positron emission tomography/computed tomography ( <jats:sup>68</jats:sup> Ga‐PSMA‐PET/CT), for detecting histopathologically confirmed prostate cancer (PCa). Patients and Methods This analysis included 97 men from the prospective, interventional, phase II DEPROMP (DEtection rate of clinically significant PROstate cancer by mpMRI and PSMA‐PET/CT fusion biopsy) trial who underwent radical prostatectomy with whole‐mount histopathological evaluation. All participants received mpMRI and PSMA‐PET/CT prior to biopsy. The mpMRI was interpreted according to Prostate Imaging‐Reporting and Data System (PI‐RADS) version(v)2.1, and PSMA‐PET/CT according to Prostate Cancer Molecular Imaging Standardised Evaluation (PROMISE) molecular imaging Tumour‐Node‐Metastasis (miTNM) criteria. The prostate was divided into 36 anatomical segments based on the PI‐RADS v2.1 sector map. Each segment was correlated with histopathological findings from prostatectomy specimens. For each imaging modality, detection rates, sensitivity, specificity, and area under the receiver operating characteristic curve (AUC) were calculated at the segment level. Results A total of 3492 prostate segments were analysed. Detection rates were 74.1% (95% confidence interval [CI] 72.6–75.5) for mpMRI, 72.2% (95% CI 70.6–73.6) for PSMA‐PET/CT, and 79.1% (95% CI 77.7–80.4) for the combined use of mpMRI and PSMA‐PET/CT. Sensitivity and specificity were 13.4% and 97.3% for mpMRI, 18.5% and 92.7% for PSMA‐PET/CT, and 25.8% and 90.5% for combined mpMRI and PSMA‐PET/CT, respectively. Threshold‐based receiver operating characteristic analyses yielded an AUC of 0.62 (95% CI 0.54–0.69) for PI‐RADS, 0.68 (95% CI 0.63–0.74) for maximum standardised uptake value, and 0.69 (95% CI 0.65–0.74) for molecular imaging PSMA. Conclusion At the segment level, mpMRI and PSMA‐PET/CT showed comparable diagnostic accuracy with high specificity but limited sensitivity. Their combination improved sensitivity and overall detection performance, underscoring the complementary value of structural and molecular imaging for lesion localisation and precision management in PCa.","PeriodicalId":8985,"journal":{"name":"BJU International","volume":"43 1","pages":""},"PeriodicalIF":4.5,"publicationDate":"2026-10-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149218579","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}