Particularly in early disease stages, advanced imaging techniques can help to identify regional lymph node metastases, creating new opportunities for targeted treatment approaches. This development has made the field of PCa therapies highly interdisciplinary, highlighting the need for a shared language among the involved medical disciplines. The Pelvic Rosetta Classification (PRC) project addresses this challenge by proposing a landmark-based lymph node map of the pelvis for PCa, similar to the Rosetta Stone, which helped decipher ancient Egyptian hieroglyphs. The PRC particularly aims to assist physicians in translating imaging findings into the operative situs by defining borders of lymph node areas that are recognizable both on imaging and during surgery.
The PRC lymph node map was developed using a Delphi-like process, involving multiple consensus and validation rounds. During this iterative process, boundaries of lymph node regions were proposed and refined by a diverse group of specialists from nuclear medicine, radiology, radiation oncology, and urology. Moreover, a 3D model based on an annotated CT scan of the pelvis was created to further enhance communication between imaging specialists and uro-oncological surgeons (http://www.prc-3d.com).
The PRC is intended for use in both academic as well as non-academic practices and is envisioned as a living project that will be updated in response to ongoing research and practical experience, always aiming to improve patient care.
Quote:
"The Pelvic Rosetta Classification is an interdisciplinary, landmark-based lymph node map of the pelvis in prostate cancer, aiming to enhance communication between medical specialists."
Written by:
- Daniel Koehler, MD, Department of Diagnostic and Interventional Radiology and Nuclear Medicine, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
- Tobias Maurer, MD, Martini-Klinik Prostate Cancer Center, University Medical Center Hamburg-Eppendorf, Hamburg, Germany; Department of Urology, University Medical Center Hamburg-Eppendorf, Hamburg, Germany; EAU Section of Imaging, European Association of Urology, Hamburg, Germany