Aslam Sohaib

University of Cambridge, Cambridge, England, United Kingdom

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Publications (52)176.96 Total impact

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    ABSTRACT: To evaluate the minimum disease burden of prostate cancer at which multiparametric magnetic resonance imaging (MRI) optimally performs. Between 2006 and 2008, 64 men underwent multiparametric MRI imaging (index test) followed by template prostate mapping biopsy (reference test). Three radiologists independently reported each quadrant of every prostate on a scale of 1 to 5: highly likely benign, likely benign, equivocal, likely malignant, highly likely malignant (≥3 or ≥4 was considered positive). There were 256 prostate sectors; bootstrapping adjustment was used to account for nonindependence. The target condition indicating cancer on biopsies was varied by changing the maximum cancer core length (MCCL) and total cancer core length (TCCL) within each sector from 1 mm to 10 mm. The sensitivity, specificity, and positive (PPVs) and negative predictive values (PPVs) were calculated for each MCCL and TCCL. Gleason ≤3+3 and Gleason ≥3+4 cancers were analyzed separately. Mean age was 62 years (range, 40-76 years), and mean prostate-specific antigen level was 8.2 μg/L (range, 2.1-43 μg/L). Fifty percent of quadrants (127 of 256) had prostate cancer, of which 65% (83 of 127) were Gleason ≤3+3. For Gleason ≤3+3, multiparametric MRI had an NPV of ≥95% at an MCCL of ≥5 mm and at a TCCL of ≥7 mm (MRI score ≥3). For Gleason ≥3+4, an NPV of ≥95% was seen at an MCCL of ≥5 mm (MRI score ≥3) and TCCL ≥6 mm. Multiparametric MRI may allow areas of the prostate which test negative to avoid biopsy. Whether multiparametric MRI can be used as a "triage" test before the first biopsy requires results from ongoing prospective validating cohort studies. Copyright © 2015 Elsevier Inc. All rights reserved.
    Urology 08/2015; DOI:10.1016/j.urology.2015.05.010 · 2.13 Impact Factor
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    ABSTRACT: Background To evaluate diffusion-weighted MR neurography (DW-MRN) for visualizing the brachial plexus and for the assessment of brachial plexopathy. Methods 40 oncological patients with symptoms of brachial plexopathy underwent 1.5 T MRI using conventional MR sequences and unidirectional DW-MRN. The images were independently reviewed by two radiologists. Anatomic visualization of the brachial plexus was scored using a 5 point scale on conventional MR sequences and then combined with DW-MRN. A brachial plexus abnormality was also scored using a 5 point scale and inter-observer agreement determined by kappa statistics. Diagnostic accuracy for brachial plexopathy assessed by conventional MRI alone versus conventional MRI combined with DW-MRN was compared by ROC analysis using reference standards. Results DW-MRN significantly improved visualization of the brachial plexus compared with conventional MRI alone (P < 0.001). When assessing brachial plexopathy, inter-observer agreement was moderate for conventional MRI (kappa = 0.48) but good for conventional MRI with DW-MRN (kappa = 0.62). DW-MRN combined with conventional MRI significantly improved diagnostic accuracy in one observer (P < 0.05) but was similar in the other observer. Conclusion DW-MRN improved visualization of the brachial plexus. Combining DW-MRN with conventional MRI can improve inter-observer agreement and detection of brachial plexopathy in symptomatic oncological patients.
    Cancer imaging : the official publication of the International Cancer Imaging Society 05/2015; 15(1). DOI:10.1186/s40644-015-0041-5 · 1.29 Impact Factor
  • Clinical Oncology 03/2015; 27(3). DOI:10.1016/j.clon.2014.11.008 · 2.83 Impact Factor
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    ABSTRACT: The aim of this study was to determine the utility of fluorine-18 fluorodeoxyglucose PET/computed tomography (F-FDG PET/CT) in managing testicular cancer. Sixty-two patients (29 seminoma, 28 nonseminoma and five mixed) underwent 75 F-FDG PET/CT scans (16 scans for primary staging, 44 for residual masses and 15 for rising tumour markers). Follow-up histology, clinical scans and tumour marker results were included for retrospective analysis. (i) Primary staging: eight of 11 patients with equivocal CT scans had true-negative F-FDG PET/CT scans. Five high-risk patients with normal stage 1 CT scans had negative F-FDG PET/CT scans, but two subsequently relapsed. (ii) Residual masses: of the 20 scans interpreted as showing viable disease, five were false positive. Nineteen scans were negative (18 true negative and one false negative). (iii) Rising tumour markers: of the 15 scans, two were false negative and 13 were true positive. F-FDG PET/CT is helpful when primary staging CT scans are equivocal but insufficiently sensitive to predict relapse in high-risk patients with normal CT scans. With residual masses, a negative scan is rarely associated with relapse. F-FDG PET/CT is helpful in defining recurrent disease in the majority of patients with rising tumour markers and negative CT scans.
    Nuclear Medicine Communications 03/2015; 36(7). DOI:10.1097/MNM.0000000000000303 · 1.37 Impact Factor
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  • S. Hafeez · M. Koh · A. Sohaib · R. Huddart
    Radiotherapy and Oncology 12/2014; 111:S34. DOI:10.1016/S0167-8140(15)30852-5 · 4.86 Impact Factor
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    ABSTRACT: To test the hypothesis that computed tomography (CT)-based signs might precede symptomatic malignant spinal cord compression (MSCC) in men with metastatic castration-resistant prostate cancer (mCRPC). A database was used to identify suitable mCRPC patients. Staging CT images were retrospectively reviewed for signs preceding MSCC. Signs of malignant paravertebral fat infiltration and epidural soft-tissue disease were defined and assessed on serial CT in 34 patients with MSCC and 58 control patients. The presence and evolution of the features were summarized using descriptive statistics. In MSCC patients, CT performed a median of 28 days prior to the diagnostic magnetic resonance imaging (MRI) demonstrated significant epidural soft tissue in 28 (80%) patients. The median time to MSCC from a combination of overt malignant paravertebral and epidural disease was 2.7 (0-14.6) months. Conversely, these signs were uncommon in the control cohort. Significant malignant paravertebral and/or epidural disease at CT precede MSCC in up to 80% of mCRPC patients and should prompt closer patient follow-up and consideration of early MRI evaluation. These CT-based features require further prospective validation. Copyright © 2014 The Royal College of Radiologists. Published by Elsevier Ltd. All rights reserved.
    Clinical Radiology 12/2014; 70(4). DOI:10.1016/j.crad.2014.05.104 · 1.66 Impact Factor
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    ABSTRACT: Purpose To compare revised Choi criteria that incorporate concurrent size and attenuation changes at early follow-up imaging with Response Evaluation Criteria in Solid Tumors (RECIST) 1.1 and original Choi criteria in stratification of clinical outcomes in patients with metastatic renal cell carcinoma (mRCC) treated with sunitinib. Materials and Methods Institutional review board approved this retrospective study and waived informed consent. Baseline and first follow-up computed tomographic scans in 69 patients (50 men, 19 women; mean age, 60.3 years; range, 19-83 years) with mRCC treated with sunitinib from October 1, 2008, to March 1, 2013, were evaluated for tumor response by using RECIST 1.1, original Choi criteria, and revised Choi criteria. Correlations with overall survival (OS) and progression-free survival (PFS) were compared and stratified according to each radiologic criteria with Kaplan-Meier and multivariate Cox regression analysis. Results Median follow-up time was 29.7 months (95% confidence interval [CI]: 18.9, 45.9). Response according to revised Choi criteria was independently correlated with OS (hazard ratio, 0.47 [95% CI: 0.23, 0.99]; P = .046) and PFS (hazard ratio, 0.53 [95% CI: 0.29, 0.99]; P = .047). Response according to RECIST was not significantly correlated with OS (hazard ratio, 0.65 [95% CI: 0.27, 1.58]; P = .344) or PFS (hazard ratio, 0.89 [95% CI: 0.42, 1.91]; P = .768). Response according to original Choi criteria was not significantly correlated with OS (hazard ratio, 0.60 [95% CI: 0.32, 1.11]; P = .106) or PFS (hazard ratio, 0.59 [95% CI: 0.34, 1.02]; P = .060). Median OS and PFS in responders according to revised Choi criteria was 39.4 months (95% CI: 9.1, upper limit not estimated) and 13.7 months (95% CI: 6.4, 24.6), respectively, compared with 12.8 months (95% CI: 8.7, 18.0) and 5.3 months (95% CI: 3.9, 8.4), respectively, in nonresponders. Conclusion Contemporaneous reduction in tumor size and attenuation were correlated with favorable clinical outcomes. Response according to revised Choi criteria showed better correlation with clinical outcomes compared with that according to RECIST or original Choi criteria in patients with mRCC treated with sunitinib. © RSNA, 2014.
    Radiology 05/2014; 273(2):132702. DOI:10.1148/radiol.14132702 · 6.21 Impact Factor
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    ABSTRACT: The delivery of a simultaneous integrated boost to the intra-prostatic tumour nodule may improve local control. The ability to deliver such treatments with hypofractionated SBRT was attempted using RapidArc (Varian Medical systems, Palo Alto, CA) and Multiplan (Accuray inc, Sunnyvale, CA).Materials and methods: 15 patients with dominant prostate nodules had RapidArc and Multiplan plans created using a 5 mm isotropic margin, except 3 mm posteriorly, aiming to deliver 47.5 Gy in 5 fractions to the boost whilst treating the whole prostate to 36.25 Gy in 5 fractions. An additional RapidArc plan was created using an 8 mm isotropic margin, except 5 mm posteriorly, to account for lack of intrafraction tracking. Both RapidArc and Multiplan can produce clinically acceptable boost plans to a dose of 47.5 Gy in 5 fractions. The mean rectal doses were lower for RapidArc plans (D50 13.2 Gy vs 15.5 Gy) but the number of missed constraints was the same for both planning methods (11/75). When the margin was increased to 8 mm/5 mm for the RapidArc plans to account for intrafraction motion, 37/75 constraints were missed. RapidArc and Multiplan can produce clinically acceptable simultaneous integrated boost plans, but the mean rectal D50 and D20 with RapidArc are lower. If the margins are increased to account for intrafraction motion, the RapidArc plans exceed at least one dose constraint in 13/15 cases. Delivering a simultaneous boost with hypofractionation appears feasible, but requires small margins needing intrafraction motion tracking.
    Radiation Oncology 10/2013; 8(1):228. DOI:10.1186/1748-717X-8-228 · 2.36 Impact Factor
  • International Journal of Gynecological Cancer 10/2013; 23(8). · 1.95 Impact Factor
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    ABSTRACT: The current pathway for men suspected of having prostate cancer [transrectal biopsy, followed in some cases by magnetic resonance imaging (MRI) for staging] results in over-diagnosis of insignificant tumours, and systematically misses disease in the anterior prostate. Multiparametric MRI has the potential to change this pathway, and if performed before biopsy, might enable the exclusion of significant disease in some men without biopsy, targeted biopsy in others, and improvements in the performance of active surveillance. For the potential benefits to be realized, the setting of standards is vital. This article summarizes the outcome of a meeting of UK radiologists, at which a consensus was achieved on (1) the indications for MRI, (2) the conduct of the scan, (3) a method and template for reporting, and (4) minimum standards for radiologists.
    Clinical Radiology 07/2013; 68(10). DOI:10.1016/j.crad.2013.03.030 · 1.66 Impact Factor
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    ABSTRACT: Sarcomas of the prostate are rare tumours. Their clinicopathologic features are well described, however, the imaging features of these tumours have rarely been documented. The purpose of this article is to illustrate the imaging findings of prostate sarcomas, with an emphasis on their appearance on magnetic resonance imaging and to identify features that may help to differentiate them from the commoner prostate adenocarcinomas.
    Cancer Imaging 05/2013; 13(2):228-37. DOI:10.1102/1470-7330.2013.0024 · 1.29 Impact Factor
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    ABSTRACT: OBJECTIVE: To describe the experience of laparoscopic staging of apparent early stage adnexal cancers. METHODS: Prospectively collected data on women who had laparoscopic staging for apparent early stage adnexal cancers from May 2008 to September 2012 was reviewed. All women had had a prior surgical procedure at which the diagnosis was made, without comprehensive staging. A systematic MEDLINE search from 1980 to 2012 for publications on laparoscopic staging was performed. RESULTS: Thirty-five women had laparoscopic staging. Median age was 45 years (range 21-73). Median operative time was 210 min (range 90-210). Four intra-operative and one post-operative complication occurred; overall complication rate 5/35 (14%). One vena cava and one transverse colon injury underwent laparotomies for repair. Laparotomy conversion rate 2/35 (6%). Following laparoscopic staging, the cancer was upstaged for eight (23%) women; microscopic omental involvement (four women), pelvic lymph node involvement (two women), para-aortic lymph node involvement (one woman) and contra-lateral ovarian involvement (one woman). After follow up for a median of 18 months (range 3-59) the disease free survival was 94% and overall survival was 100%. Nine studies were identified on laparoscopic staging of adnexal cancer, of which this is the largest single institution series. CONCLUSIONS: This study adds to the evidence that laparoscopic staging is at least as safe as staging by laparotomy with appropriate and similar oncological outcomes, but with the advantages of minimal access surgery. We therefore advocate the use of laparoscopy to achieve surgical staging for women with presumed early stage adnexal cancer.
    European journal of surgical oncology: the journal of the European Society of Surgical Oncology and the British Association of Surgical Oncology 05/2013; 39(8). DOI:10.1016/j.ejso.2013.05.007 · 2.89 Impact Factor
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    ABSTRACT: Background Extended field radiotherapy is a standard of care for low volume stage II testicular seminoma. We hypothesized that neoadjuvant carboplatin might reduce the recurrence risk.Patients and methodsIn a single-arm study, 51 patients were treated between May 1996 and November 2011 with a single cycle of carboplatin followed by radiotherapy. The radiation field was reduced from an extended abdomino-pelvic field to just the para-aortic region, and the radiation dose from 35 Gy to 30 Gy in 39 patients.ResultsAfter a median follow-up of 55 months (range 8-151 months) with 38 (74%) of the patients having been followed for >2 years, there have been no relapses (95% confidence limits of 5-year relapse-free survival of 93%-100%). Toxicity has been low with grade 3 toxicity limited to four patients with grade 3 haematological toxicity (with no clinical sequelae) and one patient with grade 3 nausea (during radiotherapy). No patients experienced grade 4 toxicity.Conclusions The results of this pilot study suggest that a single cycle of neoadjuvant carboplatin before radiotherapy may reduce recurrence risk compared with radiotherapy alone and permit a smaller radiation field, and this approach is proposed for further investigation.
    Annals of Oncology 04/2013; 24(8). DOI:10.1093/annonc/mdt148 · 6.58 Impact Factor
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    ABSTRACT: Multiparametric magnetic resonance imaging (mpMRI) is increasingly being used earlier in the prostate cancer diagnostic pathway in order to detect and localize disease. Its results can be used to help decide on the indication, type, and localization of a prostate biopsy for cancer diagnosis. In addition, mpMRI has the potential to contribute information on the characterization, or aggressiveness, of detected cancers including tumor progression over time. There is considerable variation in the way results of different MRI sequences are reported. We conducted a review of scoring systems that have been used in the detection and characterization of prostate cancer. This revealed that existing scoring and reporting systems differ in purpose, scale, and range. We evaluate these differences in this review. This first step in collating all methods of scoring and reporting mpMRI will ultimately lead to consensus approaches to develop a standardized reporting scheme that can be widely adopted and validated to ensure comparability of research outputs and optimal clinical practice.
    Journal of Magnetic Resonance Imaging 01/2013; 37(1). DOI:10.1002/jmri.23689 · 2.79 Impact Factor
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    ABSTRACT: In November 2011, the Third European Consensus Conference on Diagnosis and Treatment of Germ-Cell Cancer (GCC) was held in Berlin, Germany. This third conference followed similar meetings in 2003 (Essen, Germany) and 2006 (Amsterdam, The Netherlands) [Schmoll H-J, Souchon R, Krege S et al. European consensus on diagnosis and treatment of germ-cell cancer: a report of the European Germ-Cell Cancer Consensus Group (EGCCCG). Ann Oncol 2004; 15: 1377-1399; Krege S, Beyer J, Souchon R et al. European consensus conference on diagnosis and treatment of germ-cell cancer: a report of the second meeting of the European Germ-Cell Cancer Consensus group (EGCCCG): part I. Eur Urol 2008; 53: 478-496; Krege S, Beyer J, Souchon R et al. European consensus conference on diagnosis and treatment of germ-cell cancer: a report of the second meeting of the European Germ-Cell Cancer Consensus group (EGCCCG): part II. Eur Urol 2008; 53: 497-513]. A panel of 56 of 60 invited GCC experts from all across Europe discussed all aspects on diagnosis and treatment of GCC, with a particular focus on acute and late toxic effects as well as on survivorship issues.The panel consisted of oncologists, urologic surgeons, radiooncologists, pathologists and basic scientists, who are all actively involved in care of GCC patients. Panelists were chosen based on the publication activity in recent years. Before the meeting, panelists were asked to review the literature published since 2006 in 20 major areas concerning all aspects of diagnosis, treatment and follow-up of GCC patients, and to prepare an updated version of the previous recommendations to be discussed at the conference. In addition, ∼50 E-vote questions were drafted and presented at the conference to address the most controversial areas for a poll of expert opinions. Here, we present the main recommendations and controversies of this meeting. The votes of the panelists are added as online supplements.
    Annals of Oncology 11/2012; 24(4). DOI:10.1093/annonc/mds579 · 6.58 Impact Factor
  • Dow-Mu Koh · Aslam Sohaib
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    ABSTRACT: Diffusion-weighted magnetic resonance (MR) imaging (DWI) is now widely incorporated as a standard MR imaging sequence for the assessment of the male pelvis. DWI can improve the detection, characterization, and staging of pelvic malignancies, such as prostate, bladder, and rectal cancers. There is growing interest in applying quantitative DWI for the assessment of tumor treatment response. In addition, the technique seems promising for the evaluation of metastatic nodal and bone disease in the pelvis.
    Radiologic Clinics of North America 11/2012; 50(6):1127-44. DOI:10.1016/j.rcl.2012.08.008 · 1.83 Impact Factor
  • P Dilks · E Helbren · A Sohaib
    The British journal of radiology 10/2012; 85(1018):1429-31. DOI:10.1259/bjr/55182942 · 2.02 Impact Factor

Publication Stats

859 Citations
176.96 Total Impact Points

Institutions

  • 2015
    • University of Cambridge
      • Department of Oncology
      Cambridge, England, United Kingdom
  • 2011–2014
    • Institute of Cancer Research
      • Division of Clinical Studies
      Londinium, England, United Kingdom
  • 2013
    • Norfolk and Norwich University Hospitals NHS Foundation Trust
      • Department of Radiology
      Norwich, England, United Kingdom
  • 2007–2013
    • The Royal Marsden NHS Foundation Trust
      • Department of Radiotherapy
      Londinium, England, United Kingdom