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AI-Pathway Companion Prostate Cancer2, ein digitaler Companion zur klinischen Entscheidungsunterstützung von Siemens Healthineers, hat kürzlich eine CE-Kennzeichnung für den Einsatz im klinischen Behandlungspfad für Prostatakrebs erhalten, der zweithäufigsten Krebserkrankung (nach Lungenkrebs) bei Männern weltweit.3 Das Prüfzeichen bestätigt, dass AI-Pathway Companion Prostate Cancer die Anforderungen der Richtlinie 93/42/EWG erfüllt und als Medizinprodukt in der EU vermarktet werden kann.
Die AI-Pathway Companion Product Suite führt mit Hilfe von Künstlicher Intelligenz, darunter Natural Language Processing4, Daten zum Krankheits- und Behandlungsstatus eines Patienten zusammen und stellt sie auf einer intuitiv zu bedienenden Grafikoberfläche dar. Zusätzlich zeigt AI-Pathway Companion Prostate Cancer den Ärzten aus den Prostatakrebs-Leitlinien der Europäischen Vereinigung für Urologie sowie des National Comprehensive Cancer Network5 die Handlungsempfehlungen1 auf, die zum momentanen Status des Patienten im Behandlungspfad passen.
„Der AI-Pathway Companion erleichtert es insbesondere multidisziplinären Teams, entlang des gesamten klinischen Pfades die jeweils angemessenen Diagnose- und Behandlungsentscheidung zu finden, die den Prinzipien der evidenz-basierten Medizin entspricht. Damit können wir Gesundheitsversorgern helfen, den Patienten individuell in das Zentrum zu stellen. Wir freuen uns sehr, den AI-Pathway Companion als einen der ersten Bausteine unserer Strategie vorzustellen, unser Portfolio in Richtung klinischer Entscheidungsunterstützung basierend auf integrierter Diagnostik zu erweitern,“ sagte André Hartung, Leiter Diagnostic Imaging bei Siemens Healthineers.
Die Entscheidungsfindung für Therapie und Nachverfolgung des Therapieverlaufs beim Behandlungspfad „Prostatakrebs“ ist äußerst komplex und zeitintensiv, da zahlreiche, individuelle Parameter des Patienten zu beachten sind. Dazu zählt unter anderem, in welchem Stadium die Erkrankung entdeckt wurde, ob es eine Erstdiagnose ist, ob man bereits mit verschiedenen Therapien behandelt wurde, oder ob der Tumor nach einer zunächst erfolgreichen Behandlung erneut auftritt. Laborergebnisse, wie der PSA (Prostata-spezifisches Antigen)-Wert, pathologische Befunde aus der Prostatastanzbiopsie oder der PI-RADS (Prostate Imaging – Reporting and Data System)-Score, der die Wahrscheinlichkeit für das Vorliegen eines klinisch signifikanten Karzinoms angibt, sowie der Gleason-Score zur Einstufung der Aggressivität eines Prostatatumors, sind weitere Beispiele für Kriterien, die Ärzte heranziehen, um über die nächsten Untersuchungs- und Behandlungsschritte zu entscheiden. Dabei nutzen die Ärzte internationale, evidenzbasierte medizinische Leitlinien, die angemessene, wissenschaftlich begründete und aktuelle Verfahren in der Diagnostik und Therapie empfehlen können und weit über 100 Seiten umfassen können, so auch die Prostatakrebs-Leitlinien der Europäischen Vereinigung für Urologie6 und des National Comprehensive Cancer Network7 . Es ist leicht einzusehen, dass die Entscheidungsfindung angesichts der Datenfülle aus Befunden und Leitlinien eine große Herausforderung darstellen kann.
AI-Pathway Companion Prostate Cancer hilft, die für den einzelnen Patienten verfügbaren Daten mit den Leitlinien zusammenzuführen, um den empfohlenen Behandlungsweg zu identifizieren und ein adäquates Krankheitsmanagement zu erleichtern. Der digitale Companion durchsucht die Patientenakte sowie weitere Quellen, wie das Krankenhausinformations-System oder das PACS (Picture Archiving and Communication System), und stellt die Longitudinaldaten zum jeweiligen Krebspatienten zusammen4. Dazu werden mit Hilfe von Natural Language Processing entscheidungsrelevante Daten aus den Befunden von Radiologie, Pathologie, Genetik und Labor extrahiert und zusammengetragen und auf einer intuitiv zu bedienenden Nutzeroberfläche visualisiert. Zusätzlich wird automatisch der PI-RADS Score mit dem Gleason Score korreliert, um es den Ärzten zu erleichtern, die Tumor-Aggressivität und den daraus ableitbaren Krankheitsverlaufs einzuschätzen. Auf Basis der aktuell vorhandenen Daten durchforsten Algorithmen die Leitlinie für Prostatakrebs nach Empfehlungen, die zum individuellen Krankheitsstatus des Patienten passen. Die Algorithmen zeigen automatisch an, wo sich der Patient im Pfad befindet, empfehlen die nächsten Optionen und weisen auf eventuell noch fehlende Informationen hin.8
Auf diesen Daten basierend visualisiert AI-Pathway Companion Prostate Cancer den Status des Patienten im klinischen Pfad und gibt richtlinienbasierte Empfehlungen für weitere, auf medizinischer Evidenz basierende Handlungsschritte. Damit kann es der digitale Companion beispielsweise multidisziplinären Teams in Tumorboards erleichtern, Entscheidungen entlang des Behandlungspfades zu optimieren.
"Der Zeitaufwand für Diskussionen in unserem multidisziplinären Team (MDT) kann sehr unterschiedlich sein. Wenn eine klinische Entscheidungsunterstützungslösung den Patientenkontext intelligent und standardisiert integrieren und anzeigen könnte, während evidenzbasierte Diagnose- und Therapieempfehlungen gegeben werden, könnte dies dazu beitragen, die Diskussionen zu verkürzen und allen Teilnehmern im MDT Zeit zu sparen", sagte Prof. Helge Seifert, Chefarzt Urologie am Universitätsklinikum Basel.9
"Ich verbringe viel Zeit damit, Patienteninformationen manuell in unsere MDT-Lösung einzugeben. Wenn diese Informationen automatisch, intelligent und standardisiert integriert werden könnten, würden wir viel Zeit sparen und uns auf das Wesentliche konzentrieren können: den Patienten", sagte Dr. Christian Wetterauer, Oberarzt Urologie am Universitätsklinikum Basel.10
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(pdf, 161.47 KB)Technology, Trade and Local Media
Abhängig von den als Input verfügbaren Daten.
AI-Pathway Companion Prostate Cancer VA10A unterstützt nur Adenokarzinom-Fälle von Prostatakrebs. Das Produkt ist in einigen Ländern noch nicht käuflich zu erwerben. Aufgrund von medizinproduktrechtlichen Vorgaben kann die zukünftige Verfügbarkeit nicht zugesagt werden. Detaillierte Informationen sind bei der jeweiligen Siemens Healthineers-Organisation vor Ort erhältlich.
Quelle: Rawla, P., Epidemiology of Prostate Cancer, World J Oncol. 2019 Apr; 10(2): 63–89, www.ncbi.nlm.nih.gov/pmc/articles/PMC6497009/
Feature unterstützt durch AI-Pathway Companion Connector.
AI-Pathway Companion Prostate Cancer VA10A unterstützt NCCN-und EAU-Richtlinien.
Voraussetzung für automatisches patientenspezifisches Mapping: "Alle gemäß Leitlinien erforderlichen Daten sind verfügbar.“
Prof. Seifert ist bei einem Institut beschäftigt, das finanzielle Interstützung von Siemens Healthineers für Kooperationen erhält.
Dr. Christian Wetterauer ist bei einem Institut beschäftigt, das finanzielle Interstützung von Siemens Healthineers für Kooperationen erhält.