0:01

We're talking indications for MRI, especially

0:04

surveillance or screening, part two, and we've

0:08

already hammered home the, the different tiers

0:12

that patients exist in based on their PSA, their

0:15

Gleason score, and their clinical T category.

0:19

And we said that PSAs of 10 or less, Gleason

0:22

scores of 6 or less, and T categories of T1C,

0:27

or T2A are great candidates for surveillance.

0:31

This would be Tier 1.

0:34

So this would be something like

0:35

10 nanograms per deciliter.

0:39

So there are other criteria

0:40

that are, that are out there.

0:42

And in one of the vignettes we

0:43

talked about inclusion criteria.

0:45

I want to give you a, a specialized

0:47

criteria developed by Epstein, the

0:49

so-called Epstein inclusion criteria.

0:52

And in this scenario, similar to Tier 1, the

0:56

Gleason score must be less than or equal to.

1:00

I'll put the name up here just

1:02

to give the author credit.

1:06

Two or few core, cores of cancer.

1:09

So you've got 12 cores.

1:11

So two or less of those cores have cancer in them.

1:15

So that's something a little different

1:16

than what you've heard before.

1:18

So we'll say two cores or less.

1:24

And then finally the third

1:25

criteria is less than 50%.

1:30

Or 50 percent or less of each

1:33

core is involved by tumor.

1:35

So in other words, let's say this is a core,

1:37

and less than half of that core is involved

1:39

by tumor, area-wise or volumetrically.

1:43

Those three criteria, this one, this one,

1:45

and this one, place the patient in the

1:48

Epstein category of a surveillance candidate.

1:53

Do notice that this patient has already

1:56

had at least a single biopsy, otherwise

1:58

you wouldn't have cores to make this

2:00

designation and this Gleason designation.

2:03

So this is after a single

2:04

biopsy has been performed.

2:07

Now the patient goes into MR surveillance.