PCAI
A new method for analyzing prostate cancer biopsies
The Prostate Cancer Aggressiveness Index (PCAI) provides a groundbreaking solution to one of the major challenges in prostate cancer diagnostics: the lack of reproducible and precise analysis results, which creates uncertainty and often leads to both over- and undertreatment.
Up to 20% of patients in the ISUP 2 group undergo unnecessary radical treatment while some aggressive cancers are incorrectly recommended for active surveillance. PCAI addresses this challenge by combining advanced AI with extensive medical expertise, delivering a more reliable and reproducible analysis.
HOW PCAI WORKS
PCAI analyzes biopsies and generates an index from 0 to 100, classifying results into seven levels of aggressiveness. The system is trained on one of the world's most comprehensive databases - approximately 20,000 patient cases with 20 years of follow-up, from Martini Klinik in Hamburg. By comparing patient's biopsies with this dataset, PCAI estimates cancer aggressiveness based on the actual clinical outcomes.
Robustness and precision
PCAI is robust across variations in laboratory routines, including section thickness, staining protocols, and the market's leading scanner models.
Pilot studies demonstrates that PCAI already outperforms leading pathologists in diagnostic accuracy and reduces the "gray zones" that previously created uncertainty in decision-making.
Ongoing research aims to integrate additional parameters - such as PSA, Pi-RADS, patient age, to further enhance and individualization of treatment recommendations.
A product of international collaboration
PCAI is developed by Spearpoint Analytics in collaboration with world-leading institutions in the prostate cancer research: Martini Klinik at the Medical Center Hamburg-Eppendorf and Uppsala University Hospital.
The system has the potential to become the new standard for prostate cancer analysis.
Links to articles
Our model for grading cancer aggressiveness is founded on many years of research at Uppsala University, Martini Klinik and the University Medical Center Hamburg-Eppendorf.
In our development, we initially utilised the large biobank at the Martini-Klinik as described in:
A set of digitized biopsies from Uppsala University Hospital that we have made publicly available
Our team in Uppsala-Stockholm, Sweden published our first performance assessments
Robustness is a key consideration in developing a system for clinical use. An analysis of the state-of-the-art literature in this field resulted in a published review article
We then joined forces to create the current robust PCAI (Prostate Cancer Aggressiveness Index) and submitted a first manuscript to MedRxiv. We are currently working on an upgraded version of that publication in dialogue with a major journal.
PCAI – A more precise analysis for improved decision-making
PCAI at your clinic
As a urologist, you often face difficult treatment decisions. Uncertainty about aggressiveness can affect both treatment and quality of life.
PCAI (Prostate Cancer Aggressiveness Index) provides an accurate, reproducible analysis that clearly grades aggressiveness, giving you and your patient a more secure basis for decisions. Unnecessary surgeries can be avoided or postponed where active surveillance is appropriate. Conversely, studies have show PCAI can identify aggressive cancer that the Gleason method misses.
For individual cases – Recommend a second opinion
Regular use of PCAI
If you are interested in using PCAI regularly in your clinic, we offer the opportunity to discuss how this can be integrated into your practice. Our ambition is for PCAI to eventually be available in all laboratories handling prostate biopsies. In the meantime, we collaborate individually with each clinic to develop practical, tailored solutions.
The patient's biopsies are sent to an affiliated laboratory for AI analysis. Results are delivered digitally the same day, providing you with a timely basis for clinical decision-making.
When you need more precise basis for a decision, refer your patient to us for a PCAI-based second opinion (refer them to: www.spearpoint.se)
We manage the process from image collection to delivery of results in consultation with you and patient. Results are presented in a clear report, followed by a meeting with our urologist for further discussion.