{"doi":"10.1016/j.radonc.2025.111333","title":"PURE-MRI: An international study assessing physician accuracy in delineating the prostate and urethra on prostate MRI","abstract":"PURPOSE: Precise delineation of genitourinary structures during prostate cancer (PCa) care is critical to optimize treatment delivery while minimizing toxicity and injury. The Prostate and UREthra on MRI (PURE-MRI) study is an international, prospective study to assess physicians' accuracy segmenting prostate and urethra on MRI. METHODS: -weighted MRI (all planes). We compared these contours to reference consensus segmentations produced by a multidisciplinary panel of experts. We also evaluated performance of validated auto-segmentation AI tools. Accuracy was assessed with spatial and volumetric analyses. A mixed effects model was used to evaluate potential factors influencing contour performance. RESULTS: 62 specialists from 11 countries created 114 prostate and 110 urethra contours. Prostate median (min, max) accuracy for physicians [vs. AI] was Dice score: 0.92 (0.62, 0.95) [vs. 0.95 (0.94, 0.96)], maximum deviation inside prostate: 3.4 mm (1.0, 12.4) [vs. 3.0 mm (3.0, 3.0)], maximum deviation beyond prostate: 5.3 mm (2.4, 17.3) [vs. 3.9 mm (3.1, 4.9)], mean deviation (per case) from the reference prostate: 1.6 mm (0.9, 3.9) [vs. 1.2 mm (1.1, 1.6)]. Urethra accuracy was Dice score: 0.33 (0.03, 0.69) [vs. 0.41 (0.35, 0.48)], coverage: 36 % (3 %, 96 %) [vs. 81 % (80 %, 91 %)], maximum (2D) deviation beyond urethra: 1.6 mm (1.0, 2.3) [vs. 1.7 mm (1.3, 2.1)]. CONCLUSION: Physicians contour the prostate on MRI with overall Dice score >0.90, though typical cases still include at least one error >5 mm and sometimes >10 mm. Physician urethra contours were less accurate, with typical coverage of <40 % of the reference urethra (compared to >80 % for AI). Physician trainees performed similarly to experienced clinicians. AI tools give comparable accuracy to practicing physicians for prostate contours and achieve better coverage of the urethra.","journal":"Radiotherapy and Oncology","year":2025,"id":535780,"datarank":0.16479184330021646,"base_score":1.0986122886681096,"endowment":1.0986122886681096,"self_citation_contribution":0.16479184330021646,"citation_network_contribution":0.0,"self_endowment_contribution":0.16479184330021646,"citer_contribution":0.0,"corpus_percentile":null,"corpus_rank":null,"citation_count":2,"citer_count":0,"citers_with_citation_signal":0,"citers_with_endowment":0,"datacite_reuse_total":0,"is_dataset":false,"is_dataset_confidence":0.8242,"is_data_producer":false,"deposit_databanks":null,"is_oa":true,"file_count":0,"downloads":0,"has_version_chain":false,"published_date":"2025-01-01","fair_score":null,"fair_percentile":null,"algorithm_id":"datarank_citation_only_1hop_v6","ranking_scope":"data_only","authors":[{"id":1381053,"name":"Yuze Song","orcid":"0000-0001-5803-1254","position":1,"is_corresponding":false},{"id":929207,"name":"Anna Dornisch","orcid":null,"position":2,"is_corresponding":false},{"id":1319696,"name":"Madison Baxter","orcid":null,"position":3,"is_corresponding":false},{"id":294765,"name":"Tristan Barrett","orcid":"0000-0002-1180-1474","position":4,"is_corresponding":false},{"id":19608,"name":"Anders M. Dale","orcid":"0000-0002-6126-2966","position":5,"is_corresponding":false},{"id":262585,"name":"Mukesh G. Harisinghani","orcid":"0000-0003-0993-1947","position":6,"is_corresponding":false},{"id":584404,"name":"Sophia C. Kamran","orcid":"0000-0001-9283-6515","position":7,"is_corresponding":false},{"id":374559,"name":"Michael A. Liss","orcid":"0000-0001-6978-1026","position":8,"is_corresponding":false},{"id":393051,"name":"Robert T. Dess","orcid":"0000-0003-2331-3758","position":9,"is_corresponding":false},{"id":332010,"name":"Daniel Margolis","orcid":"0000-0001-8212-707X","position":10,"is_corresponding":false},{"id":908267,"name":"Eric Weinberg","orcid":"0000-0003-4951-7142","position":11,"is_corresponding":false},{"id":360589,"name":"Tyler M. Seibert","orcid":"0000-0002-4089-7399","position":12,"is_corresponding":false},{"id":1407944,"name":"Lily Nguyen","orcid":"0009-0004-0076-1640","position":0,"is_corresponding":true}],"reference_count":32,"raw_metadata":{"citation_network_status":"fetched"},"created_at":"2026-07-19T02:52:00.885532Z","pmid":"41412436","pmcid":null,"fwci":null,"citation_percentile":null,"influential_citations":0,"oa_status":null,"license":null,"views":0,"total_file_size_bytes":0,"version_count":0,"fair_f":null,"fair_a":null,"fair_i":null,"fair_r":null,"fair_zscore":null,"fair_rationale":null,"fair_model":null,"fair_agent_version":null,"fair_fulltext_source":null,"fair_has_llm":null,"fair_computed_at":null,"clinical_trials":[],"software_tools":[],"db_accessions":[],"linked_datasets":[],"topics":[]}