Relationship between Eccentricity and Volume Determined by Spectral Algorithms Applied to Spatially Registered Bi-Parametric MRI and Prostate Tumor Aggressiveness: A Pilot Study
Round 1
Reviewer 1 Report
Dear authors and editor, I have read the manuscript carefully. Personally I didn't find any critical issues. The English is good, the methodologies are rigorous, the results obtained are adequate for a scientific article. I only have 2 small suggestions.
1 all figures need to be improved in quality.
2. I would have implemented the manuscript with statistical analyses.
That said, I appreciated the manuscript and recommend its publication in this form.
Good
Author Response
Reviewer #1 Comments
Response: The authors thank the Reviewer for taking the time to analyze the manuscript and offering suggestions to improve the paper. Your help is greatly appreciated.
Dear authors and editor, I have read the manuscript carefully. Personally I didn't find any critical issues. The English is good, the methodologies are rigorous, the results obtained are adequate for a scientific article.
Response: The authors agree. Thanks for your kind words.
I only have 2 small suggestions.
1 all figures need to be improved in quality.
Response: The authors would like to improve the appearance of the figures. But without specifying the figures deficiencies, it is not clear what, how, and which figures need to be improved. During the production process, editors often ask for greater spatial resolution and the Figures can be modified appropriately (although the current resolution matches the journal’s requirements)
- I would have implemented the manuscript with statistical analyses.
Response: The following was added to the second to the last paragraph of the Discussion,
To assess the relationship between tumor eccentricity and volume to tumor aggressiveness, this study only reported computations of correlation coefficients (R, R12), p-values, F-Statistic probability, AUC and the 95 % confidence intervals. Previous work [12-14] on evaluations of prostate cancer patient scanned using multi-parametric MRI that included DCE reported more extensive computations, such as student t-values (with 95% confidence intervals), fitting coefficients (with 95% confidence intervals), D’Agostino-Pearson Omnibus residual normality test, Shapiro-Wilks residual normality tests, Brausch-Pagan F-value and its p-value. The added computations in previous work [12-14] confirmed the conclusions derived from those inferred from the correlation coefficients, p-values alone and added little value to the manuscript. Similarly, although computed but not reported in this paper, the additional assessments did not alter the essential conclusions. Not reporting these additional assessments simplified the discussion.
That said, I appreciated the manuscript and recommend its publication in this form.
Response: Thank you for your kind words.
Reviewer 2 Report
The authors have attempted to extend previous work on Signal to Clutter Ratio and test whether prostate tumor eccentricity and volume are indicators of tumor aggressiveness for bi-parametric (BP) MRI. The study is methodologically well performed.
The number of patients included in this study could be higher. Selection bias is present, but it can be tolerated considering that it is a pilot study.
Whether the pathohistological diagnosis for all subjects was made by the same pathologist?
Please provide reference justifying „However, in the clinical realm, there is less reliance on DCE MRI than previously.” Line 83
How do you explain this statement: „additional processing for ACE such as removing noisy principal components and regularizing the covariance matrix failed to achieve high correlation with the ISUP and CSPCa.” Line 338
The findings of this study could be of importance for clinical practice.
Author Response
Referee #2 Comments
Response: The authors thank the Reviewer for taking the time to analyze the manuscript and offering suggestions to improve the paper. Your help is greatly appreciated.
The authors have attempted to extend previous work on Signal to Clutter Ratio and test whether prostate tumor eccentricity and volume are indicators of tumor aggressiveness for bi-parametric (BP) MRI. The study is methodologically well performed.
Response: Thank you for your kind words.
The number of patients included in this study could be higher. Selection bias is present, but it can be tolerated considering that it is a pilot study.
Response: The following appears in the last paragraph of the Discussion Section,
While this study is the first of its kind, it is not without limitations. This work only analyzed a limited number of patients. Consecutive patients from the database were processed in an attempt to minimize bias. Nevertheless, this work should be treated as a pilot study.
Whether the pathohistological diagnosis for all subjects was made by the same pathologist?
Response: Section 2.2 Study Design and Populationhas been modiifed to read
Patients were scanned in four centers using nine scanners manufactured by Siemens and Philips [21]. Each centers’ staff pathologists and radiologists assessed patients at their center, independently of each other.
Please provide reference justifying „However, in the clinical realm, there is less reliance on DCE MRI than previously.” Line 83
Response: References have been added to line 83. The following sentence now reads
However, in the clinical realm, there is less reliance on DCE MRI than previously [9,17,18}.
How do you explain this statement: „additional processing for ACE such as removing noisy principal components and regularizing the covariance matrix failed to achieve high correlation with the ISUP and CSPCa.” Line 338
Response: The sentence has been amended to now read:
Similarly, additional processing for ACE such as removing noisy principal components and regularizing the covariance matrix failed to achieve high correlation with the ISUP and CSPCa unlike earlier studies that employed these covariance matrix enhancements to elevate the Signal to Clutter Ratio connection [13,14,16].
The findings of this study could be of importance for clinical practice
Response: We agree !! Thank you for your kind words.
