Prediction Medicine: Biomarkers, Risk Calculators and Magnetic Resonance Imaging as Risk Stratification Tools in Prostate Cancer Diagnosis

This review discusses the most recent evidence for currently available risk stratification tools in the detection of clinically significant prostate cancer (csPCa), and evaluates diagnostic strategies that combine these tools. Novel blood biomarkers, such as the Prostate Health Index (PHI) and 4Ksco...

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Main Authors: Daniël F. Osses, Monique J. Roobol, Ivo G. Schoots
Format: Article
Language:English
Published: MDPI AG 2019-04-01
Series:International Journal of Molecular Sciences
Subjects:
Online Access:https://www.mdpi.com/1422-0067/20/7/1637
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author Daniël F. Osses
Monique J. Roobol
Ivo G. Schoots
author_facet Daniël F. Osses
Monique J. Roobol
Ivo G. Schoots
author_sort Daniël F. Osses
collection DOAJ
description This review discusses the most recent evidence for currently available risk stratification tools in the detection of clinically significant prostate cancer (csPCa), and evaluates diagnostic strategies that combine these tools. Novel blood biomarkers, such as the Prostate Health Index (PHI) and 4Kscore, show similar ability to predict csPCa. Prostate cancer antigen 3 (PCA3) is a urinary biomarker that has inferior prediction of csPCa compared to PHI, but may be combined with other markers like TMPRSS2-ERG to improve its performance. Original risk calculators (RCs) have the advantage of incorporating easy to retrieve clinical variables and being freely accessible as a web tool/mobile application. RCs perform similarly well as most novel biomarkers. New promising risk models including novel (genetic) markers are the SelectMDx and Stockholm-3 model (S3M). Prostate magnetic resonance imaging (MRI) has evolved as an appealing tool in the diagnostic arsenal with even stratifying abilities, including in the initial biopsy setting. Merging biomarkers, RCs and MRI results in higher performances than their use as standalone tests. In the current era of prostate MRI, the way forward seems to be multivariable risk assessment based on blood and clinical parameters, potentially extended with information from urine samples, as a triaging test for the selection of candidates for MRI and biopsy.
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spelling doaj.art-2cc82c67ae734e60981fb1769e9493f32022-12-22T03:07:22ZengMDPI AGInternational Journal of Molecular Sciences1422-00672019-04-01207163710.3390/ijms20071637ijms20071637Prediction Medicine: Biomarkers, Risk Calculators and Magnetic Resonance Imaging as Risk Stratification Tools in Prostate Cancer DiagnosisDaniël F. Osses0Monique J. Roobol1Ivo G. Schoots2Department of Radiology & Nuclear Medicine, Erasmus University Medical Center, 3015 GD Rotterdam, The NetherlandsDepartment of Urology, Erasmus University Medical Center, 3015 GD Rotterdam, The NetherlandsDepartment of Radiology & Nuclear Medicine, Erasmus University Medical Center, 3015 GD Rotterdam, The NetherlandsThis review discusses the most recent evidence for currently available risk stratification tools in the detection of clinically significant prostate cancer (csPCa), and evaluates diagnostic strategies that combine these tools. Novel blood biomarkers, such as the Prostate Health Index (PHI) and 4Kscore, show similar ability to predict csPCa. Prostate cancer antigen 3 (PCA3) is a urinary biomarker that has inferior prediction of csPCa compared to PHI, but may be combined with other markers like TMPRSS2-ERG to improve its performance. Original risk calculators (RCs) have the advantage of incorporating easy to retrieve clinical variables and being freely accessible as a web tool/mobile application. RCs perform similarly well as most novel biomarkers. New promising risk models including novel (genetic) markers are the SelectMDx and Stockholm-3 model (S3M). Prostate magnetic resonance imaging (MRI) has evolved as an appealing tool in the diagnostic arsenal with even stratifying abilities, including in the initial biopsy setting. Merging biomarkers, RCs and MRI results in higher performances than their use as standalone tests. In the current era of prostate MRI, the way forward seems to be multivariable risk assessment based on blood and clinical parameters, potentially extended with information from urine samples, as a triaging test for the selection of candidates for MRI and biopsy.https://www.mdpi.com/1422-0067/20/7/1637prostate cancer detectionrisk stratificationbiomarkerrisk calculatormagnetic resonance imagingcost-effective diagnostic pathways
spellingShingle Daniël F. Osses
Monique J. Roobol
Ivo G. Schoots
Prediction Medicine: Biomarkers, Risk Calculators and Magnetic Resonance Imaging as Risk Stratification Tools in Prostate Cancer Diagnosis
International Journal of Molecular Sciences
prostate cancer detection
risk stratification
biomarker
risk calculator
magnetic resonance imaging
cost-effective diagnostic pathways
title Prediction Medicine: Biomarkers, Risk Calculators and Magnetic Resonance Imaging as Risk Stratification Tools in Prostate Cancer Diagnosis
title_full Prediction Medicine: Biomarkers, Risk Calculators and Magnetic Resonance Imaging as Risk Stratification Tools in Prostate Cancer Diagnosis
title_fullStr Prediction Medicine: Biomarkers, Risk Calculators and Magnetic Resonance Imaging as Risk Stratification Tools in Prostate Cancer Diagnosis
title_full_unstemmed Prediction Medicine: Biomarkers, Risk Calculators and Magnetic Resonance Imaging as Risk Stratification Tools in Prostate Cancer Diagnosis
title_short Prediction Medicine: Biomarkers, Risk Calculators and Magnetic Resonance Imaging as Risk Stratification Tools in Prostate Cancer Diagnosis
title_sort prediction medicine biomarkers risk calculators and magnetic resonance imaging as risk stratification tools in prostate cancer diagnosis
topic prostate cancer detection
risk stratification
biomarker
risk calculator
magnetic resonance imaging
cost-effective diagnostic pathways
url https://www.mdpi.com/1422-0067/20/7/1637
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AT ivogschoots predictionmedicinebiomarkersriskcalculatorsandmagneticresonanceimagingasriskstratificationtoolsinprostatecancerdiagnosis