Comparative Analysis of PSA Density and an MRI-Based Predictive Model to Improve the Selection of Candidates for Prostate Biopsy
This study is a head-to-head comparison between mPSAD and MRI-PMbdex. The MRI-PMbdex was created from 2432 men with suspected PCa; this cohort comprised the development and external validation cohorts of the Barcelona MRI predictive model. Pre-biopsy 3-Tesla multiparametric MRI (mpMRI) and 2 to 4-co...
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| Format: | Article |
| Language: | English |
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MDPI AG
2022-05-01
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| Series: | Cancers |
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| Online Access: | https://www.mdpi.com/2072-6694/14/10/2374 |
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| author | Juan Morote Angel Borque-Fernando Marina Triquell Anna Celma Lucas Regis Richard Mast Inés M. de Torres María E. Semidey José M. Abascal Pol Servian Anna Santamaría Jacques Planas Luis M. Esteban Enrique Trilla |
| author_facet | Juan Morote Angel Borque-Fernando Marina Triquell Anna Celma Lucas Regis Richard Mast Inés M. de Torres María E. Semidey José M. Abascal Pol Servian Anna Santamaría Jacques Planas Luis M. Esteban Enrique Trilla |
| author_sort | Juan Morote |
| collection | DOAJ |
| description | This study is a head-to-head comparison between mPSAD and MRI-PMbdex. The MRI-PMbdex was created from 2432 men with suspected PCa; this cohort comprised the development and external validation cohorts of the Barcelona MRI predictive model. Pre-biopsy 3-Tesla multiparametric MRI (mpMRI) and 2 to 4-core transrectal ultrasound (TRUS)-guided biopsies for suspicious lesions and/or 12-core TRUS systematic biopsies were scheduled. Clinically significant PCa (csPCa), defined as Gleason-based Grade Group 2 or higher, was detected in 934 men (38.4%). The area under the curve was 0.893 (95% confidence interval [CI]: 0.880–0.906) for MRI-PMbdex and 0.764 (95% CI: 0.774–0.783) for mPSAD, with <i>p</i> < 0.001. MRI-PMbdex showed net benefit over biopsy in all men when the probability of csPCa was greater than 2%, while mPSAD did the same when the probability of csPCa was greater than 18%. Thresholds of 13.5% for MRI-PMbdex and 0.628 ng/mL<sup>2</sup> for mPSAD had 95% sensitivity for csPCa and presented 51.1% specificity for MRI-PMbdex and 19.6% specificity for mPSAD, with <i>p</i> < 0.001. MRI-PMbdex exhibited net benefit over mPSAD in men with prostate imaging report and data system (PI-RADS) <4, while neither exhibited any benefit in men with PI-RADS 5. Hence, we can conclude that MRI-PMbdex is more accurate than mPSAD for the proper selection of candidates for prostate biopsy among men with suspected PCa, with the exception of men with a PI-RAD S 5 score, for whom neither tool exhibited clinical guidance to determine the need for biopsy. |
| first_indexed | 2024-03-10T03:12:51Z |
| format | Article |
| id | doaj.art-a54a62f25dc54a7081e26a569191cfd8 |
| institution | Directory Open Access Journal |
| issn | 2072-6694 |
| language | English |
| last_indexed | 2024-03-10T03:12:51Z |
| publishDate | 2022-05-01 |
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| series | Cancers |
| spelling | doaj.art-a54a62f25dc54a7081e26a569191cfd82023-11-23T10:22:15ZengMDPI AGCancers2072-66942022-05-011410237410.3390/cancers14102374Comparative Analysis of PSA Density and an MRI-Based Predictive Model to Improve the Selection of Candidates for Prostate BiopsyJuan Morote0Angel Borque-Fernando1Marina Triquell2Anna Celma3Lucas Regis4Richard Mast5Inés M. de Torres6María E. Semidey7José M. Abascal8Pol Servian9Anna Santamaría10Jacques Planas11Luis M. Esteban12Enrique Trilla13Department of Urology, Vall d’Hebron Hospital, 08035 Barcelona, SpainDepartment of Urology, Hospital Miguel Servet, IIS-Aragon, 50009 Zaragoza, SpainDepartment of Urology, Vall d’Hebron Hospital, 08035 Barcelona, SpainDepartment of Urology, Vall d’Hebron Hospital, 08035 Barcelona, SpainDepartment of Urology, Vall d’Hebron Hospital, 08035 Barcelona, SpainDepartment of Radiology, Vall d’Hebron Hospital, 08035 Barcelona, SpainDepartment of Pathology, Vall d´Hebron Hospital, 08035 Barcelona, SpainDepartment of Pathology, Vall d´Hebron Hospital, 08035 Barcelona, SpainDepartment of Urology, Parc de Salut Mar, Universitat Pompeu Fabra, 08003 Barcelona, SpainDepartment of Urology, Hospital Germans Trias i Pujol, 08035 Badalona, SpainVall d´Hebron Research Institute, 08035 Barcelona, SpainDepartment of Urology, Vall d’Hebron Hospital, 08035 Barcelona, SpainDepartment of Applied Mathematics, Escuela Universitaria Politécnica La Almunia, Universidad de Zaragoza, 50100 Zaragoza, SpainDepartment of Urology, Vall d’Hebron Hospital, 08035 Barcelona, SpainThis study is a head-to-head comparison between mPSAD and MRI-PMbdex. The MRI-PMbdex was created from 2432 men with suspected PCa; this cohort comprised the development and external validation cohorts of the Barcelona MRI predictive model. Pre-biopsy 3-Tesla multiparametric MRI (mpMRI) and 2 to 4-core transrectal ultrasound (TRUS)-guided biopsies for suspicious lesions and/or 12-core TRUS systematic biopsies were scheduled. Clinically significant PCa (csPCa), defined as Gleason-based Grade Group 2 or higher, was detected in 934 men (38.4%). The area under the curve was 0.893 (95% confidence interval [CI]: 0.880–0.906) for MRI-PMbdex and 0.764 (95% CI: 0.774–0.783) for mPSAD, with <i>p</i> < 0.001. MRI-PMbdex showed net benefit over biopsy in all men when the probability of csPCa was greater than 2%, while mPSAD did the same when the probability of csPCa was greater than 18%. Thresholds of 13.5% for MRI-PMbdex and 0.628 ng/mL<sup>2</sup> for mPSAD had 95% sensitivity for csPCa and presented 51.1% specificity for MRI-PMbdex and 19.6% specificity for mPSAD, with <i>p</i> < 0.001. MRI-PMbdex exhibited net benefit over mPSAD in men with prostate imaging report and data system (PI-RADS) <4, while neither exhibited any benefit in men with PI-RADS 5. Hence, we can conclude that MRI-PMbdex is more accurate than mPSAD for the proper selection of candidates for prostate biopsy among men with suspected PCa, with the exception of men with a PI-RAD S 5 score, for whom neither tool exhibited clinical guidance to determine the need for biopsy.https://www.mdpi.com/2072-6694/14/10/2374prostate-specific antigen densitypredictive modelclinically significant prostate cancer |
| spellingShingle | Juan Morote Angel Borque-Fernando Marina Triquell Anna Celma Lucas Regis Richard Mast Inés M. de Torres María E. Semidey José M. Abascal Pol Servian Anna Santamaría Jacques Planas Luis M. Esteban Enrique Trilla Comparative Analysis of PSA Density and an MRI-Based Predictive Model to Improve the Selection of Candidates for Prostate Biopsy Cancers prostate-specific antigen density predictive model clinically significant prostate cancer |
| title | Comparative Analysis of PSA Density and an MRI-Based Predictive Model to Improve the Selection of Candidates for Prostate Biopsy |
| title_full | Comparative Analysis of PSA Density and an MRI-Based Predictive Model to Improve the Selection of Candidates for Prostate Biopsy |
| title_fullStr | Comparative Analysis of PSA Density and an MRI-Based Predictive Model to Improve the Selection of Candidates for Prostate Biopsy |
| title_full_unstemmed | Comparative Analysis of PSA Density and an MRI-Based Predictive Model to Improve the Selection of Candidates for Prostate Biopsy |
| title_short | Comparative Analysis of PSA Density and an MRI-Based Predictive Model to Improve the Selection of Candidates for Prostate Biopsy |
| title_sort | comparative analysis of psa density and an mri based predictive model to improve the selection of candidates for prostate biopsy |
| topic | prostate-specific antigen density predictive model clinically significant prostate cancer |
| url | https://www.mdpi.com/2072-6694/14/10/2374 |
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