AI Article Synopsis
- The study aimed to adapt and validate prostate cancer risk calculators (ERSPC RCs) in a modern Norwegian context to help decrease unnecessary pre-emptive multiparametric MRI (mpMRI) and biopsies.
- Data from 303 patients who underwent mpMRI and biopsies were analyzed; results showed the MRI-ERSPC-RCs were well-calibrated, while the ERSPC RCs 3/4 needed adjustments for accuracy.
- The findings suggest that utilizing the updated risk calculators can significantly reduce the number of unnecessary procedures, with minimal risk of missing clinically significant prostate cancer cases.
Article Abstract
Objectives: To recalibrate and validate the European Randomized Study of Screening for Prostate Cancer risk calculators (ERSPC RCs) 3/4 and the magnetic resonance imaging (MRI)-ERSPC-RCs to a contemporary Norwegian setting to reduce upfront prostate multiparametric MRI (mpMRI) and prostate biopsies.
Patients And Methods: We retrospectively identified and entered all men who underwent prostate mpMRI and subsequent prostate biopsy between January 2016 and March 2017 in a Norwegian centre into a database. mpMRI was reported using PI-RADS v2.0 and clinically significant prostate cancer (csPCa) defined as Gleason ≥ 3 + 4. Probabilities of csPCa and any prostate cancer (PCa) on biopsy were calculated by the ERSPC RCs 3/4 and the MRI-ERSPC-RC and compared with biopsy results. RCs were then recalibrated to account for differences in prevalence between the development and current cohorts (if indicated), and calibration, discrimination and clinical usefulness assessed.
Results: Three hundred and three patients were included. The MRI-ERSPC-RCs were perfectly calibrated to our cohort, although the ERSPC RCs 3/4 needed recalibration. Area under the receiver operating curve (AUC) for the ERSPC RCs 3/4 was 0.82 for the discrimination of csPCa and 0.77 for any PCa. The AUC for the MRI-ERSPC-RCs was 0.89 for csPCa and 0.85 for any PCa. Decision curve analysis showed clear net benefit for both the ERSPC RCs 3/4 (>2% risk of csPCa threshold to biopsy) and for the MRI-ERSPC-RCs (>1% risk of csPCa threshold), with a greater net benefit for the MRI-RCs. Using a >10% risk of csPCa or 20% risk of any PCa threshold for the ERSPC RCs 3/4, 15.5% of mpMRIs could be omitted, missing 0.8% of csPCa. Using the MRI-ERSPC-RCs, 23.4% of biopsies could be omitted with the same threshold, missing 0.8% of csPCa.
Conclusion: The ERSPC RCs 3/4 and MRI-ERSPC-RCs can considerably reduce both upfront mpMRI and prostate biopsies with little risk of missing csPCa.
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| http://www.ncbi.nlm.nih.gov/pmc/articles/PMC9349589 | PMC |
| http://dx.doi.org/10.1002/bco2.146 | DOI Listing |
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Reducing prostate biopsies and magnetic resonance imaging with prostate cancer risk stratification.
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Article Synopsis
- The study aimed to adapt and validate prostate cancer risk calculators (ERSPC RCs) in a modern Norwegian context to help decrease unnecessary pre-emptive multiparametric MRI (mpMRI) and biopsies.
- Data from 303 patients who underwent mpMRI and biopsies were analyzed; results showed the MRI-ERSPC-RCs were well-calibrated, while the ERSPC RCs 3/4 needed adjustments for accuracy.
- The findings suggest that utilizing the updated risk calculators can significantly reduce the number of unnecessary procedures, with minimal risk of missing clinically significant prostate cancer cases.
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