Elucidating the need for prostate cancer risk calculators in conjunction with mpMRI in initial risk assessment before prostate biopsy at a tertiary prostate cancer center

Autor: Philipp Krausewitz, Thomas Büttner, Marthe von Danwitz, Richard Weiten, Alexander Cox, Niklas Klümper, Johannes Stein, Julian Luetkens, Glen Kristiansen, Manuel Ritter, Jörg Ellinger
Jazyk: angličtina
Rok vydání: 2024
Předmět:
Zdroj: BMC Urology, Vol 24, Iss 1, Pp 1-9 (2024)
Druh dokumentu: article
ISSN: 1471-2490
DOI: 10.1186/s12894-024-01460-5
Popis: Abstract Objective Utilizing personalized risk assessment for clinically significant prostate cancer (csPCa) incorporating multiparametric magnetic resonance imaging (mpMRI) reduces biopsies and overdiagnosis. We validated both multi- and univariate risk models in biopsy-naïve men, with and without the inclusion of mpMRI data for csPCa detection. Methods N = 565 men underwent mpMRI-targeted prostate biopsy, and the diagnostic performance of risk calculators (RCs), mpMRI alone, and clinical measures were compared using receiver operating characteristic curve (ROC) analysis and decision curve analysis (DCA). Subgroups were stratified based on mpMRI findings and quality. Results csPCa was detected in 56.3%. PI-RADS score achieved the highest area under the curve (AUC) when comparing univariate risk models (AUC 0.82, p 0.5; saved biopsies 16%). In men with suspicious mpMRI, both mpMRI-based RCs and the PI-RADS score predicted csPCa excellently (AUC 0.82–0.79 vs. 0.80, p > 0.05), highlighting superior performance compared to non-MRI-based models (all p
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