Diagnostic evaluation and incorporation of PSA density and the prostate imaging and data reporting system (PIRADS) version 2 classification in risk-nomograms for prostate cancer

Cabello, M.A. Rodríguez; Rubio, Santiago Méndez; Sancho, Arturo Platas; Rodríguez, Joaquín Carballido

doi:10.1007/s00345-022-04118-9

Cited by 6 publications

(7 citation statements)

References 28 publications

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“…Prior studies have shown that PSAD has greater predictive value for the detection of CS prostate cancer compared to PSA. 19,20 Additionally, the combination of PSAD and mpMRI has shown greater predictive value for the detection of CS prostate cancer on biopsy as well as adverse pathological features at radical prostatectomy compared to PI-RADS scores alone. [21][22][23] It has recently been suggested that patients with PI-RADS 5 lesions and a PSAD>0.15 ng/mL 2 can forego systematic biopsies.…”

Section: Discussionmentioning

confidence: 99%

“…Higher PSAD was associated with CS prostate cancer on fusion biopsy. Prior studies have shown that PSAD has greater predictive value for the detection of CS prostate cancer compared to PSA 19,20 . Additionally, the combination of PSAD and mpMRI has shown greater predictive value for the detection of CS prostate cancer on biopsy as well as adverse pathological features at radical prostatectomy compared to PI‐RADS scores alone 21–23 .…”

Section: Discussionmentioning

confidence: 99%

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Development and validation of nomogram to improve the specificity of multiparametric MRI for clinically significant prostate cancer

Shiekh,

Houenstein,

Ramahi

et al. 2023

Int J of Urology

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ObjectiveTo develop and validate a nomogram to improve the specificity of prostate imaging reporting and data system (PI‐RADS) on multiparametric magnetic resonance imaging (MRI) for clinically significant prostate cancer on targeted fusion biopsy.MethodsA retrospective review of patients who underwent fusion biopsy for PI‐RADS 3–5 lesions using UroNav and Artemis systems between 2016 and 2022 was performed. Patients were divided into those with CS disease on fusion biopsy (Gleason grade group ≥2) versus those without. Multivariable analysis was used to identify variables associated with CS disease. A 100‐point nomogram was constructed, and ROC curve was generated.Results1485 lesions (1032 patients) were identified, 510 (34%) were PI‐RADS 3, 586 (40%) were PI‐RADS 4, and 389 (26%) were PI‐RADS 5. Of these, 11% of PI‐RADS 3, 39% of PI‐RADS 4, and 61% of PI‐RADS 5 showed CS disease. CS disease was associated with older age (OR 1.04, 95% CI 1.02–1.06, p < 0.01), previous negative biopsy (OR 0.52, 95% CI 0.36–0.74, p < 0.01), presence of multiple PI‐RADS 3–5 lesions (OR 0.61, 95% CI 0.45–0.83, p < 0.01), peripheral zone location (OR 1.88, 95% CI 1.30–2.70, p < 0.01), PSA density (OR 1.48 per 0.1 unit, 95% CI 1.33–1.64, p < 0.01), PI‐RADS score 4 (OR 3.28, 95% CI 2.21–4.87, p < 0.01), and PI‐RADS score 5 (OR 7.65, 95% CI 4.93–11.85, p < 0.01). Area under ROC curve was 82% for nomogram compared to 75% for PI‐RADS score alone.ConclusionWe report a nomogram that combines PI‐RADS score with other clinical parameters. The nomogram outperforms PI‐RADS score for the detection of CS prostate cancer.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Development and validation of nomogram to improve the specificity of multiparametric MRI for clinically significant prostate cancer

Shiekh,

Houenstein,

Ramahi

et al. 2023

Int J of Urology

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“…However, PSAD and PIRADSv2 ≥3 demonstrated the highest sensitivity, with a combined sensitivity of almost 95% and AUC of 0.80 [6]. The combination of the four aforementioned predictive clinical characteristics into a nomogram resulted in a specificity of almost 85% for clinically significant disease [6]. Nomograms that incorporate age may decrease the increased false-positive PSA rates observed with increasing age.…”

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confidence: 98%

“…PSAD and MRI visibility have been used in conjunction to enhance the prediction of clinically significant cancer within a cohort of men with PSA > 4 ng/mL and/or suspicious digital rectal exam (DRE). One study found a significant association between clinically significant prostate cancer and age, DRE, PSAD, and Prostate Imaging Reporting and Data System version 2 (PIRADSv2) [6]. However, PSAD and PIRADSv2 ≥3 demonstrated the highest sensitivity, with a combined sensitivity of almost 95% and AUC of 0.80 [6].…”

mentioning

confidence: 99%

“…One study found a significant association between clinically significant prostate cancer and age, DRE, PSAD, and Prostate Imaging Reporting and Data System version 2 (PIRADSv2) [6]. However, PSAD and PIRADSv2 ≥3 demonstrated the highest sensitivity, with a combined sensitivity of almost 95% and AUC of 0.80 [6]. The combination of the four aforementioned predictive clinical characteristics into a nomogram resulted in a specificity of almost 85% for clinically significant disease [6].…”

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Role of PSA Density and MRI in PSA Interpretation. Comment on Lumbreras et al. Variables Associated with False-Positive PSA Results: A Cohort Study with Real-World Data. Cancers 2023, 15, 261

Jue

Alameddine

2023

Cancers

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Predicting clinically significant prostate cancer following suspicious mpMRI: analyses from a high-volume center

Jahnen,

Hausler,

Meissner

et al. 2024

World J Urol

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Purpose mpMRI is routinely used to stratify the risk of clinically significant prostate cancer (csPCa) in men with elevated PSA values before biopsy. This study aimed to calculate a multivariable risk model incorporating standard risk factors and mpMRI findings for predicting csPCa on subsequent prostate biopsy. Methods Data from 677 patients undergoing mpMRI ultrasound fusion biopsy of the prostate at the TUM University Hospital tertiary urological center between 2019 and 2023 were analyzed. Patient age at biopsy (67 (median); 33–88 (range) (years)), PSA (7.2; 0.3–439 (ng/ml)), prostate volume (45; 10–300 (ml)), PSA density (0.15; 0.01–8.4), PI-RADS (V.2.0 protocol) score of index lesion (92.2% ≥3), prior negative biopsy (12.9%), suspicious digital rectal examination (31.2%), biopsy cores taken (12; 2–22), and pathological biopsy outcome were analyzed with multivariable logistic regression for independent associations with the detection of csPCa defined as ISUP ≥ 3 (n = 212 (35.2%)) and ISUP ≥ 2 (n = 459 (67.8%) performed on 603 patients with complete information. Results Older age (OR: 1.64 for a 10-year increase; p < 0.001), higher PSA density (OR: 1.60 for a doubling; p < 0.001), higher PI-RADS score of the index lesion (OR: 2.35 for an increase of 1; p < 0.001), and a prior negative biopsy (OR: 0.43; p = 0.01) were associated with csPCa. Conclusion mpMRI findings are the dominant predictor for csPCa on follow-up prostate biopsy. However, PSA density, age, and prior negative biopsy history are independent predictors. They must be considered when discussing the individual risk for csPCa following suspicious mpMRI and may help facilitate the further diagnostical approach.

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Diagnostic evaluation and incorporation of PSA density and the prostate imaging and data reporting system (PIRADS) version 2 classification in risk-nomograms for prostate cancer

Cited by 6 publications

References 28 publications

Development and validation of nomogram to improve the specificity of multiparametric MRI for clinically significant prostate cancer

Development and validation of nomogram to improve the specificity of multiparametric MRI for clinically significant prostate cancer

Role of PSA Density and MRI in PSA Interpretation. Comment on Lumbreras et al. Variables Associated with False-Positive PSA Results: A Cohort Study with Real-World Data. Cancers 2023, 15, 261

Predicting clinically significant prostate cancer following suspicious mpMRI: analyses from a high-volume center

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