Establishment of an Individualized Predictive Model to Reduce the Core Number for Systematic Prostate Biopsy: A Dual Center Study Based on Stratification of the Disease Risk Score

Abstract

PurposeTo establish an individualized prostate biopsy model that reduces unnecessary biopsy cores based on multiparameter MRI (mpMRI).Materials and MethodsThis retrospective, non-inferiority dual-center study retrospectively included 609 patients from the Changhai Hospital from June 2017 to November 2020 and 431 patients from the Fujian Union Hospital between 2014 and 2019. Clinical, radiological, and pathological data were analyzed. Data from the Changhai Hospital were used for modeling by calculating the patients’ disease risk scores. Data from the Fujian Union Hospital were used for external verification.ResultsBased on the data of 609 patients from the Changhai Hospital, we divided the patients evenly into five layers according to the disease risk score. The area under the receiver operating characteristic (ROC) curve (AUC) with 95% confidence intervals (CI) was analyzed. Twelve-core systemic biopsy (12-SBx) was used as the reference standard. The SBx cores from each layer were reduced to 9, 6, 5, 4, and 4. The data of 279 patients with benign pathological results from the Fujian Union Hospital were incorporated into the model. No patients were in the first layer. The accuracies of the models for the other layers were 88, 96.43, 94.87, and 94.59%. The accuracy of each layer would be increased to 96, 100, 100, and 97.30% if the diagnosis of non-clinically significant prostate cancer was excluded.ConclusionsIn this study, we established an individualized biopsy model using data from a dual center. The results showed great accuracy of the model, indicating its future clinical application.

Personalized Optimization of Systematic Prostate Biopsy Core Number Based on mpMRI Radiomics Features

“…Higher TPSA concentrations were associated with a wider distribution of cancerous lesions in patients with PCa, enabling these lesions to be easily detected through biopsy [26]. Therefore, a limited number of biopsy cores was found to be su cient for the accurate diagnosis of patients with TPSA levels ≥ 20 ng/ml [27]. In our study, a feasible model of core reduction was developed that considers individual factors, such as age, TPSA and PI-RADS, with the integration of mpMRI radiomics factors into this model resulting in a gradual reduction in the number of cores and a more individualized approach to biopsy.…”