Toward an MRI-based nomogram for the prediction of transperineal prostate biopsy outcome: A physician and patient decision tool

Lee, Su‐Min; Liyanage, Sidath H.; Wulaningsih, Wahyu; Wolfe, Konrad; Carr, T. W.; Younis, Choudhry; Hemelrijck, Mieke Van; Popert, Rick; Acher, Peter

doi:10.1016/j.urolonc.2017.07.018

Cited by 30 publications

(39 citation statements)

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“…It helps accelerate evidence generation through providing observational studies that can generate new hypotheses and support policy makers. Prior to its formal development, a wide variety of studies had already been published using the clinical data of GSTT's cancer patients (based on individual ethics or audit approval) including various studies focused on prostate cancer [4][5][6][7][8][9], breast cancer [10][11][12][13] and renal cancer [14]. The below case study shows how data from Guy's Cancer Cohort was used to address a clinically important question for bladder cancer:…”

Section: Utility and Discussionmentioning

confidence: 99%

Guy’s cancer cohort – real world evidence for cancer pathways

et al. 2020

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Background: The burden of disease due to cancer remains substantial. Since the value of real-world evidence has also been recognised by regulatory agencies, we established a Research Ethics Committee (REC) approved research database for cancer patients (Reference: 18/NW/0297). Construction and content: Guy's Cancer Cohort introduces the concept of opt-out consent processes for research in a subset of oncology patients diagnosed and treated at a large NHS Trust in the UK. From April 2016 until March 2017, 1388 eligible patients visited Guy's and St Thomas' NHS Foundation Trust (GSTT) for breast cancer management. For urological cancers this number was 1757 and for lung cancer 677. The Cohort consists of a large repository of routinely collected clinical data recorded both retrospectively and prospectively. The database contains detailed clinical information collected at various timepoints across the treatment pathway inclusive of diagnostic data, and data on disease progression, recurrence and survival. Conclusions: Guy's Cancer Cohort provides a valuable infrastructure to answer a wide variety of research questions of a clinical, mechanistic, and supportive care nature. Clinical research using this database will result in improved patient safety and experience. Guy's Cancer Cohort promotes collaborative research and will accept applications for the release of anonymised datasets for research purposes.

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Section: Utility and Discussionmentioning

confidence: 99%

Guy’s cancer cohort – real world evidence for cancer pathways

et al. 2020

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“…The added value of mpMRI to clinical variables in prediction of biopsy outcome has already been shown (eg, PROMIS, PRECISION, and MRI‐FIRST, trials). More recently, nomograms/models for prostate MRI findings were developed . In a study by Lee et al, an internally validated nomogram/model using MRI performed without intravenous contrast agent was able to accurately predict PCa and SPCa in transperineal prostate biopsy.…”

Section: Discussionmentioning

confidence: 99%

“…More recently, nomograms/models for prostate MRI findings were developed . In a study by Lee et al, an internally validated nomogram/model using MRI performed without intravenous contrast agent was able to accurately predict PCa and SPCa in transperineal prostate biopsy. Recently, Boesen et al developed and internally validated a nomogram for prediction of prostate biopsy outcome based on bpMRI, which consisted of a T 2 w and a single DWI acquisition .…”

Section: Discussionmentioning

confidence: 99%

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Qualitative and Quantitative Reporting of a Unique Biparametric MRI: Towards Biparametric MRI‐Based Nomograms for Prediction of Prostate Biopsy Outcome in Men With a Clinical Suspicion of Prostate Cancer (IMPROD and MULTI‐IMPROD Trials)

Perez

Jambor

Kauko

et al. 2019

Magnetic Resonance Imaging

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Background: Multiparametric MRI of the prostate has been shown to improve the risk stratification of men with an elevated prostate-specific antigen (PSA). However, long acquisition time, high cost, and inter-center/reader variability of a routine prostate multiparametric MRI limit its wider adoption. Purpose: To develop and validate nomograms based on unique rapid biparametric MRI (bpMRI) qualitative and quantitative derived variables for prediction of clinically significant cancer (SPCa). Study Type: Retrospective analyses of single (IMPROD, NCT01864135) and multiinstitution trials (MULTI-IMPROD, NCT02241122). Population: 161 and 338 prospectively enrolled men who completed the IMPROD and MULTI-IMPROD trials, respectively. Field Strength/Sequence: IMPROD bpMRI: 3T/1.5T, T 2 -weighted imaging, three separate diffusion-weighted imaging (DWI) acquisitions: 1) b-values 0, 100, 200, 300, 500 s/mm 2 ; 2) b values 0, 1500 s/mm 2 ; 3) values 0, 2000 s/mm 2 . Assessment: The primary endpoint of the combined trial analysis was the diagnostic accuracy of the combination of IMPROD bpMRI and clinical variables for detection of SPCa.View this article online at wileyonlinelibrary.com.

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“…Due to the predictive value of mpMRI in PCa diagnosis, recently new multivariate risk prediction tools have been constructed, with the inclusion of the mpMRI suspicion score [20][21][22][23][24][25][26][27][28][29]. The purpose of this review is to explore the performance of these new MRI risk models for indicating a biopsy for prostate cancer diagnosis.…”

Section: Introductionmentioning

confidence: 99%

Multivariate risk prediction tools including MRI for individualized biopsy decision in prostate cancer diagnosis: current status and future directions

Schoots

Roobol

2019

World J Urol

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Background and purpose Individualized risk-adapted algorithms in prostate cancer (PCa) diagnosis using predictive prebiopsy variables in addition to prostate-specific antigen value may result in a considerable reduction of unnecessary systematic biopsies. Multi-parametric magnetic resonance imaging (mpMRI) has emerged as a secondary prediction tool that can further improve the detection of clinically significant prostate cancer (csPCa). This review explores the performance of new MRI risk models for indicating a biopsy for prostate cancer diagnosis. Results and considerations The area under the receiver-operating characteristic curve for detecting csPCa varies between 0.64 and 0.91 in biopsy-naïve men, and between 0.78 and 0.93 in men with a previous negative biopsy. The utility of multivariate risk prediction tools including MRI suspicion scores as an extra input parameter has the potential to avoid a notable number of biopsies and detection of clinically insignificant PCa at a low price of missing some csPCa. The trade-off depends on the risk threshold that is chosen. In biopsy-naïve men a net benefit was obtained at a risk threshold of above 10% for csPCa in most MRI risk prediction models. All constructed MRI risk models used (referral) patient cohorts with high prevalence of csPCa. Using more representative cohorts from daily clinical screening, net benefit may attenuate at lower risk thresholds. Strengths and limitations of these models are discussed. Future directions To assess their wider applicability, in-depth analysis of mpMRI predictive qualities should be further investigated, in combination with required external validation of these models in a multicenter setting with large prospective datasets.

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Toward an MRI-based nomogram for the prediction of transperineal prostate biopsy outcome: A physician and patient decision tool

Abstract: These internally validated MR-based nomograms were able to accurately predict TPSB outcomes for prostate cancer, especially significant disease. Our findings support the combination of prebiopsy MRI results and clinical factors as part of the biopsy decision-making process.

Cited by 30 publications

References 34 publications

Guy’s cancer cohort – real world evidence for cancer pathways

Guy’s cancer cohort – real world evidence for cancer pathways

Qualitative and Quantitative Reporting of a Unique Biparametric MRI: Towards Biparametric MRI‐Based Nomograms for Prediction of Prostate Biopsy Outcome in Men With a Clinical Suspicion of Prostate Cancer (IMPROD and MULTI‐IMPROD Trials)

Multivariate risk prediction tools including MRI for individualized biopsy decision in prostate cancer diagnosis: current status and future directions

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