A Clinically Significant Prostate Cancer Predictive Model Using Digital Rectal Examination Prostate Volume Category to Stratify Initial Prostate Cancer Suspicion and Reduce Magnetic Resonance Imaging Demand

Early detection of PCa (PCa) has evolved towards clinically significant PCa (csPCa) after the spread of pre-biopsy multiparametric magnetic resonance imaging (mpMRI). However, PCa suspicion remains based on prostate-specific antigen (PSA) elevation and/or abnormal digital rectal examination (DRE). T...

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Bibliographic Details
Authors: Morote Robles, Juan|||0000-0002-2168-323X, Borque-Fernando, Ángel|||0000-0003-0178-4567, Triquell, Marina|||0000-0003-3881-8177, Campistol i Torres, Miriam|||0000-0002-3212-3473, Celma, Ana|||0000-0002-3128-3811, Regis, Lucas|||0000-0001-7121-1946, Abascal, Jose Maria|||0000-0001-8374-6593, Servian, Pol|||0000-0002-3727-8159, Planas Morin, Jacques|||0000-0002-0222-584X, Méndez Fernández, Olga|||0000-0003-4237-330X, Esteban, Luis M.|||0000-0002-3007-302X, Trilla Herrera, Enrique|||0000-0001-9401-0872
Format: article
Publication Date:2022
Country:España
Institution:Universitat Autònoma de Barcelona
Repository:Dipòsit Digital de Documents de la UAB
Language:English
OAI Identifier:oai:ddd.uab.cat:282411
Online Access:https://ddd.uab.cat/record/282411
https://dx.doi.org/urn:doi:10.3390/cancers14205100
Access Level:Open access
Keyword:Clinically significant
Development
External validation
Magnetic resonance imaging
Predictive model
Prostate cancer
Risk calculator
Suspicion
Description
Summary:Early detection of PCa (PCa) has evolved towards clinically significant PCa (csPCa) after the spread of pre-biopsy multiparametric magnetic resonance imaging (mpMRI). However, PCa suspicion remains based on prostate-specific antigen (PSA) elevation and/or abnormal digital rectal examination (DRE). This change of paradigm and approach has reduced unnecessary prostate biopsies and overdetection of insignificant PCa, while the demand for mpMRI has skyrocketed despite its implementation not being allowed at all sites. The European Association of Urology (EAU) proposes risk-organized models for early detection of csPCa stratifying the initial PCa suspicion to reduce MRI scans and then prostate biopsies after mpMRI. Risk calculators are efficient tools for individualizing the risk of csPCa, especially when prostate volume is included in the predictive models. After the development and external validation of the Barcelona MRI risk calculator (BCN-RC 2) for the selection of candidates for prostate biopsy, we have now developed and externally validated BCN-RC 1 with the aim of reduce mpMRI demand. Both BCN-RC 1 and RC 2 are ready to be integrated in a risk-organized model for early detection of csPCa. A predictive model including age, PCa family history, biopsy status (initial vs repeat), DRE (normal vs abnormal), serum prostate-specific antigen (PSA), and DRE prostate volume ca-tegory was developed to stratify initial PCa suspicion in 1486 men with PSA.

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