Improving the Early Detection of Clinically Significant Prostate Cancer in Men in the Challenging Prostate Imaging-Reporting and Data System 3 Category

The efficacy of tools for selection of candidates for prostate biopsy after multiparametric magnetic resonance imaging (MRI) varies across Prostate Imaging-Reporting and Data System (PI-RADS) categories. The new Proclarix test performs better than prostate-specific antigen density and the European R...

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Autores: Morote Robles, Juan|||0000-0002-2168-323X, Campistol i Torres, Miriam|||0000-0002-3212-3473, Triquell, Marina|||0000-0003-3881-8177, Celma, Ana|||0000-0002-3128-3811, Regis, Lucas|||0000-0001-7121-1946, de Torres, Inés|||0000-0002-5495-9140, Semidey Raven, Maria Eugenia|||0000-0001-8539-9265, Mast, Richard|||0000-0001-6005-800X, Santamaría Margalef, Anna|||0000-0001-6726-8990, Planas Morin, Jacques|||0000-0002-0222-584X, Trilla Herrera, Enrique|||0000-0001-9401-0872
Tipo de recurso: artículo
Fecha de publicación:2022
País:España
Institución:Universitat Autònoma de Barcelona
Repositorio:Dipòsit Digital de Documents de la UAB
Idioma:inglés
OAI Identifier:oai:ddd.uab.cat:257285
Acceso en línea:https://ddd.uab.cat/record/257285
https://dx.doi.org/urn:doi:10.1016/j.euros.2021.12.009
Access Level:acceso abierto
Palabra clave:Clinically significant prostate cancer
Multiparametric magnetic resonance imaging
Proclarix
Prostate-specific antigen density
European Randomized Study of Screening for Prostate Cancer predictive model
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network_name_str España
repository_id_str
dc.title.none.fl_str_mv Improving the Early Detection of Clinically Significant Prostate Cancer in Men in the Challenging Prostate Imaging-Reporting and Data System 3 Category
title Improving the Early Detection of Clinically Significant Prostate Cancer in Men in the Challenging Prostate Imaging-Reporting and Data System 3 Category
spellingShingle Improving the Early Detection of Clinically Significant Prostate Cancer in Men in the Challenging Prostate Imaging-Reporting and Data System 3 Category
Morote Robles, Juan|||0000-0002-2168-323X
Clinically significant prostate cancer
Multiparametric magnetic resonance imaging
Proclarix
Prostate-specific antigen density
European Randomized Study of Screening for Prostate Cancer predictive model
title_short Improving the Early Detection of Clinically Significant Prostate Cancer in Men in the Challenging Prostate Imaging-Reporting and Data System 3 Category
title_full Improving the Early Detection of Clinically Significant Prostate Cancer in Men in the Challenging Prostate Imaging-Reporting and Data System 3 Category
title_fullStr Improving the Early Detection of Clinically Significant Prostate Cancer in Men in the Challenging Prostate Imaging-Reporting and Data System 3 Category
title_full_unstemmed Improving the Early Detection of Clinically Significant Prostate Cancer in Men in the Challenging Prostate Imaging-Reporting and Data System 3 Category
title_sort Improving the Early Detection of Clinically Significant Prostate Cancer in Men in the Challenging Prostate Imaging-Reporting and Data System 3 Category
dc.creator.none.fl_str_mv Morote Robles, Juan|||0000-0002-2168-323X
Campistol i Torres, Miriam|||0000-0002-3212-3473
Triquell, Marina|||0000-0003-3881-8177
Celma, Ana|||0000-0002-3128-3811
Regis, Lucas|||0000-0001-7121-1946
de Torres, Inés|||0000-0002-5495-9140
Semidey Raven, Maria Eugenia|||0000-0001-8539-9265
Mast, Richard|||0000-0001-6005-800X
Santamaría Margalef, Anna|||0000-0001-6726-8990
Planas Morin, Jacques|||0000-0002-0222-584X
Trilla Herrera, Enrique|||0000-0001-9401-0872
author Morote Robles, Juan|||0000-0002-2168-323X
author_facet Morote Robles, Juan|||0000-0002-2168-323X
Campistol i Torres, Miriam|||0000-0002-3212-3473
Triquell, Marina|||0000-0003-3881-8177
Celma, Ana|||0000-0002-3128-3811
Regis, Lucas|||0000-0001-7121-1946
de Torres, Inés|||0000-0002-5495-9140
Semidey Raven, Maria Eugenia|||0000-0001-8539-9265
Mast, Richard|||0000-0001-6005-800X
Santamaría Margalef, Anna|||0000-0001-6726-8990
Planas Morin, Jacques|||0000-0002-0222-584X
Trilla Herrera, Enrique|||0000-0001-9401-0872
author_role author
author2 Campistol i Torres, Miriam|||0000-0002-3212-3473
Triquell, Marina|||0000-0003-3881-8177
Celma, Ana|||0000-0002-3128-3811
Regis, Lucas|||0000-0001-7121-1946
de Torres, Inés|||0000-0002-5495-9140
Semidey Raven, Maria Eugenia|||0000-0001-8539-9265
Mast, Richard|||0000-0001-6005-800X
Santamaría Margalef, Anna|||0000-0001-6726-8990
Planas Morin, Jacques|||0000-0002-0222-584X
Trilla Herrera, Enrique|||0000-0001-9401-0872
author2_role author
author
author
author
author
author
author
author
author
author
dc.subject.none.fl_str_mv Clinically significant prostate cancer
Multiparametric magnetic resonance imaging
Proclarix
Prostate-specific antigen density
European Randomized Study of Screening for Prostate Cancer predictive model
topic Clinically significant prostate cancer
Multiparametric magnetic resonance imaging
Proclarix
Prostate-specific antigen density
European Randomized Study of Screening for Prostate Cancer predictive model
description The efficacy of tools for selection of candidates for prostate biopsy after multiparametric magnetic resonance imaging (MRI) varies across Prostate Imaging-Reporting and Data System (PI-RADS) categories. The new Proclarix test performs better than prostate-specific antigen density and the European Randomized Study of Screening for Prostate Cancer MRI predictive model in the challenging PI-RADS 3 category. Proclarix guaranteed 100% detection of clinically significant prostate cancer (PCa), avoiding almost one-quarter of prostate biopsies and decreasing overdetection of insignificant PCa from 16.6% to 11.2%. Prostate Imaging-Reporting and Data System (PI-RADS) category 3 is a challenging scenario for detection of clinically significant prostate cancer (csPCa) and some tools can improve the selection of appropriate candidates for prostate biopsy. To assess the performance of the European Randomized Study of Screening for Prostate Cancer (ERSPC) magnetic resonance imaging (MRI) model, the new Proclarix test, and prostate-specific antigen density (PSAD) in selecting candidates for prostate biopsy among men in the PI-RADS 3 category. We conducted a head-to-head prospective analysis of 567 men suspected of having PCa for whom guided and systematic biopsies were scheduled between January 2018 and March 2020 in a single academic institution. A PI-RADS v.2 category 3 lesion was identified in 169 men (29.8%). csPCa, insignificant PCa (iPCa), and unnecessary biopsy rates were analysed. csPCa was defined as grade group ≥2. Receiver operating characteristic (ROC) curves, decision curve analysis curves, and clinical utility curves were plotted. PCa was detected in 53/169 men (31.4%) with a PI-RADS 3 lesion, identified as csPCa in 25 (14.8%) and iPCa in 28 (16.6%). The area under the ROC curve for csPCa detection was 0.703 (95% confidence interval [CI] 0.621-0.768) for Proclarix, 0.657 (95% CI 0.547-0.766) for the ERSPC MRI model, and 0.612 (95% CI 0.497-0.727) for PSAD (p = 0.027). The threshold with the highest sensitivity was 10% for Proclarix, 1.5% for the ERSPC MRI model, and 0.07 ng/ml/cm 3 for PSAD, which yielded sensitivity of 100%, 91%, and 84%, respectively. Some 21.3%, 26.2%, and 7.1% of biopsies would be avoided with Proclarix, PSAD, and the ERSPC MRI model, respectively. Proclarix showed a net benefit over PSAD and the ERSPC MRI model. Both Proclarix and PSAD reduced iPCa overdetection from 16.6% to 11.3%, while the ERSPC MRI model reduced iPCa overdetection to 15.4%. Proclarix was more accurate in selecting appropriate candidates for prostate biopsy among men in the PI-RADS 3 category when compared to PSAD and the ERSPC MRI model. Proclarix detected 100% of csPCa cases and would reduce prostate biopsies by 21.3% and iPCa overdetection by 5.3%. We compared three methods and found that the Proclarix test can optimise the detection of clinically significant prostate cancer in men with a score of 3 on the Prostate Imaging-Reporting and Data System for magnetic resonance imaging scans.
publishDate 2022
dc.date.none.fl_str_mv 2
2022-01-01
2022
2022-01-01
dc.type.none.fl_str_mv Article
http://purl.org/coar/resource_type/c_6501
VoR
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dc.type.openaire.fl_str_mv info:eu-repo/semantics/article
format article
dc.identifier.none.fl_str_mv https://ddd.uab.cat/record/257285
https://dx.doi.org/urn:doi:10.1016/j.euros.2021.12.009
url https://ddd.uab.cat/record/257285
https://dx.doi.org/urn:doi:10.1016/j.euros.2021.12.009
dc.language.none.fl_str_mv Inglés
eng
language_invalid_str_mv Inglés
language eng
dc.relation.none.fl_str_mv Instituto de Salud Carlos III https://doi.org/10.13039/501100004587 PI20/01666
dc.rights.none.fl_str_mv open access
http://purl.org/coar/access_right/c_abf2
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dc.rights.openaire.fl_str_mv info:eu-repo/semantics/openAccess
rights_invalid_str_mv open access
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eu_rights_str_mv openAccess
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dc.source.none.fl_str_mv reponame:Dipòsit Digital de Documents de la UAB
instname:Universitat Autònoma de Barcelona
instname_str Universitat Autònoma de Barcelona
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spelling Improving the Early Detection of Clinically Significant Prostate Cancer in Men in the Challenging Prostate Imaging-Reporting and Data System 3 CategoryMorote Robles, Juan|||0000-0002-2168-323XCampistol i Torres, Miriam|||0000-0002-3212-3473Triquell, Marina|||0000-0003-3881-8177Celma, Ana|||0000-0002-3128-3811Regis, Lucas|||0000-0001-7121-1946de Torres, Inés|||0000-0002-5495-9140Semidey Raven, Maria Eugenia|||0000-0001-8539-9265Mast, Richard|||0000-0001-6005-800XSantamaría Margalef, Anna|||0000-0001-6726-8990Planas Morin, Jacques|||0000-0002-0222-584XTrilla Herrera, Enrique|||0000-0001-9401-0872Clinically significant prostate cancerMultiparametric magnetic resonance imagingProclarixProstate-specific antigen densityEuropean Randomized Study of Screening for Prostate Cancer predictive modelThe efficacy of tools for selection of candidates for prostate biopsy after multiparametric magnetic resonance imaging (MRI) varies across Prostate Imaging-Reporting and Data System (PI-RADS) categories. The new Proclarix test performs better than prostate-specific antigen density and the European Randomized Study of Screening for Prostate Cancer MRI predictive model in the challenging PI-RADS 3 category. Proclarix guaranteed 100% detection of clinically significant prostate cancer (PCa), avoiding almost one-quarter of prostate biopsies and decreasing overdetection of insignificant PCa from 16.6% to 11.2%. Prostate Imaging-Reporting and Data System (PI-RADS) category 3 is a challenging scenario for detection of clinically significant prostate cancer (csPCa) and some tools can improve the selection of appropriate candidates for prostate biopsy. To assess the performance of the European Randomized Study of Screening for Prostate Cancer (ERSPC) magnetic resonance imaging (MRI) model, the new Proclarix test, and prostate-specific antigen density (PSAD) in selecting candidates for prostate biopsy among men in the PI-RADS 3 category. We conducted a head-to-head prospective analysis of 567 men suspected of having PCa for whom guided and systematic biopsies were scheduled between January 2018 and March 2020 in a single academic institution. A PI-RADS v.2 category 3 lesion was identified in 169 men (29.8%). csPCa, insignificant PCa (iPCa), and unnecessary biopsy rates were analysed. csPCa was defined as grade group ≥2. Receiver operating characteristic (ROC) curves, decision curve analysis curves, and clinical utility curves were plotted. PCa was detected in 53/169 men (31.4%) with a PI-RADS 3 lesion, identified as csPCa in 25 (14.8%) and iPCa in 28 (16.6%). The area under the ROC curve for csPCa detection was 0.703 (95% confidence interval [CI] 0.621-0.768) for Proclarix, 0.657 (95% CI 0.547-0.766) for the ERSPC MRI model, and 0.612 (95% CI 0.497-0.727) for PSAD (p = 0.027). The threshold with the highest sensitivity was 10% for Proclarix, 1.5% for the ERSPC MRI model, and 0.07 ng/ml/cm 3 for PSAD, which yielded sensitivity of 100%, 91%, and 84%, respectively. Some 21.3%, 26.2%, and 7.1% of biopsies would be avoided with Proclarix, PSAD, and the ERSPC MRI model, respectively. Proclarix showed a net benefit over PSAD and the ERSPC MRI model. Both Proclarix and PSAD reduced iPCa overdetection from 16.6% to 11.3%, while the ERSPC MRI model reduced iPCa overdetection to 15.4%. Proclarix was more accurate in selecting appropriate candidates for prostate biopsy among men in the PI-RADS 3 category when compared to PSAD and the ERSPC MRI model. Proclarix detected 100% of csPCa cases and would reduce prostate biopsies by 21.3% and iPCa overdetection by 5.3%. We compared three methods and found that the Proclarix test can optimise the detection of clinically significant prostate cancer in men with a score of 3 on the Prostate Imaging-Reporting and Data System for magnetic resonance imaging scans. 22022-01-0120222022-01-01Articlehttp://purl.org/coar/resource_type/c_6501VoRhttp://purl.org/coar/version/c_970fb48d4fbd8a85info:eu-repo/semantics/articleapplication/pdfhttps://ddd.uab.cat/record/257285https://dx.doi.org/urn:doi:10.1016/j.euros.2021.12.009reponame:Dipòsit Digital de Documents de la UABinstname:Universitat Autònoma de BarcelonaInglésengInstituto de Salud Carlos III https://doi.org/10.13039/501100004587 PI20/01666open accesshttp://purl.org/coar/access_right/c_abf2Aquest document està subjecte a una llicència d'ús Creative Commons. Es permet la reproducció total o parcial, la distribució i la comunicació pública de l'obra, sempre que es reconegui l'autoria de l'obra original. No es permet la creació d'obres derivades.https://creativecommons.org/licenses/by-nd/4.0/info:eu-repo/semantics/openAccessoai:ddd.uab.cat:2572852026-06-06T12:50:31Z
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