A 4K score/MRI‐based nomogram for predicting prostate cancer, clinically significant prostate cancer, and unfavorable prostate cancer
Abstract Background The detection of prostate cancer requires histological confirmation in biopsy core. Currently, number of unnecessary prostate biopsies are being performed in the United States. This is due to the absence of appropriate biopsy decision‐making protocol. Aim To develop and validate...
Main Authors: | , , , , , , , , , , , , |
---|---|
Format: | Article |
Language: | English |
Published: |
Wiley
2021-08-01
|
Series: | Cancer Reports |
Subjects: | |
Online Access: | https://doi.org/10.1002/cnr2.1357 |
id |
doaj-03aad02b8f2e48808b476663f51176e2 |
---|---|
record_format |
Article |
spelling |
doaj-03aad02b8f2e48808b476663f51176e22021-08-26T11:47:37ZengWileyCancer Reports2573-83482021-08-0144n/an/a10.1002/cnr2.1357A 4K score/MRI‐based nomogram for predicting prostate cancer, clinically significant prostate cancer, and unfavorable prostate cancerVinayak G. Wagaskar0Stanislaw Sobotka1Parita Ratnani2James Young3Anna Lantz4Sneha Parekh5Ugo Giovanni Falagario6Li Li7Sara Lewis8Kenneth Haines III9Sanoj Punnen10Peter Wiklund11Ash Tewari12Department of Urology Icahn School of Medicine at Mount Sinai Hospital New York New York USADepartment of Urology Icahn School of Medicine at Mount Sinai Hospital New York New York USADepartment of Urology Icahn School of Medicine at Mount Sinai Hospital New York New York USADepartment of Urology Icahn School of Medicine at Mount Sinai Hospital New York New York USADepartment of Urology Icahn School of Medicine at Mount Sinai Hospital New York New York USADepartment of Urology Icahn School of Medicine at Mount Sinai Hospital New York New York USADepartment of Urology Icahn School of Medicine at Mount Sinai Hospital New York New York USADepartment of Pathology Icahn School of Medicine at Mount Sinai Hospital New York New York USADepartment of Radiology Icahn School of Medicine at Mount Sinai Hospital New York New York USADepartment of Pathology Icahn School of Medicine at Mount Sinai Hospital New York New York USADepartment of Urology University of Miami, Miller School of Medicine Miami Florida USADepartment of Urology Icahn School of Medicine at Mount Sinai Hospital New York New York USADepartment of Urology Icahn School of Medicine at Mount Sinai Hospital New York New York USAAbstract Background The detection of prostate cancer requires histological confirmation in biopsy core. Currently, number of unnecessary prostate biopsies are being performed in the United States. This is due to the absence of appropriate biopsy decision‐making protocol. Aim To develop and validate a 4K score/multiparametric magnetic resonance imaging (mpMRI)‐based nomogram to predict prostate cancer (PCa), clinically significant prostate cancer (csPCa), and unfavorable prostate cancer (uPCa). Methods and Results Retrospective, single‐center study evaluating a cohort of 574 men with 4K score test >7% or suspicious digital rectal examination (DRE) or Prostate Imaging Reporting and Data System (PI‐RADS) scores 3, 4, or 5 on mpMRI that underwent systematic and/or mpMRI/ultrasound fusion–targeted prostate biopsy between 2016 and 2020. External cohort included 622 men. csPCa and uPCa were defined as Gleason score ≥3 + 4 and ≥4 + 3 on biopsy, respectively. Multivariable logistic regression analysis was performed to build nomogram for predicting PCa, csPCa, and uPCa. Validation was performed by plotting the area under the curve (AUC) and comparing nomogram‐predicted probabilities with actual rates of PCa, csPCa, and uPCa probabilities in the external cohort. 4K score, a PI‐RADS ≥4, prostate volume and prior negative biopsy were significant predictors of PCa, csPCa, and uPCa. AUCs were 0.84, 0.88, and 0.86 for the prediction of PCa, csPCa, and uPCa, respectively. The predicted and actual rates of PCa, csPCa, and uPCa showed agreement across all percentage probability ranges in the validation cohort. Using the prediction model at threshold of 30, 30% of overall biopsies, 41% of benign biopsies, and 19% of diagnosed indolent PCa could be avoided, while missing 9% of csPCa. Conclusion This novel nomogram would reduce unnecessary prostate biopsies and decrease detection of clinically insignificant PCa.https://doi.org/10.1002/cnr2.13574K score testbiopsymultiparametric MRIprostate cancer |
collection |
DOAJ |
language |
English |
format |
Article |
sources |
DOAJ |
author |
Vinayak G. Wagaskar Stanislaw Sobotka Parita Ratnani James Young Anna Lantz Sneha Parekh Ugo Giovanni Falagario Li Li Sara Lewis Kenneth Haines III Sanoj Punnen Peter Wiklund Ash Tewari |
spellingShingle |
Vinayak G. Wagaskar Stanislaw Sobotka Parita Ratnani James Young Anna Lantz Sneha Parekh Ugo Giovanni Falagario Li Li Sara Lewis Kenneth Haines III Sanoj Punnen Peter Wiklund Ash Tewari A 4K score/MRI‐based nomogram for predicting prostate cancer, clinically significant prostate cancer, and unfavorable prostate cancer Cancer Reports 4K score test biopsy multiparametric MRI prostate cancer |
author_facet |
Vinayak G. Wagaskar Stanislaw Sobotka Parita Ratnani James Young Anna Lantz Sneha Parekh Ugo Giovanni Falagario Li Li Sara Lewis Kenneth Haines III Sanoj Punnen Peter Wiklund Ash Tewari |
author_sort |
Vinayak G. Wagaskar |
title |
A 4K score/MRI‐based nomogram for predicting prostate cancer, clinically significant prostate cancer, and unfavorable prostate cancer |
title_short |
A 4K score/MRI‐based nomogram for predicting prostate cancer, clinically significant prostate cancer, and unfavorable prostate cancer |
title_full |
A 4K score/MRI‐based nomogram for predicting prostate cancer, clinically significant prostate cancer, and unfavorable prostate cancer |
title_fullStr |
A 4K score/MRI‐based nomogram for predicting prostate cancer, clinically significant prostate cancer, and unfavorable prostate cancer |
title_full_unstemmed |
A 4K score/MRI‐based nomogram for predicting prostate cancer, clinically significant prostate cancer, and unfavorable prostate cancer |
title_sort |
4k score/mri‐based nomogram for predicting prostate cancer, clinically significant prostate cancer, and unfavorable prostate cancer |
publisher |
Wiley |
series |
Cancer Reports |
issn |
2573-8348 |
publishDate |
2021-08-01 |
description |
Abstract Background The detection of prostate cancer requires histological confirmation in biopsy core. Currently, number of unnecessary prostate biopsies are being performed in the United States. This is due to the absence of appropriate biopsy decision‐making protocol. Aim To develop and validate a 4K score/multiparametric magnetic resonance imaging (mpMRI)‐based nomogram to predict prostate cancer (PCa), clinically significant prostate cancer (csPCa), and unfavorable prostate cancer (uPCa). Methods and Results Retrospective, single‐center study evaluating a cohort of 574 men with 4K score test >7% or suspicious digital rectal examination (DRE) or Prostate Imaging Reporting and Data System (PI‐RADS) scores 3, 4, or 5 on mpMRI that underwent systematic and/or mpMRI/ultrasound fusion–targeted prostate biopsy between 2016 and 2020. External cohort included 622 men. csPCa and uPCa were defined as Gleason score ≥3 + 4 and ≥4 + 3 on biopsy, respectively. Multivariable logistic regression analysis was performed to build nomogram for predicting PCa, csPCa, and uPCa. Validation was performed by plotting the area under the curve (AUC) and comparing nomogram‐predicted probabilities with actual rates of PCa, csPCa, and uPCa probabilities in the external cohort. 4K score, a PI‐RADS ≥4, prostate volume and prior negative biopsy were significant predictors of PCa, csPCa, and uPCa. AUCs were 0.84, 0.88, and 0.86 for the prediction of PCa, csPCa, and uPCa, respectively. The predicted and actual rates of PCa, csPCa, and uPCa showed agreement across all percentage probability ranges in the validation cohort. Using the prediction model at threshold of 30, 30% of overall biopsies, 41% of benign biopsies, and 19% of diagnosed indolent PCa could be avoided, while missing 9% of csPCa. Conclusion This novel nomogram would reduce unnecessary prostate biopsies and decrease detection of clinically insignificant PCa. |
topic |
4K score test biopsy multiparametric MRI prostate cancer |
url |
https://doi.org/10.1002/cnr2.1357 |
work_keys_str_mv |
AT vinayakgwagaskar a4kscoremribasednomogramforpredictingprostatecancerclinicallysignificantprostatecancerandunfavorableprostatecancer AT stanislawsobotka a4kscoremribasednomogramforpredictingprostatecancerclinicallysignificantprostatecancerandunfavorableprostatecancer AT paritaratnani a4kscoremribasednomogramforpredictingprostatecancerclinicallysignificantprostatecancerandunfavorableprostatecancer AT jamesyoung a4kscoremribasednomogramforpredictingprostatecancerclinicallysignificantprostatecancerandunfavorableprostatecancer AT annalantz a4kscoremribasednomogramforpredictingprostatecancerclinicallysignificantprostatecancerandunfavorableprostatecancer AT snehaparekh a4kscoremribasednomogramforpredictingprostatecancerclinicallysignificantprostatecancerandunfavorableprostatecancer AT ugogiovannifalagario a4kscoremribasednomogramforpredictingprostatecancerclinicallysignificantprostatecancerandunfavorableprostatecancer AT lili a4kscoremribasednomogramforpredictingprostatecancerclinicallysignificantprostatecancerandunfavorableprostatecancer AT saralewis a4kscoremribasednomogramforpredictingprostatecancerclinicallysignificantprostatecancerandunfavorableprostatecancer AT kennethhainesiii a4kscoremribasednomogramforpredictingprostatecancerclinicallysignificantprostatecancerandunfavorableprostatecancer AT sanojpunnen a4kscoremribasednomogramforpredictingprostatecancerclinicallysignificantprostatecancerandunfavorableprostatecancer AT peterwiklund a4kscoremribasednomogramforpredictingprostatecancerclinicallysignificantprostatecancerandunfavorableprostatecancer AT ashtewari a4kscoremribasednomogramforpredictingprostatecancerclinicallysignificantprostatecancerandunfavorableprostatecancer AT vinayakgwagaskar 4kscoremribasednomogramforpredictingprostatecancerclinicallysignificantprostatecancerandunfavorableprostatecancer AT stanislawsobotka 4kscoremribasednomogramforpredictingprostatecancerclinicallysignificantprostatecancerandunfavorableprostatecancer AT paritaratnani 4kscoremribasednomogramforpredictingprostatecancerclinicallysignificantprostatecancerandunfavorableprostatecancer AT jamesyoung 4kscoremribasednomogramforpredictingprostatecancerclinicallysignificantprostatecancerandunfavorableprostatecancer AT annalantz 4kscoremribasednomogramforpredictingprostatecancerclinicallysignificantprostatecancerandunfavorableprostatecancer AT snehaparekh 4kscoremribasednomogramforpredictingprostatecancerclinicallysignificantprostatecancerandunfavorableprostatecancer AT ugogiovannifalagario 4kscoremribasednomogramforpredictingprostatecancerclinicallysignificantprostatecancerandunfavorableprostatecancer AT lili 4kscoremribasednomogramforpredictingprostatecancerclinicallysignificantprostatecancerandunfavorableprostatecancer AT saralewis 4kscoremribasednomogramforpredictingprostatecancerclinicallysignificantprostatecancerandunfavorableprostatecancer AT kennethhainesiii 4kscoremribasednomogramforpredictingprostatecancerclinicallysignificantprostatecancerandunfavorableprostatecancer AT sanojpunnen 4kscoremribasednomogramforpredictingprostatecancerclinicallysignificantprostatecancerandunfavorableprostatecancer AT peterwiklund 4kscoremribasednomogramforpredictingprostatecancerclinicallysignificantprostatecancerandunfavorableprostatecancer AT ashtewari 4kscoremribasednomogramforpredictingprostatecancerclinicallysignificantprostatecancerandunfavorableprostatecancer |
_version_ |
1721195540285227008 |