SelectMDx and Multiparametric Magnetic Resonance Imaging of the Prostate for Men Undergoing Primary Prostate Biopsy: A Prospective Assessment in a Multi-Institutional Study
Prostate-specific antigen (PSA) testing as the sole indication for prostate biopsy lacks specificity, resulting in overdiagnosis of indolent prostate cancer (PCa) and missing clinically significant PCa (csPCa). SelectMDx is a biomarker-based risk score to assess urinary HOXC6 and DLX1 mRNA expressio...
Main Authors: | , , , , , , , , , , , , , , , , , , , , |
---|---|
Format: | Article |
Language: | English |
Published: |
MDPI AG
2021-04-01
|
Series: | Cancers |
Subjects: | |
Online Access: | https://www.mdpi.com/2072-6694/13/9/2047 |
id |
doaj-486d4230c50544df97d5da6645fb46fa |
---|---|
record_format |
Article |
collection |
DOAJ |
language |
English |
format |
Article |
sources |
DOAJ |
author |
Martina Maggi Francesco Del Giudice Ugo G. Falagario Andrea Cocci Giorgio Ivan Russo Marina Di Mauro Giuseppe Salvatore Sepe Fabio Galasso Rosario Leonardi Gabriele Iacona Peter R. Carroll Matthew R. Cooperberg Angelo Porreca Matteo Ferro Giuseppe Lucarelli Daniela Terracciano Luigi Cormio Giuseppe Carrieri Ettore De Berardinis Alessandro Sciarra Gian Maria Busetto |
spellingShingle |
Martina Maggi Francesco Del Giudice Ugo G. Falagario Andrea Cocci Giorgio Ivan Russo Marina Di Mauro Giuseppe Salvatore Sepe Fabio Galasso Rosario Leonardi Gabriele Iacona Peter R. Carroll Matthew R. Cooperberg Angelo Porreca Matteo Ferro Giuseppe Lucarelli Daniela Terracciano Luigi Cormio Giuseppe Carrieri Ettore De Berardinis Alessandro Sciarra Gian Maria Busetto SelectMDx and Multiparametric Magnetic Resonance Imaging of the Prostate for Men Undergoing Primary Prostate Biopsy: A Prospective Assessment in a Multi-Institutional Study Cancers prostate neoplasm urinary biomarker mpMRI prostate biopsy early detection PSA |
author_facet |
Martina Maggi Francesco Del Giudice Ugo G. Falagario Andrea Cocci Giorgio Ivan Russo Marina Di Mauro Giuseppe Salvatore Sepe Fabio Galasso Rosario Leonardi Gabriele Iacona Peter R. Carroll Matthew R. Cooperberg Angelo Porreca Matteo Ferro Giuseppe Lucarelli Daniela Terracciano Luigi Cormio Giuseppe Carrieri Ettore De Berardinis Alessandro Sciarra Gian Maria Busetto |
author_sort |
Martina Maggi |
title |
SelectMDx and Multiparametric Magnetic Resonance Imaging of the Prostate for Men Undergoing Primary Prostate Biopsy: A Prospective Assessment in a Multi-Institutional Study |
title_short |
SelectMDx and Multiparametric Magnetic Resonance Imaging of the Prostate for Men Undergoing Primary Prostate Biopsy: A Prospective Assessment in a Multi-Institutional Study |
title_full |
SelectMDx and Multiparametric Magnetic Resonance Imaging of the Prostate for Men Undergoing Primary Prostate Biopsy: A Prospective Assessment in a Multi-Institutional Study |
title_fullStr |
SelectMDx and Multiparametric Magnetic Resonance Imaging of the Prostate for Men Undergoing Primary Prostate Biopsy: A Prospective Assessment in a Multi-Institutional Study |
title_full_unstemmed |
SelectMDx and Multiparametric Magnetic Resonance Imaging of the Prostate for Men Undergoing Primary Prostate Biopsy: A Prospective Assessment in a Multi-Institutional Study |
title_sort |
selectmdx and multiparametric magnetic resonance imaging of the prostate for men undergoing primary prostate biopsy: a prospective assessment in a multi-institutional study |
publisher |
MDPI AG |
series |
Cancers |
issn |
2072-6694 |
publishDate |
2021-04-01 |
description |
Prostate-specific antigen (PSA) testing as the sole indication for prostate biopsy lacks specificity, resulting in overdiagnosis of indolent prostate cancer (PCa) and missing clinically significant PCa (csPCa). SelectMDx is a biomarker-based risk score to assess urinary HOXC6 and DLX1 mRNA expression combined with traditional clinical risk factors. The aim of this prospective multi-institutional study was to evaluate the diagnostic accuracy of SelectMDx and its association with multiparametric magnetic resonance (mpMRI) when predicting PCa in prostate biopsies. Overall, 310 consecutive subjects were included. All patients underwent mpMRI and SelectMDx prior to prostate biopsy. SelectMDx and mpMRI showed sensitivity and specificity of 86.5% vs. 51.9%, and 73.8% vs. 88.3%, respectively, in predicting PCa at biopsy, and 87.1% vs. 61.3%, and 63.7% vs. 83.9%, respectively, in predicting csPCa at biopsy. SelectMDx was revealed to be a good predictor of PCa, while with regards to csPCa detection, it was demonstrated to be less effective, showing results similar to mpMRI. With analysis of strategies assessed to define the best diagnostic strategy to avoid unnecessary biopsy, SelectMDx appeared to be a reliable pathway after an initial negative mpMRI. Thus, biopsy could be proposed for all cases of mpMRI PI-RADS 4–5 score, and to those with Prostate Imaging-Reporting and Data System (PI-RADS) 1–3 score followed by a positive SelectMDx. |
topic |
prostate neoplasm urinary biomarker mpMRI prostate biopsy early detection PSA |
url |
https://www.mdpi.com/2072-6694/13/9/2047 |
work_keys_str_mv |
AT martinamaggi selectmdxandmultiparametricmagneticresonanceimagingoftheprostateformenundergoingprimaryprostatebiopsyaprospectiveassessmentinamultiinstitutionalstudy AT francescodelgiudice selectmdxandmultiparametricmagneticresonanceimagingoftheprostateformenundergoingprimaryprostatebiopsyaprospectiveassessmentinamultiinstitutionalstudy AT ugogfalagario selectmdxandmultiparametricmagneticresonanceimagingoftheprostateformenundergoingprimaryprostatebiopsyaprospectiveassessmentinamultiinstitutionalstudy AT andreacocci selectmdxandmultiparametricmagneticresonanceimagingoftheprostateformenundergoingprimaryprostatebiopsyaprospectiveassessmentinamultiinstitutionalstudy AT giorgioivanrusso selectmdxandmultiparametricmagneticresonanceimagingoftheprostateformenundergoingprimaryprostatebiopsyaprospectiveassessmentinamultiinstitutionalstudy AT marinadimauro selectmdxandmultiparametricmagneticresonanceimagingoftheprostateformenundergoingprimaryprostatebiopsyaprospectiveassessmentinamultiinstitutionalstudy AT giuseppesalvatoresepe selectmdxandmultiparametricmagneticresonanceimagingoftheprostateformenundergoingprimaryprostatebiopsyaprospectiveassessmentinamultiinstitutionalstudy AT fabiogalasso selectmdxandmultiparametricmagneticresonanceimagingoftheprostateformenundergoingprimaryprostatebiopsyaprospectiveassessmentinamultiinstitutionalstudy AT rosarioleonardi selectmdxandmultiparametricmagneticresonanceimagingoftheprostateformenundergoingprimaryprostatebiopsyaprospectiveassessmentinamultiinstitutionalstudy AT gabrieleiacona selectmdxandmultiparametricmagneticresonanceimagingoftheprostateformenundergoingprimaryprostatebiopsyaprospectiveassessmentinamultiinstitutionalstudy AT peterrcarroll selectmdxandmultiparametricmagneticresonanceimagingoftheprostateformenundergoingprimaryprostatebiopsyaprospectiveassessmentinamultiinstitutionalstudy AT matthewrcooperberg selectmdxandmultiparametricmagneticresonanceimagingoftheprostateformenundergoingprimaryprostatebiopsyaprospectiveassessmentinamultiinstitutionalstudy AT angeloporreca selectmdxandmultiparametricmagneticresonanceimagingoftheprostateformenundergoingprimaryprostatebiopsyaprospectiveassessmentinamultiinstitutionalstudy AT matteoferro selectmdxandmultiparametricmagneticresonanceimagingoftheprostateformenundergoingprimaryprostatebiopsyaprospectiveassessmentinamultiinstitutionalstudy AT giuseppelucarelli selectmdxandmultiparametricmagneticresonanceimagingoftheprostateformenundergoingprimaryprostatebiopsyaprospectiveassessmentinamultiinstitutionalstudy AT danielaterracciano selectmdxandmultiparametricmagneticresonanceimagingoftheprostateformenundergoingprimaryprostatebiopsyaprospectiveassessmentinamultiinstitutionalstudy AT luigicormio selectmdxandmultiparametricmagneticresonanceimagingoftheprostateformenundergoingprimaryprostatebiopsyaprospectiveassessmentinamultiinstitutionalstudy AT giuseppecarrieri selectmdxandmultiparametricmagneticresonanceimagingoftheprostateformenundergoingprimaryprostatebiopsyaprospectiveassessmentinamultiinstitutionalstudy AT ettoredeberardinis selectmdxandmultiparametricmagneticresonanceimagingoftheprostateformenundergoingprimaryprostatebiopsyaprospectiveassessmentinamultiinstitutionalstudy AT alessandrosciarra selectmdxandmultiparametricmagneticresonanceimagingoftheprostateformenundergoingprimaryprostatebiopsyaprospectiveassessmentinamultiinstitutionalstudy AT gianmariabusetto selectmdxandmultiparametricmagneticresonanceimagingoftheprostateformenundergoingprimaryprostatebiopsyaprospectiveassessmentinamultiinstitutionalstudy |
_version_ |
1721512153653968896 |
spelling |
doaj-486d4230c50544df97d5da6645fb46fa2021-04-23T23:03:43ZengMDPI AGCancers2072-66942021-04-01132047204710.3390/cancers13092047SelectMDx and Multiparametric Magnetic Resonance Imaging of the Prostate for Men Undergoing Primary Prostate Biopsy: A Prospective Assessment in a Multi-Institutional StudyMartina Maggi0Francesco Del Giudice1Ugo G. Falagario2Andrea Cocci3Giorgio Ivan Russo4Marina Di Mauro5Giuseppe Salvatore Sepe6Fabio Galasso7Rosario Leonardi8Gabriele Iacona9Peter R. Carroll10Matthew R. Cooperberg11Angelo Porreca12Matteo Ferro13Giuseppe Lucarelli14Daniela Terracciano15Luigi Cormio16Giuseppe Carrieri17Ettore De Berardinis18Alessandro Sciarra19Gian Maria Busetto20Department of Urology, Sapienza Rome University, Policlinico Umberto I, 00161 Rome, ItalyDepartment of Urology, Sapienza Rome University, Policlinico Umberto I, 00161 Rome, ItalyDepartment of Urology and Renal Transplantation, University of Foggia, Policlinico Riuniti, 71122 Foggia, ItalyDepartment of Urology, University of Florence, Careggi Hospital, 50139 Florence, ItalyDepartment of Urology, University of Catania, 95100 Catania, ItalyDepartment of Urology, University of Catania, 95100 Catania, ItalyDepartment of Urology, Padre Pio Clinic, 81034 Mondragone, ItalyDepartment of Urology, Eboli Hospital, 84025 Eboli, ItalyDepartment of Urology, Musumeci GECAS Clinic, 95030 Gravina di Catania, ItalyDepartment of Urology, Centro Uro-Andrologico (C.Ur.A.), 95024 Acireale, ItalyDepartment of Urology, UCSF Helen Diller Comprehensive Cancer Center, University of California, San Francisco, CA 94143, USADepartment of Urology, UCSF Helen Diller Comprehensive Cancer Center, University of California, San Francisco, CA 94143, USADepartment of Urology, Veneto Institute of Oncology (IOV), 35128 Padua, ItalyDepartment of Urology, European Institute of Oncology (IEO) IRCCS, 20141 Milan, ItalyDepartment of Emergency and Organ Transplantation-Urology, Andrology and Kidney Transplantation Unit, University of Bari, 74121 Bari, ItalyDepartment of Translational Medical Sciences, University of Naples Federico II, 80131 Naples, ItalyDepartment of Urology and Renal Transplantation, University of Foggia, Policlinico Riuniti, 71122 Foggia, ItalyDepartment of Urology and Renal Transplantation, University of Foggia, Policlinico Riuniti, 71122 Foggia, ItalyDepartment of Urology, Sapienza Rome University, Policlinico Umberto I, 00161 Rome, ItalyDepartment of Urology, Sapienza Rome University, Policlinico Umberto I, 00161 Rome, ItalyDepartment of Urology and Renal Transplantation, University of Foggia, Policlinico Riuniti, 71122 Foggia, ItalyProstate-specific antigen (PSA) testing as the sole indication for prostate biopsy lacks specificity, resulting in overdiagnosis of indolent prostate cancer (PCa) and missing clinically significant PCa (csPCa). SelectMDx is a biomarker-based risk score to assess urinary HOXC6 and DLX1 mRNA expression combined with traditional clinical risk factors. The aim of this prospective multi-institutional study was to evaluate the diagnostic accuracy of SelectMDx and its association with multiparametric magnetic resonance (mpMRI) when predicting PCa in prostate biopsies. Overall, 310 consecutive subjects were included. All patients underwent mpMRI and SelectMDx prior to prostate biopsy. SelectMDx and mpMRI showed sensitivity and specificity of 86.5% vs. 51.9%, and 73.8% vs. 88.3%, respectively, in predicting PCa at biopsy, and 87.1% vs. 61.3%, and 63.7% vs. 83.9%, respectively, in predicting csPCa at biopsy. SelectMDx was revealed to be a good predictor of PCa, while with regards to csPCa detection, it was demonstrated to be less effective, showing results similar to mpMRI. With analysis of strategies assessed to define the best diagnostic strategy to avoid unnecessary biopsy, SelectMDx appeared to be a reliable pathway after an initial negative mpMRI. Thus, biopsy could be proposed for all cases of mpMRI PI-RADS 4–5 score, and to those with Prostate Imaging-Reporting and Data System (PI-RADS) 1–3 score followed by a positive SelectMDx.https://www.mdpi.com/2072-6694/13/9/2047prostate neoplasmurinary biomarkermpMRIprostate biopsyearly detectionPSA |