Comparison of Rotterdam and Barcelona Magnetic Resonance Imaging Risk Calculators for Predicting Clinically Significant Prostate Cancer
Morote Robles, Juan (Hospital Universitari Vall d'Hebron)
Borque-Fernando, Ángel (Hospital Universitario Miguel Servet (Saragossa))
Triquell, Marina (Hospital Universitari Vall d'Hebron)
Campistol, Miriam (Hospital Universitari Vall d'Hebron)
Servian, Pol (Institut Germans Trias i Pujol. Hospital Universitari Germans Trias i Pujol)
Abascal, Jose Maria (Parc de Salut MAR de Barcelona)
Planas, Jacques (Hospital Universitari Vall d'Hebron)
Méndez Fernández, Olga (Hospital Universitari Vall d'Hebron)
Esteban, Luis M. (Universidad de Zaragoza)
Trilla Herrera, Enrique (Hospital Universitari Vall d'Hebron)
Universitat Autònoma de Barcelona

Date:	2023
Abstract:	The Barcelona magnetic resonance imaging (MRI)-based risk calculator (BCN MRI-RC) exhibited, in the analysed population, better behaviour than the Rotterdam-MRI risk calculator to improve candidate selection for prostate biopsy for the early detection of clinically significant prostate cancer. We note the importance of the discrimination, net benefit, and clinical utility analysis regarding Prostate Imaging Reporting and Data System (PI-RADS) categories. We summarise that both risk calculators were helpful in men with PI-RADS 3, only the BCN MRI-RC in those with PI-RADS 4, and none of these in men with negative MRI and PI-RADS 5. Magnetic resonance imaging (MRI)-based risk calculators (MRI-RCs) individualise the likelihood of clinically significant prostate cancer (csPCa) and improve candidate selection for prostate biopsy beyond the Prostate Imaging Reporting and Data System (PI-RADS). To compare the Barcelona (BCN) and Rotterdam (ROT) MRI-RCs in an entire population and according to the PI-RADS categories. A prospective comparison of BCN- and ROT-RC in 946 men with suspected prostate cancer in whom systematic biopsy was performed, as well as target biopsies of PI-RADS ≥3 lesions. Saved biopsies and undetected csPCa (grade group ≥2) were determined. The csPCa detection was 40. 8%. The median risks of csPCa from BCN- and ROT-RC were, respectively, 67. 1% and 25% in men with csPCa, whereas 10. 5% and 3% in those without csPCa (p < 0. 001). The areas under the curve were 0. 856 and 0. 844, respectively (p = 0. 116). BCN-RC showed a higher net benefit and clinical utility over ROT-RC. Using appropriate thresholds, respectively, 75% and 80% of biopsies were needed to identify 50% of csPCa detected in men with PI-RADS <3, whereas 35% and 21% of biopsies were saved, missing 10% of csPCa detected in men with PI-RADS 3. BCN-RC saved 15% of biopsies, missing 2% of csPCa in men with PI-RADS 4, whereas ROT-RC saved 10%, missing 6%. No RC saved biopsies without missing csPCa in men with PI-RADS 5. ROT-RC provided a lower and narrower range of csPCa probabilities than BCN-RC. BCN-RC showed a net benefit over ROT-RC in the entire population. However, BCN-RC was useful in men with PI-RADS 3 and 4, whereas ROT-RC was useful only in those with PI-RADS 3. No RC seemed to be helpful in men with negative MRI and PI-RADS 5. Barcelona risk calculator was more helpful than Rotterdam risk calculator to select candidates for prostate biopsy.
Grants:	Instituto de Salud Carlos III PI20/01666
Rights:	Aquest 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 no sigui amb finalitats comercials, i sempre que es reconegui l'autoria de l'obra original. No es permet la creació d'obres derivades.
Language:	Anglès
Document:	Article ; recerca ; Versió publicada
Subject:	Clinically significant ; Early detection ; Magnetic resonance imaging ; Predictive model ; Prostate cancer ; Risk calculator
Published in:	European Urology Open Science, Vol. 53 (may 2023) , p. 46-54, ISSN 2666-1683

DOI: 10.1016/j.euros.2023.03.013
PMID: 37441350

9 p, 1.7 MB

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Research literature > UAB research groups literature > Research Centres and Groups (research output) > Health sciences and biosciences > Institut d'Investigació en Ciencies de la Salut Germans Trias i Pujol (IGTP)
Articles > Research articles
Articles > Published articles