f6c9e22415c68052062baf260f0b4220 pmc_8946272.pdf 6c1dc35054e8aac92e0514bd1daadfc6c5004d77 pmc_8946272.pdf 3847c8a1bd21f687c9d7e60d7d6ec0fa78359948aabe0f9ff3801ed97e88f4ed pmc_8946272.pdf Title: The Barcelona Predictive Model of Clinically Significant Prostate Cancer Subject: A new and externally validated MRI-PM for csPCa was developed in the metropolitan area of Barcelona, and a web-RC designed with the new option of selecting the csPCa probability threshold. The development cohort comprised 1486 men scheduled to undergo a 3-tesla multiparametric MRI (mpMRI) and guided and/or systematic biopsies in one academic institution of Barcelona. The external validation cohort comprised 946 men in whom the same diagnostic approach was carried out as in the development cohort, in two other academic institutions of the same metropolitan area. CsPCa was detected in 36.9% of men in the development cohort and 40.8% in the external validation cohort (p = 0.054). The area under the curve of mpMRI increased from 0.842 to 0.897 in the developed MRI-PM (p < 0.001), and from 0.743 to 0.858 in the external validation cohort (p < 0.001). A selected 15% threshold avoided 40.1% of prostate biopsies and missed 5.4% of the 36.9% csPCa detected in the development cohort. In men with PI-RADS <3, 4.3% would be biopsied and 32.3% of all existing 4.2% of csPCa would be detected. In men with PI-RADS 3, 62% of prostate biopsies would be avoided and 28% of all existing 12.4% of csPCa would be undetected. In men with PI-RADS 4, 4% of prostate biopsies would be avoided and 0.6% of all existing 43.1% of csPCa would be undetected. In men with PI-RADS 5, 0.6% of prostate biopsies would be avoided and none of the existing 42.0% of csPCa would be undetected. The Barcelona MRI-PM presented good performance on the overall population; however, its clinical usefulness varied regarding the PI-RADS category. The selection of csPCa probability thresholds in the designed RC may facilitate external validation and outperformance of MRI-PMs in specific PI-RADS categories. Keywords: clinically significant prostate cancer; magnetic resonance imaging; predictive model; risk calculator Author: Juan Morote, Angel Borque-Fernando, Marina Triquell, Anna Celma, Lucas Regis, Manel Escobar, Richard Mast, Inés M. de Torres, María E. Semidey, José M. Abascal, Carles Sola, Pol Servian, Daniel Salvador, Anna Santamaría, Jacques Planas, Luis M. Esteban and Enrique Trilla Creator: LaTeX with hyperref Producer: pdfTeX-1.40.21 CreationDate: Mon Mar 21 11:13:50 2022 CET ModDate: Mon Mar 21 11:21:24 2022 CET Tagged: no UserProperties: no Suspects: no Form: none JavaScript: no Pages: 13 Encrypted: no Page size: 595.276 x 841.89 pts (A4) Page rot: 0 File size: 1736121 bytes Optimized: no PDF version: 1.7 name type encoding emb sub uni object ID ------------------------------------ ----------------- ---------------- --- --- --- --------- YSPQJI+VnURWPalladioL-Bold Type 1 Custom yes yes no 10 0 BVTAWX+URWPalladioL-Bold Type 1 Custom yes yes no 15 0 LFSOAA+URWPalladioL-Roma Type 1 Custom yes yes no 20 0 DYKJNB+URWPalladioL-Ital Type 1 Custom yes yes no 24 0 EUXRTG+VnURWPalladioL Type 1 Custom yes yes no 28 0 MCBCCI+SourceSansRoman-Regular Type 1C Custom yes yes no 36 0 MCBCCM+SourceSansRoman.613wght Type 1C Custom yes yes no 40 0 MCBCCO+SourceSansRoman-Bold Type 1C Custom yes yes no 44 0 LCJEVJ+TimesNewRomanPS-BoldItalicMT Type 1C WinAnsi yes yes no 57 0 CDEILJ+PalatinoLinotype,Bold TrueType WinAnsi yes yes no 85 0 CDEILL+PalatinoLinotype TrueType WinAnsi yes yes no 88 0 CDEILN+PalatinoLinotype,Italic TrueType WinAnsi yes yes no 91 0 CDELFN+Arial CID TrueType Identity-H yes yes yes 94 0 WBVKDJ+URWPalladioL-BoldItal Type 1 Custom yes yes no 106 0 CDEILJ+PalatinoLinotype,Bold TrueType WinAnsi yes yes no 116 0 CDEILL+PalatinoLinotype TrueType WinAnsi yes yes no 119 0 CDEILN+PalatinoLinotype,Italic TrueType WinAnsi yes yes no 122 0 CDEILJ+PalatinoLinotype,Bold TrueType WinAnsi yes yes no 132 0 CDEILL+PalatinoLinotype TrueType WinAnsi yes yes no 135 0 CDEILN+PalatinoLinotype,Italic TrueType WinAnsi yes yes no 138 0 CDEILJ+PalatinoLinotype,Bold TrueType WinAnsi yes yes no 146 0 CDEILL+PalatinoLinotype TrueType WinAnsi yes yes no 149 0 CDEILN+PalatinoLinotype,Italic TrueType WinAnsi yes yes no 152 0 CDFDCB+Calibri CID TrueType Identity-H yes yes yes 163 0 CDFDGB+ArialNarrow TrueType WinAnsi yes yes no 169 0 CDEILJ+PalatinoLinotype,Bold TrueType WinAnsi yes yes no 172 0 CDEILL+PalatinoLinotype TrueType WinAnsi yes yes no 175 0 CDEILN+PalatinoLinotype,Italic TrueType WinAnsi yes yes no 178 0 BOLMEN+SFRM0900 Type 1 Custom yes yes no 192 0 Jhove (Rel. 1.22.1, 2019-04-17) Date: 2022-06-02 02:43:05 CEST RepresentationInformation: pmc_8946272.pdf ReportingModule: PDF-hul, Rel. 1.12.1 (2019-04-17) LastModified: 2022-04-26 18:00:25 CEST Size: 1736121 Format: PDF Version: 1.7 Status: Well-Formed and valid SignatureMatches: PDF-hul MIMEtype: application/pdf PDFMetadata: Objects: 381 FreeObjects: 1 IncrementalUpdates: 0 DocumentCatalog: PageLayout: SinglePage PageMode: UseNone Outlines: Item: Title: Introduction Destination: edu.harvard.hul.ois.jhove.module.pdf.PdfSimpleObject@4923ab24 Item: Title: Materials and Methods Destination: edu.harvard.hul.ois.jhove.module.pdf.PdfSimpleObject@44c8afef Children: Item: Title: Development Cohort Destination: edu.harvard.hul.ois.jhove.module.pdf.PdfSimpleObject@7b69c6ba Item: Title: External Validation Cohort Destination: edu.harvard.hul.ois.jhove.module.pdf.PdfSimpleObject@46daef40 Item: Title: MRI Technique and Evaluation Destination: edu.harvard.hul.ois.jhove.module.pdf.PdfSimpleObject@12f41634 Item: Title: Prostate Biopsy Procedure Destination: edu.harvard.hul.ois.jhove.module.pdf.PdfSimpleObject@13c27452 Item: Title: Pathologic Analysis and csPCa Definition Destination: edu.harvard.hul.ois.jhove.module.pdf.PdfSimpleObject@262b2c86 Item: Title: Development of MRI-PM Destination: edu.harvard.hul.ois.jhove.module.pdf.PdfSimpleObject@371a67ec Item: Title: Endpoint Measurements for the Performance Analysis of MRIPM Destination: edu.harvard.hul.ois.jhove.module.pdf.PdfSimpleObject@5ed828d Item: Title: Statistical Analysis Destination: edu.harvard.hul.ois.jhove.module.pdf.PdfSimpleObject@50d0686 Item: Title: Results Destination: edu.harvard.hul.ois.jhove.module.pdf.PdfSimpleObject@7a3d45bd Children: Item: Title: Characteristics of Development and External Validation Cohorts Destination: edu.harvard.hul.ois.jhove.module.pdf.PdfSimpleObject@1e7c7811 Item: Title: MRI-Based Predictive Model Development and Performance Destination: edu.harvard.hul.ois.jhove.module.pdf.PdfSimpleObject@77ec78b9 Item: Title: External Validation of MRI-PM and Its Performance Destination: edu.harvard.hul.ois.jhove.module.pdf.PdfSimpleObject@1a3869f4 Item: Title: Web-RC Design Destination: edu.harvard.hul.ois.jhove.module.pdf.PdfSimpleObject@a38d7a3 Item: Title: Discussion Destination: edu.harvard.hul.ois.jhove.module.pdf.PdfSimpleObject@77f99a05 Item: Title: Conclusions Destination: edu.harvard.hul.ois.jhove.module.pdf.PdfSimpleObject@63440df3 Item: Title: References Destination: edu.harvard.hul.ois.jhove.module.pdf.PdfSimpleObject@3aeaafa6 Info: Title: The Barcelona Predictive Model of Clinically Significant Prostate Cancer Author: Juan Morote, Angel Borque-Fernando, Marina Triquell, Anna Celma, Lucas Regis, Manel Escobar, Richard Mast, Inés M. de Torres, María E. Semidey, José M. Abascal, Carles Sola, Pol Servian, Daniel Salvador, Anna Santamaría, Jacques Planas, Luis M. Esteban and Enrique Trilla Subject: A new and externally validated MRI-PM for csPCa was developed in the metropolitan area of Barcelona, and a web-RC designed with the new option of selecting the csPCa probability threshold. The development cohort comprised 1486 men scheduled to undergo a 3-tesla multiparametric MRI (mpMRI) and guided and/or systematic biopsies in one academic institution of Barcelona. The external validation cohort comprised 946 men in whom the same diagnostic approach was carried out as in the development cohort, in two other academic institutions of the same metropolitan area. CsPCa was detected in 36.9% of men in the development cohort and 40.8% in the external validation cohort (p = 0.054). The area under the curve of mpMRI increased from 0.842 to 0.897 in the developed MRI-PM (p < 0.001), and from 0.743 to 0.858 in the external validation cohort (p < 0.001). A selected 15% threshold avoided 40.1% of prostate biopsies and missed 5.4% of the 36.9% csPCa detected in the development cohort. In men with PI-RADS <3, 4.3% would be biopsied and 32.3% of all existing 4.2% of csPCa would be detected. In men with PI-RADS 3, 62% of prostate biopsies would be avoided and 28% of all existing 12.4% of csPCa would be undetected. In men with PI-RADS 4, 4% of prostate biopsies would be avoided and 0.6% of all existing 43.1% of csPCa would be undetected. In men with PI-RADS 5, 0.6% of prostate biopsies would be avoided and none of the existing 42.0% of csPCa would be undetected. The Barcelona MRI-PM presented good performance on the overall population; however, its clinical usefulness varied regarding the PI-RADS category. The selection of csPCa probability thresholds in the designed RC may facilitate external validation and outperformance of MRI-PMs in specific PI-RADS categories. 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