197d6268cd0b5b992e8344e2519ab3dc pmc_9139805.pdf 5670bea37ef92069da4a461394c3739630d3290a pmc_9139805.pdf fa9df177248a5d01a4a005b114153ae90297a020ea4e514442b31c3dfb21b250 pmc_9139805.pdf Title: Comparative Analysis of PSA Density and an MRI-Based Predictive Model to Improve the Selection of Candidates for Prostate Biopsy Subject: This study is a head-to-head comparison between mPSAD and MRI-PMbdex. The MRI-PMbdex was created from 2432 men with suspected PCa; this cohort comprised the development and external validation cohorts of the Barcelona MRI predictive model. Pre-biopsy 3-Tesla multiparametric MRI (mpMRI) and 2 to 4-core transrectal ultrasound (TRUS)-guided biopsies for suspicious lesions and/or 12-core TRUS systematic biopsies were scheduled. Clinically significant PCa (csPCa), defined as Gleason-based Grade Group 2 or higher, was detected in 934 men (38.4%). The area under the curve was 0.893 (95% confidence interval [CI]: 0.880–0.906) for MRI-PMbdex and 0.764 (95% CI: 0.774–0.783) for mPSAD, with p < 0.001. MRI-PMbdex showed net benefit over biopsy in all men when the probability of csPCa was greater than 2%, while mPSAD did the same when the probability of csPCa was greater than 18%. Thresholds of 13.5% for MRI-PMbdex and 0.628 ng/mL2 for mPSAD had 95% sensitivity for csPCa and presented 51.1% specificity for MRI-PMbdex and 19.6% specificity for mPSAD, with p < 0.001. MRI-PMbdex exhibited net benefit over mPSAD in men with prostate imaging report and data system (PI-RADS) <4, while neither exhibited any benefit in men with PI-RADS 5. Hence, we can conclude that MRI-PMbdex is more accurate than mPSAD for the proper selection of candidates for prostate biopsy among men with suspected PCa, with the exception of men with a PI-RAD S 5 score, for whom neither tool exhibited clinical guidance to determine the need for biopsy. Keywords: prostate-specific antigen density; predictive model; clinically significant prostate cancer Author: Juan Morote, Angel Borque-Fernando, Marina Triquell, Anna Celma, Lucas Regis, Richard Mast, Inés M. de Torres, María E. Semidey, José M. Abascal, Pol Servian, Anna Santamaría, Jacques Planas, Luis M. Esteban and Enrique Trilla Creator: LaTeX with hyperref Producer: pdfTeX-1.40.21 CreationDate: Thu May 12 05:25:50 2022 CEST ModDate: Thu May 12 05:35:56 2022 CEST Tagged: no UserProperties: no Suspects: no Form: none JavaScript: no Pages: 22 Encrypted: no Page size: 595.276 x 841.89 pts (A4) Page rot: 0 File size: 3828446 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 LWJOET+VnURWPalladioL Type 1 Custom yes yes no 15 0 BLATDB+URWPalladioL-Bold Type 1 Custom yes yes no 19 0 GCQJTB+URWPalladioL-Roma Type 1 Custom yes yes no 24 0 MWGALL+URWPalladioL-Ital Type 1 Custom yes yes no 28 0 QGYAWM+SFRM0800 Type 1 Custom yes yes no 32 0 LCJEVJ+TimesNewRomanPS-BoldItalicMT Type 1C WinAnsi yes yes no 52 0 IKKWKP+CMSY10 Type 1 Builtin yes yes no 77 0 CKBPVA+EURM10 Type 1 Builtin yes yes no 81 0 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Linotype,Bold TrueType WinAnsi yes yes no 314 0 ABCDEE+Palatino Linotype TrueType WinAnsi yes yes no 318 0 ABCDEE+Palatino Linotype,Italic TrueType WinAnsi yes yes no 322 0 ABCDEE+Palatino Linotype,Bold TrueType WinAnsi yes yes no 335 0 ABCDEE+Palatino Linotype TrueType WinAnsi yes yes no 339 0 ABCDEE+Palatino Linotype,Italic TrueType WinAnsi yes yes no 343 0 ABCDEE+Palatino Linotype CID TrueType Identity-H yes yes yes 347 0 BOLMEN+SFRM0900 Type 1 Custom yes yes no 361 0 Jhove (Rel. 1.22.1, 2019-04-17) Date: 2023-09-28 02:35:04 CEST RepresentationInformation: pmc_9139805.pdf ReportingModule: PDF-hul, Rel. 1.12.1 (2019-04-17) LastModified: 2023-09-27 02:17:58 CEST Size: 3828446 Format: PDF Version: 1.7 Status: Well-Formed and valid SignatureMatches: PDF-hul MIMEtype: application/pdf PDFMetadata: Objects: 652 FreeObjects: 1 IncrementalUpdates: 0 DocumentCatalog: PageLayout: SinglePage PageMode: UseNone Outlines: Item: Title: Introduction Destination: edu.harvard.hul.ois.jhove.module.pdf.PdfSimpleObject@262b2c86 Item: Title: Materials and Methods Destination: edu.harvard.hul.ois.jhove.module.pdf.PdfSimpleObject@371a67ec Children: Item: Title: Design, Setting and Participants Destination: edu.harvard.hul.ois.jhove.module.pdf.PdfSimpleObject@5ed828d Item: Title: Intervention Destination: edu.harvard.hul.ois.jhove.module.pdf.PdfSimpleObject@50d0686 Item: Title: MRI Technique and Evaluation Destination: edu.harvard.hul.ois.jhove.module.pdf.PdfSimpleObject@7a3d45bd Item: Title: Prostate Biopsy Procedure Destination: edu.harvard.hul.ois.jhove.module.pdf.PdfSimpleObject@1e7c7811 Item: Title: Pathologic Analysis and csPCa Definition Destination: edu.harvard.hul.ois.jhove.module.pdf.PdfSimpleObject@77ec78b9 Item: Title: Endpoint Measurements Destination: edu.harvard.hul.ois.jhove.module.pdf.PdfSimpleObject@1a3869f4 Item: Title: Statistical Analysis Destination: edu.harvard.hul.ois.jhove.module.pdf.PdfSimpleObject@a38d7a3 Item: Title: Results Destination: edu.harvard.hul.ois.jhove.module.pdf.PdfSimpleObject@77f99a05 Children: Item: Title: Characteristics of the Study Population Destination: edu.harvard.hul.ois.jhove.module.pdf.PdfSimpleObject@63440df3 Item: Title: Performance of mPSAD and MRI-PMbdex in the Entire Population Destination: edu.harvard.hul.ois.jhove.module.pdf.PdfSimpleObject@3aeaafa6 Item: Title: Performance of mPSAD and MRI-PMbdex According to the PI-RADS Categories Destination: edu.harvard.hul.ois.jhove.module.pdf.PdfSimpleObject@76a3e297 Item: Title: Discussion Destination: edu.harvard.hul.ois.jhove.module.pdf.PdfSimpleObject@4d3167f4 Item: Title: Conclusions Destination: edu.harvard.hul.ois.jhove.module.pdf.PdfSimpleObject@ed9d034 Item: Title: References Destination: edu.harvard.hul.ois.jhove.module.pdf.PdfSimpleObject@6121c9d6 Info: Title: Comparative Analysis of PSA Density and an MRI-Based Predictive Model to Improve the Selection of Candidates for Prostate Biopsy Author: Juan Morote, Angel Borque-Fernando, Marina Triquell, Anna Celma, Lucas Regis, Richard Mast, Inés M. de Torres, María E. Semidey, José M. Abascal, Pol Servian, Anna Santamaría, Jacques Planas, Luis M. Esteban and Enrique Trilla Subject: This study is a head-to-head comparison between mPSAD and MRI-PMbdex. The MRI-PMbdex was created from 2432 men with suspected PCa; this cohort comprised the development and external validation cohorts of the Barcelona MRI predictive model. Pre-biopsy 3-Tesla multiparametric MRI (mpMRI) and 2 to 4-core transrectal ultrasound (TRUS)-guided biopsies for suspicious lesions and/or 12-core TRUS systematic biopsies were scheduled. Clinically significant PCa (csPCa), defined as Gleason-based Grade Group 2 or higher, was detected in 934 men (38.4%). The area under the curve was 0.893 (95% confidence interval [CI]: 0.880 0.906) for MRI-PMbdex and 0.764 (95% CI: 0.774 0.783) for mPSAD, with p < 0.001. MRI-PMbdex showed net benefit over biopsy in all men when the probability of csPCa was greater than 2%, while mPSAD did the same when the probability of csPCa was greater than 18%. Thresholds of 13.5% for MRI-PMbdex and 0.628 ng/mL2 for mPSAD had 95% sensitivity for csPCa and presented 51.1% specificity for MRI-PMbdex and 19.6% specificity for mPSAD, with p < 0.001. MRI-PMbdex exhibited net benefit over mPSAD in men with prostate imaging report and data system (PI-RADS) <4, while neither exhibited any benefit in men with PI-RADS 5. Hence, we can conclude that MRI-PMbdex is more accurate than mPSAD for the proper selection of candidates for prostate biopsy among men with suspected PCa, with the exception of men with a PI-RAD S 5 score, for whom neither tool exhibited clinical guidance to determine the need for biopsy. 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