311fb4579c17e7d529d3784a6ce60fd9 pmc_9179369.pdf fd57c8966d3b9f0bab60e401ec54f65fd4fc4d1b pmc_9179369.pdf 50a8c171e6bd24a0ee57a95c8cc25085f592d59f521d1a4ee3bd764c787897aa pmc_9179369.pdf Title: Comparison of Proclarix, PSA Density and MRI-ERSPC Risk Calculator to Select Patients for Prostate Biopsy after mpMRI Subject: Tools to properly select candidates for prostate biopsy after magnetic resonance imaging (MRI) have usually been analyzed in overall populations with suspected prostate cancer (PCa). However, the performance of these tools can change regarding the Prostate Imaging-Reporting and Data System (PI-RADS) categories due to the different incidence of clinically significant PCa (csPCa). The objective of the study was to analyze PSA density (PSAD), MRI-ERSPC risk calculator (RC), and Proclarix to properly select candidates for prostate biopsy regarding PI-RADS categories. We performed a head-to-head analysis of 567 men with suspected PCa, PSA > 3 ng/mL and/or abnormal rectal examination, in whom two to four core transrectal ultrasound (TRUS) guided biopsies to PI-RADS three lesions and/or 12-core TRUS systematic biopsies were performed after 3-tesla mpMRI between January 2018 and March 2020 in one academic institution. The overall detection of csPCa was 40.9% (6% in PI-RADS < 3, 14.8% in PI-RADS 3, 55.3% in PI-RADS 4, and 88.9% in PI-RADS 5). MRI-ERSPC model exhibited a net benefit over PSAD and Proclarix in the overall population. Proclarix outperformed PSAD and MRI-ERSPC RC in PI-RADS 3. PSAD outperformed MRI-ESRPC RC and Proclarix in PI-RADS > 3, although none of them exhibited 100% sensitivity for csPCa in this setting. Therefore, tools to properly select candidates for prostate biopsy after MRI must be analyzed regarding the PI-RADS categories. While MRI-ERSPC RC outperformed PSAD and Proclarix in the overall population, Proclarix outperformed in PI-RADS 3, and no tool guaranteed 100% detection of csPCa in PI-RADS 4 and 5. Keywords: clinically significant prostate cancer; PSA density; Proclarix; MRI-ERSPC; magnetic resonance imaging Author: Miriam Campistol, Juan Morote, Marina Triquell, Lucas Regis, Ana Celma, Inés de Torres, María E. Semidey, Richard Mast, Anna Santamaría, Jacques Planas and Enrique Trilla Creator: LaTeX with hyperref Producer: pdfTeX-1.40.21 CreationDate: Mon May 30 13:42:47 2022 CEST ModDate: Mon May 30 13:44:34 2022 CEST Custom Metadata: no Metadata Stream: no Tagged: no UserProperties: no Suspects: no Form: none JavaScript: no Pages: 9 Encrypted: no Page size: 595.276 x 841.89 pts (A4) Page rot: 0 File size: 1600028 bytes Optimized: no PDF version: 1.7 name type encoding emb sub uni object ID ------------------------------------ ----------------- ---------------- --- --- --- --------- ZHOANP+VnURWPalladioL Type 1 Custom yes yes no 10 0 EFGRRE+URWPalladioL-Bold Type 1 Custom yes yes no 15 0 GLRDWI+URWPalladioL-Roma Type 1 Custom yes yes no 20 0 FRNXOE+URWPalladioL-Ital Type 1 Custom yes yes no 24 0 RQPVQI+CMSY10 Type 1 Builtin yes yes no 28 0 YSPQJI+VnURWPalladioL-Bold Type 1 Custom yes yes no 32 0 LCJEVJ+TimesNewRomanPS-BoldItalicMT Type 1C WinAnsi yes yes no 51 0 CKBPVA+EURM10 Type 1 Builtin yes yes no 73 0 BCDEEE+PalatinoLinotype-Bold TrueType WinAnsi yes yes no 88 0 BCDFEE+PalatinoLinotype-Roman TrueType WinAnsi yes yes no 92 0 BCDGEE+PalatinoLinotype-Italic TrueType WinAnsi yes yes no 96 0 BCDHEE+PalatinoLinotype-Roman CID TrueType Identity-H yes yes yes 100 0 BCDEEE+PalatinoLinotype-Bold TrueType WinAnsi yes yes no 116 0 BCDFEE+PalatinoLinotype-Roman TrueType WinAnsi yes yes no 120 0 BCDGEE+PalatinoLinotype-Italic TrueType WinAnsi yes yes no 124 0 BCDEEE+PalatinoLinotype-Bold TrueType WinAnsi yes yes no 138 0 BCDFEE+PalatinoLinotype-Roman TrueType WinAnsi yes yes no 142 0 BCDGEE+PalatinoLinotype-Italic TrueType WinAnsi yes yes no 146 0 SYVAVM+VnURWPalladioL-Italic Type 1 Custom yes yes no 161 0 Jhove (Rel. 1.28.0, 2023-05-18) Date: 2024-05-17 03:30:04 CEST RepresentationInformation: pmc_9179369.pdf ReportingModule: PDF-hul, Rel. 1.12.4 (2023-03-16) LastModified: 2024-05-17 02:38:24 CEST Size: 1600028 Format: PDF Version: 1.7 Status: Well-Formed and valid SignatureMatches: PDF-hul MIMEtype: application/pdf PDFMetadata: Objects: 292 FreeObjects: 1 IncrementalUpdates: 0 DocumentCatalog: PageLayout: SinglePage PageMode: UseNone Outlines: Item: Title: Introduction Destination: section.1 Item: Title: Materials and Methods Destination: section.2 Children: Item: Title: Design, Setting and Participants Destination: subsection.2.1 Item: Title: Intervention Destination: subsection.2.2 Item: Title: Endpoint Measurements Destination: subsection.2.3 Item: Title: Statistical Analyses Destination: subsection.2.4 Item: Title: Results Destination: section.3 Children: Item: Title: Characteristics of the Study Population and Distribution of Overall PCa, csPCa, and iPCa by PI-RADS Category Destination: subsection.3.1 Item: Title: Overall Efficacy, Net Benefit, and Clinical Utility of mpMRI, PSAD, MRI-ERSPC RC, and Proclarix, and Overall Performances after the Selection of Appropriate Thresholds Destination: subsection.3.2 Item: Title: Efficacy, Net Benefit, Clinical Utility, and Performance of PSAD, MRI-ERSPC RC, and Proclarix by PI-RADS Category Destination: subsection.3.3 Item: Title: Discussion Destination: section.4 Item: Title: Conclusions Destination: section.5 Item: Title: References Destination: section.5 Info: Title: Comparison of Proclarix, PSA Density and MRI-ERSPC Risk Calculator to Select Patients for Prostate Biopsy after mpMRI Author: Miriam Campistol, Juan Morote, Marina Triquell, Lucas Regis, Ana Celma, Inés de Torres, María E. Semidey, Richard Mast, Anna Santamaría, Jacques Planas and Enrique Trilla Subject: Tools to properly select candidates for prostate biopsy after magnetic resonance imaging (MRI) have usually been analyzed in overall populations with suspected prostate cancer (PCa). However, the performance of these tools can change regarding the Prostate Imaging-Reporting and Data System (PI-RADS) categories due to the different incidence of clinically significant PCa (csPCa). The objective of the study was to analyze PSA density (PSAD), MRI-ERSPC risk calculator (RC), and Proclarix to properly select candidates for prostate biopsy regarding PI-RADS categories. We performed a head-to-head analysis of 567 men with suspected PCa, PSA > 3 ng/mL and/or abnormal rectal examination, in whom two to four core transrectal ultrasound (TRUS) guided biopsies to PI-RADS three lesions and/or 12-core TRUS systematic biopsies were performed after 3-tesla mpMRI between January 2018 and March 2020 in one academic institution. The overall detection of csPCa was 40.9% (6% in PI-RADS < 3, 14.8% in PI-RADS 3, 55.3% in PI-RADS 4, and 88.9% in PI-RADS 5). MRI-ERSPC model exhibited a net benefit over PSAD and Proclarix in the overall population. Proclarix outperformed PSAD and MRI-ERSPC RC in PI-RADS 3. PSAD outperformed MRI-ESRPC RC and Proclarix in PI-RADS > 3, although none of them exhibited 100% sensitivity for csPCa in this setting. Therefore, tools to properly select candidates for prostate biopsy after MRI must be analyzed regarding the PI-RADS categories. While MRI-ERSPC RC outperformed PSAD and Proclarix in the overall population, Proclarix outperformed in PI-RADS 3, and no tool guaranteed 100% detection of csPCa in PI-RADS 4 and 5. 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