b5326bc756a608b4a9adf6f293445460 pmc_9600141.pdf 760b91563b12cdf88071dd36281ba81d59464668 pmc_9600141.pdf 8f86b45989e561de61dd33531c96dbde74cfcd379cc7509ee8e151e5da955469 pmc_9600141.pdf Title: A Clinically Significant Prostate Cancer Predictive Model Using Digital Rectal Examination Prostate Volume Category to Stratify Initial Prostate Cancer Suspicion and Reduce Magnetic Resonance Imaging Demand Subject: A predictive model including age, PCa family history, biopsy status (initial vs repeat), DRE (normal vs abnormal), serum prostate-specific antigen (PSA), and DRE prostate volume ca-tegory was developed to stratify initial PCa suspicion in 1486 men with PSA > 3 ng/mL and/or abnormal DRE, in whom mpMRI followed; 2- to 4-core TRUS-guided biopsies where Prostate Imaging Report and Data System (PI-RADS) > 3 lesions and/or 12-core TRUS systematic biopsies were performed in one academic institution between 1 January 2016–31 December 2019. The csPCa detection rate, defined as International Society of Uro-Pathology grade group 2 or higher, was 36.9%. An external validation of designed BCN-RC 1 was carried out on 946 men from two other institutions in the same metropolitan area, using the same criteria of PCa suspicion and diagnostic approach, yielded a csPCa detection rate of 40.8%. The areas under the receiver operating characteristic curves of BCN-RC 1 were 0.823 (95% CI: 0.800–0.846) in the development cohort and 0.837 (95% CI: 0.811–0.863) in the validation cohort (p = 0.447). In both cohorts, BCN-RC 1 exhibited net benefit over performing mpMRI in all men from 8 and 12% risk thresholds, respectively. At 0.95 sensitivity of csPCa, the specificities of BCN-RC 1 were 0.24 (95% CI: 0.22–0.26) in the development cohort and 0.34 (95% CI: 0.31–0.37) in the validation cohort (p < 0.001). The percentages of avoided mpMRI scans were 17.2% in the development cohort and 22.3% in the validation cohort, missing between 1.8% and 2% of csPCa among men at risk of PCa. In summary, BCN-RC 1 can stratify initial PCa suspicion, reducing the demand of mpMRI, with an acceptable loss of csPCa. Keywords: prostate cancer; suspicion; clinically significant; predictive model; risk calculator; external validation; magnetic resonance imaging; development; external validation Author: Juan Morote, Ángel Borque-Fernando, Marina Triquell, Miriam Campistol, Anna Celma, Lucas Regis, José M. Abascal, Pol Servian, Jacques Planas, Olga Mendez, Luis M. Esteban and Enrique Trilla Creator: LaTeX with hyperref Producer: pdfTeX-1.40.21 CreationDate: Wed Oct 19 14:50:58 2022 CEST ModDate: Wed Oct 19 14:56:57 2022 CEST Tagged: no UserProperties: no Suspects: no Form: none JavaScript: no Pages: 14 Encrypted: no Page size: 595.276 x 841.89 pts (A4) Page rot: 0 File size: 2314902 bytes Optimized: no PDF version: 1.7 name type encoding emb sub uni object ID ------------------------------------ ----------------- ---------------- --- --- --- --------- AIPYBR+VnURWPalladioL-Bold Type 1 Custom yes yes no 10 0 WJBVBI+VnURWPalladioL Type 1 Custom yes yes no 15 0 ILOYRE+URWPalladioL-Bold Type 1 Custom yes yes no 19 0 PBKXCD+URWPalladioL-Roma Type 1 Custom yes yes no 24 0 HFDCBI+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 PDTLUH+CMSY10 Type 1 Builtin yes yes no 74 0 WABLSD+SFRM1000 Type 1 Custom yes yes no 78 0 CKBPVA+EURM10 Type 1 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242 0 EHIKPH+PalatinoLinotype-Roman TrueType WinAnsi yes yes no 245 0 EHIKLE+PalatinoLinotype-Bold CID TrueType Identity-H yes yes yes 253 0 EHJBEF+Calibri TrueType WinAnsi yes yes no 259 0 EHIKME+PalatinoLinotype-Roman CID TrueType Identity-H yes yes yes 262 0 EHIKPE+PalatinoLinotype-Italic CID TrueType Identity-H yes yes yes 268 0 EHIKPF+PalatinoLinotype-Italic TrueType WinAnsi yes yes no 274 0 EHIKPG+PalatinoLinotype-Bold TrueType WinAnsi yes yes no 277 0 EHIKPH+PalatinoLinotype-Roman TrueType WinAnsi yes yes no 280 0 Jhove (Rel. 1.22.1, 2019-04-17) Date: 2023-09-19 02:32:27 CEST RepresentationInformation: pmc_9600141.pdf ReportingModule: PDF-hul, Rel. 1.12.1 (2019-04-17) LastModified: 2023-09-15 02:23:25 CEST Size: 2314902 Format: PDF Version: 1.7 Status: Well-Formed and valid SignatureMatches: PDF-hul MIMEtype: application/pdf PDFMetadata: Objects: 492 FreeObjects: 1 IncrementalUpdates: 0 DocumentCatalog: PageLayout: SinglePage PageMode: UseNone Outlines: Item: Title: Introduction Destination: edu.harvard.hul.ois.jhove.module.pdf.PdfSimpleObject@44c8afef Item: Title: Materials and Methods Destination: edu.harvard.hul.ois.jhove.module.pdf.PdfSimpleObject@7b69c6ba Children: Item: Title: Development Cohort Destination: edu.harvard.hul.ois.jhove.module.pdf.PdfSimpleObject@46daef40 Item: Title: Validation Cohort Destination: edu.harvard.hul.ois.jhove.module.pdf.PdfSimpleObject@12f41634 Item: Title: MpMRI Characteristics Destination: edu.harvard.hul.ois.jhove.module.pdf.PdfSimpleObject@13c27452 Item: Title: DRE-Prostate Volume Category Assessment Destination: edu.harvard.hul.ois.jhove.module.pdf.PdfSimpleObject@262b2c86 Item: Title: CsPCa Definition Destination: edu.harvard.hul.ois.jhove.module.pdf.PdfSimpleObject@371a67ec Item: Title: Predictive Model Development Destination: edu.harvard.hul.ois.jhove.module.pdf.PdfSimpleObject@5ed828d Item: Title: Endpoint Measurements Destination: edu.harvard.hul.ois.jhove.module.pdf.PdfSimpleObject@50d0686 Item: Title: Statistical Analysis Destination: edu.harvard.hul.ois.jhove.module.pdf.PdfSimpleObject@7a3d45bd Item: Title: Results Destination: edu.harvard.hul.ois.jhove.module.pdf.PdfSimpleObject@1e7c7811 Children: Item: Title: Characteristics of the Development and Validation Cohorts Destination: edu.harvard.hul.ois.jhove.module.pdf.PdfSimpleObject@77ec78b9 Item: Title: Development of the Predictive Model and Its Calibration in the Development and Validation Cohorts Destination: edu.harvard.hul.ois.jhove.module.pdf.PdfSimpleObject@1a3869f4 Item: Title: Discrimination Ability of BCN-RC 1 for csPCa, Net Benefit over Performing mpMRI in All Men, Clinical Utility and Performance in the Development and Validation Cohorts 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: A Clinically Significant Prostate Cancer Predictive Model Using Digital Rectal Examination Prostate Volume Category to Stratify Initial Prostate Cancer Suspicion and Reduce Magnetic Resonance Imaging Demand Author: Juan Morote, Ángel Borque-Fernando, Marina Triquell, Miriam Campistol, Anna Celma, Lucas Regis, José M. Abascal, Pol Servian, Jacques Planas, Olga Mendez, Luis M. Esteban and Enrique Trilla Subject: A predictive model including age, PCa family history, biopsy status (initial vs repeat), DRE (normal vs abnormal), serum prostate-specific antigen (PSA), and DRE prostate volume ca-tegory was developed to stratify initial PCa suspicion in 1486 men with PSA > 3 ng/mL and/or abnormal DRE, in whom mpMRI followed; 2- to 4-core TRUS-guided biopsies where Prostate Imaging Report and Data System (PI-RADS) > 3 lesions and/or 12-core TRUS systematic biopsies were performed in one academic institution between 1 January 2016 31 December 2019. The csPCa detection rate, defined as International Society of Uro-Pathology grade group 2 or higher, was 36.9%. An external validation of designed BCN-RC 1 was carried out on 946 men from two other institutions in the same metropolitan area, using the same criteria of PCa suspicion and diagnostic approach, yielded a csPCa detection rate of 40.8%. The areas under the receiver operating characteristic curves of BCN-RC 1 were 0.823 (95% CI: 0.800 0.846) in the development cohort and 0.837 (95% CI: 0.811 0.863) in the validation cohort (p = 0.447). In both cohorts, BCN-RC 1 exhibited net benefit over performing mpMRI in all men from 8 and 12% risk thresholds, respectively. At 0.95 sensitivity of csPCa, the specificities of BCN-RC 1 were 0.24 (95% CI: 0.22 0.26) in the development cohort and 0.34 (95% CI: 0.31 0.37) in the validation cohort (p < 0.001). The percentages of avoided mpMRI scans were 17.2% in the development cohort and 22.3% in the validation cohort, missing between 1.8% and 2% of csPCa among men at risk of PCa. In summary, BCN-RC 1 can stratify initial PCa suspicion, reducing the demand of mpMRI, with an acceptable loss of csPCa. 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