5ec49e1f406d3c6381e6cef5ab892251 pmc_11815984.pdf f8cf85f6cd07fb9c453909900022f34151ed9360 pmc_11815984.pdf 79117150ed068fc1ec6ba2dc02729e21ee91ddb89284c422d86c868612be9769 pmc_11815984.pdf Title: Validation of the Barcelona Magnetic Resonance Imaging Predictive Model for Significant Prostate Cancer Detection in Men Undergoing Mapping per 0.5 Mm-Core Targeted Biopsies of Suspicious Lesions and Perilesional Areas Subject: Background/Objectives: Validation of predictive models (PMs) is crucial to be implemented in new populations or when advances in diagnostic approaches occurred. The aim of this study is to validate the BCN-MRI PM for sPCa when a highly effective prostate biopsy protocol is used. Methods: A prospective cohort of 457 men suspected of having PCa, for whom MRI results were reported with the Prostate Imaging-Reporting and Data System (PI-RADS) v 2.1, underwent a per 0.5 mm-core mapping targeted biopsy of suspicious lesions and perilesional areas, followed by a 12-core-systematic biopsy. These procedures took place between 1 February 2022, and 29 February 2024, at a reference center for prostate biopsy. The individual likelihood of sPCa was assessed through the BCN-MRI risk calculator. Results: The overall sPCa detection rate was 58.3%. The calibration curve of the BCN-MRI PM showed an appropriate accuracy between expected and observed probabilities with a discrimination ability for sPCa yielding an area under the curve (AUC) of 0.862 (95% CI 0.828–0.896) comparable to the AUC of 0.858 (95% CI 0.833–0.883) observed in the development cohort. The application of the BCN-MRI PM provided a net benefit over performing biopsies on all men, avoiding 24.9% of prostate biopsies at 95% sensitivity for sPCa, compared to the 23.7% reduction observed in the development cohort. Conclusions: We conclude that the BCN-MRI PM is ready to be implemented when this biopsy protocol is employed. Keywords: prostate biopsy; protocol; significant prostate cancer; detection Author: Nahuel Paesano, Violeta Catalá, Larisa Tcholakian, Xavier Alomar, Miguel Ángel Barranco, Jonathan Hernández-Mancera, Berta Miró, Enrique Trilla and Juan Morote Creator: LaTeX with hyperref Producer: pdfTeX-1.40.25 CreationDate: Fri Jan 31 12:52:22 2025 CET ModDate: Fri Jan 31 12:56:26 2025 CET Custom Metadata: no Metadata Stream: no Tagged: no UserProperties: no Suspects: no Form: none JavaScript: no Pages: 12 Encrypted: no Page size: 595.276 x 841.89 pts (A4) Page rot: 0 File size: 1788985 bytes Optimized: no PDF version: 1.7 name type encoding emb sub uni object ID ------------------------------------ ----------------- ---------------- --- --- --- --------- MIKRSI+VnURWPalladioL Type 1 Custom yes yes yes 10 0 DARQWC+URWPalladioL-Roma Type 1 Custom yes yes yes 16 0 QYTWMH+URWPalladioL-Bold Type 1 Custom yes yes yes 22 0 TALUIW+URWPalladioL-Ital Type 1 Custom yes yes yes 27 0 LFPJOF+PalatinoLinotype-Bold CID TrueType Identity-H yes yes yes 71 0 LFPLHF+PalatinoLinotype-BoldItalic TrueType WinAnsi yes yes no 77 0 LFPLKF+Calibri CID TrueType Identity-H yes yes yes 80 0 LFPLLG+Calibri TrueType WinAnsi yes yes no 86 0 LFPJOG+PalatinoLinotype-Roman CID TrueType Identity-H yes yes yes 89 0 LFPJOH+PalatinoLinotype-Italic CID TrueType Identity-H yes yes yes 95 0 LFPJOI+PalatinoLinotype-Italic TrueType WinAnsi yes yes no 101 0 LFPJOJ+PalatinoLinotype-Bold TrueType WinAnsi yes yes no 104 0 LFPJOK+PalatinoLinotype-Roman TrueType WinAnsi yes yes no 107 0 LFPKCK+PalatinoLinotype-Roman TrueType MacRoman yes yes no 110 0 LFPLDF+PalatinoLinotype-Italic TrueType MacRoman yes yes no 113 0 LFPJOF+PalatinoLinotype-Bold CID TrueType Identity-H yes yes yes 130 0 LFPLHF+PalatinoLinotype-BoldItalic TrueType WinAnsi yes yes no 136 0 LFPLKF+Calibri CID TrueType Identity-H yes yes yes 139 0 LFPLLG+Calibri TrueType WinAnsi yes yes no 145 0 LFPJOG+PalatinoLinotype-Roman CID TrueType Identity-H yes yes yes 148 0 LFPJOH+PalatinoLinotype-Italic CID TrueType Identity-H yes yes yes 154 0 LFPJOI+PalatinoLinotype-Italic TrueType WinAnsi yes yes no 160 0 LFPJOJ+PalatinoLinotype-Bold TrueType WinAnsi yes yes no 163 0 LFPJOK+PalatinoLinotype-Roman TrueType WinAnsi yes yes no 166 0 LFPKCK+PalatinoLinotype-Roman TrueType MacRoman yes yes no 169 0 LFPLDF+PalatinoLinotype-Italic TrueType MacRoman yes yes no 172 0 LFPJOF+PalatinoLinotype-Bold CID TrueType Identity-H yes yes yes 186 0 LFPLHF+PalatinoLinotype-BoldItalic TrueType WinAnsi yes yes no 192 0 LFPJOG+PalatinoLinotype-Roman CID TrueType Identity-H yes yes yes 195 0 LFPJOH+PalatinoLinotype-Italic CID TrueType Identity-H yes yes yes 201 0 LFPJOI+PalatinoLinotype-Italic TrueType WinAnsi yes yes no 207 0 LFPJOJ+PalatinoLinotype-Bold TrueType WinAnsi yes yes no 210 0 LFPJOK+PalatinoLinotype-Roman TrueType WinAnsi yes yes no 213 0 LFPKCK+PalatinoLinotype-Roman TrueType MacRoman yes yes no 216 0 LFPJOF+PalatinoLinotype-Bold CID TrueType Identity-H yes yes yes 226 0 LFPJOG+PalatinoLinotype-Roman CID TrueType Identity-H yes yes yes 232 0 LFPJOH+PalatinoLinotype-Italic CID TrueType Identity-H yes yes yes 238 0 LFPJOI+PalatinoLinotype-Italic TrueType WinAnsi yes yes no 244 0 LFPJOJ+PalatinoLinotype-Bold TrueType WinAnsi yes yes no 247 0 LFPJOK+PalatinoLinotype-Roman TrueType WinAnsi yes yes no 250 0 LFPKCK+PalatinoLinotype-Roman TrueType MacRoman yes yes no 253 0 Jhove (Rel. 1.28.0, 2023-05-18) Date: 2025-02-26 02:08:26 CET RepresentationInformation: pmc_11815984.pdf ReportingModule: PDF-hul, Rel. 1.12.4 (2023-03-16) LastModified: 2025-02-26 02:04:05 CET Size: 1788985 Format: PDF Version: 1.7 Status: Well-Formed and valid SignatureMatches: PDF-hul MIMEtype: application/pdf PDFMetadata: Objects: 419 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, Participants, and Setting Destination: subsection.2.1 Item: Title: Diagnostic Approach for sPCa Detection in Prostate Biopsies Destination: subsection.2.2 Item: Title: Assessment of Individual sPCa Likelihood Destination: subsection.2.3 Item: Title: Statistical Analysis Destination: subsection.2.4 Item: Title: Results Destination: section.3 Children: Item: Title: Characteristics of the Validation Cohort Destination: subsection.3.1 Item: Title: Calibration of the BCN-MRI PM in the Validation Cohort Destination: subsection.3.2 Item: Title: Discrimination Ability, Net Benefit, and Clinical Utility of the BCN-MRI PM for sPCa Detection Destination: subsection.3.3 Item: Title: Potential Clinical Utility of the BCN-MRI PM According to the PI-RADS v 2.1 Score Destination: subsection.3.4 Item: Title: Discussion Destination: section.4 Item: Title: Conclusions Destination: section.5 Item: Title: References Destination: section.6 Info: Title: Validation of the Barcelona Magnetic Resonance Imaging Predictive Model for Significant Prostate Cancer Detection in Men Undergoing Mapping per 0.5 Mm-Core Targeted Biopsies of Suspicious Lesions and Perilesional Areas Author: Nahuel Paesano, Violeta Catalá, Larisa Tcholakian, Xavier Alomar, Miguel Ángel Barranco, Jonathan Hernández-Mancera, Berta Miró, Enrique Trilla and Juan Morote Subject: Background/Objectives: Validation of predictive models (PMs) is crucial to be implemented in new populations or when advances in diagnostic approaches occurred. The aim of this study is to validate the BCN-MRI PM for sPCa when a highly effective prostate biopsy protocol is used. Methods: A prospective cohort of 457 men suspected of having PCa, for whom MRI results were reported with the Prostate Imaging-Reporting and Data System (PI-RADS) v 2.1, underwent a per 0.5 mm-core mapping targeted biopsy of suspicious lesions and perilesional areas, followed by a 12-core-systematic biopsy. These procedures took place between 1 February 2022, and 29 February 2024, at a reference center for prostate biopsy. The individual likelihood of sPCa was assessed through the BCN-MRI risk calculator. Results: The overall sPCa detection rate was 58.3%. The calibration curve of the BCN-MRI PM showed an appropriate accuracy between expected and observed probabilities with a discrimination ability for sPCa yielding an area under the curve (AUC) of 0.862 (95% CI 0.828 0.896) comparable to the AUC of 0.858 (95% CI 0.833 0.883) observed in the development cohort. The application of the BCN-MRI PM provided a net benefit over performing biopsies on all men, avoiding 24.9% of prostate biopsies at 95% sensitivity for sPCa, compared to the 23.7% reduction observed in the development cohort. Conclusions: We conclude that the BCN-MRI PM is ready to be implemented when this biopsy protocol is employed. Keywords: prostate biopsy; protocol; significant prostate cancer; detection Creator: LaTeX with hyperref Producer: pdfTeX-1.40.25 CreationDate: Fri Jan 31 12:52:22 CET 2025 ModDate: Fri Jan 31 12:56:26 CET 2025 ID: 0xcb7bf267b97506a57ab670f6d89a58e5, 0xcb7bf267b97506a57ab670f6d89a58e5 Filters: FilterPipeline: FlateDecode Fonts: Type1: Font: BaseFont: DARQWC+URWPalladioL-Roma FontSubset: true FirstChar: 2 LastChar: 246 FontDescriptor: FontName: DARQWC+URWPalladioL-Roma Flags: Symbolic FontBBox: -166, -283, 1021, 943 FontFile: true EncodingDictionary: Differences: true ToUnicode: true Font: BaseFont: QYTWMH+URWPalladioL-Bold FontSubset: true FirstChar: 2 LastChar: 243 FontDescriptor: FontName: QYTWMH+URWPalladioL-Bold Flags: Symbolic FontBBox: -152, -301, 1000, 935 FontFile: true EncodingDictionary: Differences: true ToUnicode: true Font: BaseFont: MIKRSI+VnURWPalladioL FontSubset: true FirstChar: 225 LastChar: 225 FontDescriptor: FontName: MIKRSI+VnURWPalladioL Flags: Symbolic FontBBox: -166, -283, 1021, 943 FontFile: true EncodingDictionary: Differences: true ToUnicode: true Font: BaseFont: TALUIW+URWPalladioL-Ital FontSubset: true FirstChar: 2 LastChar: 122 FontDescriptor: FontName: TALUIW+URWPalladioL-Ital Flags: Symbolic FontBBox: -170, -305, 1010, 941 FontFile: true EncodingDictionary: Differences: true ToUnicode: true Pages: Page: Sequence: 1 Annotations: Annotation: Subtype: Link Rect: 122, 177, 152, 186 Annotation: Subtype: Link Rect: 34, 165, 140, 174 Annotation: Subtype: Link Rect: 36, 75, 152, 84 Annotation: Subtype: Link Rect: 34, 63, 89, 72 Annotation: Subtype: Link Rect: 34, 773, 130, 809 Annotation: Subtype: Link Rect: 515, 773, 560, 809 Annotation: Subtype: Link Rect: 433, 608, 444, 621 Annotation: Subtype: Link Rect: 409, 27, 560, 37 Annotation: Subtype: Link Rect: 34, 379, 87, 398 Page: Sequence: 2 Annotations: Annotation: Subtype: Link Rect: 357, 675, 364, 684 ActionDest: 263 Annotation: Subtype: Link Rect: 214, 633, 221, 642 ActionDest: 263 Annotation: Subtype: Link Rect: 464, 619, 471, 628 ActionDest: 263 Annotation: Subtype: Link Rect: 277, 563, 284, 572 ActionDest: 263 Annotation: Subtype: Link Rect: 253, 508, 260, 517 ActionDest: 263 Annotation: Subtype: Link Rect: 520, 480, 527, 489 ActionDest: 263 Annotation: Subtype: Link Rect: 506, 424, 513, 433 ActionDest: 263 Annotation: Subtype: Link Rect: 517, 368, 524, 377 ActionDest: 263 Annotation: Subtype: Link Rect: 524, 368, 531, 377 ActionDest: 263 Annotation: Subtype: Link Rect: 165, 296, 429, 308 Annotation: Subtype: Link Rect: 245, 243, 257, 252 ActionDest: 263 Annotation: Subtype: Link Rect: 405, 201, 417, 210 ActionDest: 263 Annotation: Subtype: Link Rect: 417, 201, 429, 210 ActionDest: 263 Annotation: Subtype: Link Rect: 199, 173, 211, 182 ActionDest: 263 Annotation: Subtype: Link Rect: 452, 132, 464, 141 ActionDest: 263 Annotation: Subtype: Link Rect: 465, 132, 476, 141 ActionDest: 263 Page: Sequence: 3 Annotations: Annotation: Subtype: Link Rect: 201, 462, 213, 471 ActionDest: 263 Annotation: Subtype: Link Rect: 359, 434, 371, 443 ActionDest: 266 Annotation: Subtype: Link Rect: 335, 392, 347, 401 ActionDest: 266 Annotation: Subtype: Link Rect: 347, 392, 359, 401 ActionDest: 266 Annotation: Subtype: Link Rect: 520, 295, 532, 304 ActionDest: 266 Annotation: Subtype: Link Rect: 533, 295, 545, 304 ActionDest: 266 Annotation: Subtype: Link Rect: 165, 224, 436, 236 Page: Sequence: 4 Annotations: Annotation: Subtype: Link Rect: 497, 661, 509, 670 ActionDest: 266 Annotation: Subtype: Link Rect: 384, 543, 391, 555 ActionDest: 56 Annotation: Subtype: Link Rect: 527, 91, 534, 103 ActionDest: 59 Page: Sequence: 5 Annotations: Annotation: Subtype: Link Rect: 544, 478, 551, 490 ActionDest: 59 Annotation: Subtype: Link Rect: 423, 437, 430, 449 ActionDest: 59 Annotation: Subtype: Link Rect: 439, 439, 451, 448 ActionDest: 263 Annotation: Subtype: Link Rect: 344, 129, 355, 138 ActionDest: 263 Annotation: Subtype: Link Rect: 337, 89, 344, 101 ActionDest: 180 Annotation: Subtype: Link Rect: 459, 75, 466, 87 ActionDest: 180 Annotation: Subtype: Link Rect: 476, 78, 488, 87 ActionDest: 263 Page: Sequence: 6 Annotations: Annotation: Subtype: Link Rect: 312, 549, 323, 557 ActionDest: 263 Annotation: Subtype: Link Rect: 202, 497, 209, 507 ActionDest: 180 Annotation: Subtype: Link Rect: 213, 150, 220, 162 ActionDest: 220 Page: Sequence: 7 Annotations: Annotation: Subtype: Link Rect: 401, 622, 408, 634 ActionDest: 220 Page: Sequence: 8 Annotations: Annotation: Subtype: Link Rect: 433, 700, 445, 709 ActionDest: 266 Annotation: Subtype: Link Rect: 448, 700, 460, 709 ActionDest: 266 Annotation: Subtype: Link Rect: 238, 574, 250, 583 ActionDest: 266 Annotation: Subtype: Link Rect: 314, 435, 326, 444 ActionDest: 263 Annotation: Subtype: Link Rect: 487, 296, 499, 305 ActionDest: 263 Annotation: Subtype: Link Rect: 454, 240, 461, 249 ActionDest: 263 Annotation: Subtype: Link Rect: 462, 240, 474, 249 ActionDest: 266 Annotation: Subtype: Link Rect: 311, 198, 323, 207 ActionDest: 266 Annotation: Subtype: Link Rect: 213, 129, 225, 138 ActionDest: 266 Annotation: Subtype: Link Rect: 225, 129, 237, 138 ActionDest: 266 Annotation: Subtype: Link Rect: 274, 101, 286, 110 ActionDest: 266 Page: Sequence: 9 Annotations: Annotation: Subtype: Link Rect: 453, 758, 465, 767 ActionDest: 266 Annotation: Subtype: Link Rect: 465, 758, 477, 767 ActionDest: 266 Annotation: Subtype: Link Rect: 443, 382, 455, 391 ActionDest: 263 Annotation: Subtype: Link Rect: 455, 382, 467, 391 ActionDest: 266 Annotation: Subtype: Link Rect: 401, 271, 413, 280 ActionDest: 266 Annotation: Subtype: Link Rect: 308, 229, 320, 238 ActionDest: 266 Annotation: Subtype: Link Rect: 429, 215, 441, 224 ActionDest: 266 Annotation: Subtype: Link Rect: 439, 173, 451, 182 ActionDest: 266 Annotation: Subtype: Link Rect: 410, 146, 422, 155 ActionDest: 266 Annotation: Subtype: Link Rect: 425, 146, 437, 155 ActionDest: 270 Page: Sequence: 10 Annotations: Annotation: Subtype: Link Rect: 108, 491, 146, 501 Annotation: Subtype: Link Rect: 152, 491, 188, 501 Annotation: Subtype: Link Rect: 104, 453, 141, 463 Annotation: Subtype: Link Rect: 147, 453, 183, 463 Annotation: Subtype: Link Rect: 157, 414, 194, 424 Annotation: Subtype: Link Rect: 201, 414, 237, 424 Annotation: Subtype: Link Rect: 261, 388, 298, 399 Annotation: Subtype: Link Rect: 95, 338, 133, 348 Annotation: Subtype: Link Rect: 445, 311, 482, 322 Annotation: Subtype: Link Rect: 503, 298, 540, 309 Annotation: Subtype: Link Rect: 501, 273, 538, 284 Annotation: Subtype: Link Rect: 536, 247, 560, 258 Annotation: Subtype: Link Rect: 56, 235, 396, 246 Annotation: Subtype: Link Rect: 481, 209, 518, 220 Annotation: Subtype: Link Rect: 477, 184, 514, 195 Annotation: Subtype: Link Rect: 270, 145, 307, 156 Annotation: Subtype: Link Rect: 314, 145, 350, 156 Annotation: Subtype: Link Rect: 249, 120, 287, 131 Annotation: Subtype: Link Rect: 293, 120, 329, 131 Annotation: Subtype: Link Rect: 470, 107, 508, 118 Annotation: Subtype: Link Rect: 265, 69, 302, 80 Annotation: Subtype: Link Rect: 308, 69, 344, 80 Page: Sequence: 11 Annotations: Annotation: Subtype: Link Rect: 216, 731, 254, 742 Annotation: Subtype: Link Rect: 489, 718, 526, 729 Annotation: Subtype: Link Rect: 448, 692, 485, 703 Annotation: Subtype: Link Rect: 374, 654, 411, 665 Annotation: Subtype: Link Rect: 109, 616, 146, 627 Annotation: Subtype: Link Rect: 415, 590, 453, 601 Annotation: Subtype: Link Rect: 314, 552, 351, 563 Annotation: Subtype: Link Rect: 357, 552, 393, 563 Annotation: Subtype: Link Rect: 245, 513, 282, 524 Annotation: Subtype: Link Rect: 289, 513, 325, 524 Annotation: Subtype: Link Rect: 425, 488, 463, 499 Annotation: Subtype: Link Rect: 469, 488, 505, 499 Annotation: Subtype: Link Rect: 95, 450, 133, 461 Annotation: Subtype: Link Rect: 540, 424, 560, 435 Annotation: Subtype: Link Rect: 56, 411, 292, 422 Annotation: Subtype: Link Rect: 316, 373, 354, 384 Annotation: Subtype: Link Rect: 520, 335, 557, 346 Annotation: Subtype: Link Rect: 270, 296, 307, 307 Annotation: Subtype: Link Rect: 446, 271, 484, 282 Annotation: Subtype: Link Rect: 458, 245, 495, 256 Annotation: Subtype: Link Rect: 516, 220, 554, 231 Annotation: Subtype: Link Rect: 135, 195, 173, 205 Annotation: Subtype: Link Rect: 179, 195, 215, 205 Annotation: Subtype: Link Rect: 100, 157, 137, 167 Annotation: Subtype: Link Rect: 320, 130, 358, 141 Annotation: Subtype: Link Rect: 519, 106, 557, 116 Annotation: Subtype: Link Rect: 430, 79, 467, 90 Page: Sequence: 12 Annotations: Annotation: Subtype: Link Rect: 278, 743, 315, 754 Annotation: Subtype: Link Rect: 104, 706, 142, 716 Annotation: Subtype: Link Rect: 337, 679, 374, 690 Annotation: Subtype: Link Rect: 348, 654, 386, 665 Annotation: Subtype: Link Rect: 406, 628, 444, 639 Annotation: Subtype: Link Rect: 104, 591, 142, 601 Annotation: Subtype: Link Rect: 148, 591, 184, 601 Annotation: Subtype: Link Rect: 131, 514, 168, 524 Annotation: Subtype: Link Rect: 175, 514, 211, 524 Annotation: Subtype: Link Rect: 203, 476, 241, 486 Annotation: Subtype: Link Rect: 157, 438, 194, 448 Checksum: bffa7edb Type: CRC32 Checksum: 5ec49e1f406d3c6381e6cef5ab892251 Type: MD5 Checksum: f8cf85f6cd07fb9c453909900022f34151ed9360 Type: SHA-1 Checksum: 79117150ed068fc1ec6ba2dc02729e21ee91ddb89284c422d86c868612be9769 Type: SHA-256