PMID- 35733400 OWN - NLM STAT- MEDLINE DCOM- 20230126 LR - 20230412 IS - 1464-410X (Electronic) IS - 1464-4096 (Print) IS - 1464-4096 (Linking) VI - 131 IP - 2 DP - 2023 Feb TI - A prostate biopsy risk calculator based on MRI: development and comparison of the Prospective Loyola University multiparametric MRI (PLUM) and Prostate Biopsy Collaborative Group (PBCG) risk calculators. PG - 227-235 LID - 10.1111/bju.15835 [doi] AB - OBJECTIVES: To develop and validate a prostate cancer (PCa) risk calculator (RC) incorporating multiparametric magnetic resonance imaging (mpMRI) and to compare its performance with that of the Prostate Biopsy Collaborative Group (PBCG) RC. PATIENTS AND METHODS: Men without a PCa diagnosis receiving mpMRI before biopsy in the Prospective Loyola University mpMRI (PLUM) Prostate Biopsy Cohort (2015-2020) were included. Data from a separate institution were used for external validation. The primary outcome was diagnosis of no cancer, grade group (GG)1 PCa, and clinically significant (cs)PCa (>/=GG2). Binary logistic regression was used to explore standard clinical and mpMRI variables (prostate volume, Prostate Imaging-Reporting Data System [PI-RADS] version 2.0 lesions) with the final PLUM RC, based on a multinomial logistic regression model. Receiver-operating characteristic curve, calibration curves, and decision-curve analysis were evaluated in the training and validation cohorts. RESULTS: A total of 1010 patients were included for development (N = 674 training [47.8% PCa, 30.9% csPCa], N = 336 internal validation) and 371 for external validation. The PLUM RC outperformed the PBCG RC in the training (area under the curve [AUC] 85.9% vs 66.0%; P < 0.001), internal validation (AUC 88.2% vs 67.8%; P < 0.001) and external validation (AUC 83.9% vs 69.4%; P < 0.001) cohorts for csPCa detection. The PBCG RC was prone to overprediction while the PLUM RC was well calibrated. At a threshold probability of 15%, the PLUM RC vs the PBCG RC could avoid 13.8 vs 2.7 biopsies per 100 patients without missing any csPCa. At a cost level of missing 7.5% of csPCa, the PLUM RC could have avoided 41.0% (566/1381) of biopsies compared to 19.1% (264/1381) for the PBCG RC. The PLUM RC compared favourably with the Stanford Prostate Cancer Calculator (SPCC; AUC 84.1% vs 81.1%; P = 0.002) and the MRI-European Randomized Study of Screening for Prostate Cancer (ERSPC) RC (AUC 84.5% vs 82.6%; P = 0.05). CONCLUSIONS: The mpMRI-based PLUM RC significantly outperformed the PBCG RC and compared favourably with other mpMRI-based RCs. A large proportion of biopsies could be avoided using the PLUM RC in shared decision making while maintaining optimal detection of csPCa. CI - (c) 2022 The Authors. BJU International published by John Wiley & Sons Ltd on behalf of BJU International. FAU - Patel, Hiten D AU - Patel HD AUID- ORCID: 0000-0003-4028-010X AD - Department of Urology, Loyola University Medical Center, Maywood, IL, USA. AD - Department of Urology, Feinberg School of Medicine, Northwestern University, Chicago, IL, USA. FAU - Koehne, Elizabeth L AU - Koehne EL AD - Department of Urology, Loyola University Medical Center, Maywood, IL, USA. FAU - Shea, Steven M AU - Shea SM AD - Department of Radiology, Loyola University Medical Center, Maywood, IL, USA. FAU - Fang, Andrew M AU - Fang AM AD - Department of Urology, University of Alabama at Birmingham, Birmingham, AL, USA. FAU - Gerena, Marielia AU - Gerena M AD - Department of Radiology, Loyola University Medical Center, Maywood, IL, USA. FAU - Gorbonos, Alex AU - Gorbonos A AD - Department of Urology, Loyola University Medical Center, Maywood, IL, USA. FAU - Quek, Marcus L AU - Quek ML AD - Department of Urology, Loyola University Medical Center, Maywood, IL, USA. FAU - Flanigan, Robert C AU - Flanigan RC AD - Department of Urology, Loyola University Medical Center, Maywood, IL, USA. FAU - Goldberg, Ari AU - Goldberg A AD - Department of Radiology, Loyola University Medical Center, Maywood, IL, USA. FAU - Rais-Bahrami, Soroush AU - Rais-Bahrami S AUID- ORCID: 0000-0001-9466-9925 AD - Department of Urology, University of Alabama at Birmingham, Birmingham, AL, USA. AD - Department of Radiology, University of Alabama at Birmingham, Birmingham, AL, USA. AD - O'Neal Comprehensive Cancer Center, University of Alabama at Birmingham, Birmingham, AL, USA. FAU - Gupta, Gopal N AU - Gupta GN AD - Department of Urology, Loyola University Medical Center, Maywood, IL, USA. AD - Department of Radiology, Loyola University Medical Center, Maywood, IL, USA. AD - Department of Surgery, Loyola University Medical Center, Maywood, IL, USA. LA - eng GR - P30 CA013148/CA/NCI NIH HHS/United States GR - ACS-IRG 001-53/Comprehensive Cancer Center, University of Alabama at Birmingham/ GR - Siemens Medical Solutions USA/ PT - Journal Article PT - Research Support, N.I.H., Extramural PT - Research Support, Non-U.S. Gov't DEP - 20220711 PL - England TA - BJU Int JT - BJU international JID - 100886721 RN - EC 3.4.21.77 (Prostate-Specific Antigen) SB - IM MH - Male MH - Humans MH - Magnetic Resonance Imaging/methods MH - *Multiparametric Magnetic Resonance Imaging/methods MH - Prostate/diagnostic imaging/pathology MH - *Prostatic Neoplasms/pathology MH - *Prunus domestica MH - Prospective Studies MH - Universities MH - Biopsy MH - Prostate-Specific Antigen PMC - PMC9772358 MID - NIHMS1818848 OTO - NOTNLM OT - #PCSM OT - #ProstateCancer OT - #uroonc OT - diagnostic studies OT - magnetic resonance imaging OT - predictive model OT - prostate biopsy OT - prostate cancer EDAT- 2022/06/24 06:00 MHDA- 2023/01/27 06:00 PMCR- 2023/04/10 CRDT- 2022/06/23 02:04 PHST- 2022/06/24 06:00 [pubmed] PHST- 2023/01/27 06:00 [medline] PHST- 2022/06/23 02:04 [entrez] PHST- 2023/04/10 00:00 [pmc-release] AID - BJU15835 [pii] AID - 10.1111/bju.15835 [doi] PST - ppublish SO - BJU Int. 2023 Feb;131(2):227-235. doi: 10.1111/bju.15835. Epub 2022 Jul 11.