Cargando…

Performance of prostate health index and PSA density in a diverse biopsy‐naïve cohort with mpMRI for detecting significant prostate cancer

OBJECTIVE: To compare Prostate Health Index (PHI) and prostate‐specific antigen (PSA) density as secondary tests after multiparametric magnetic resonance imaging (mpMRI) in improving the detection accuracy of Gleason grade group (GG) 2‐5 prostate cancer (PCa) and in decreasing unnecessary biopsies i...

Descripción completa

Detalles Bibliográficos
Autores principales: Carbunaru, Samuel, Stinson, James, Babajide, Rilwan, Hollowell, Courtney M. P., Yang, Ximing, Sekosan, Marin, Ferrer, Karen, Kajdacsy‐Balla, Andre, Abelleira, Josephine, Ruden, Maria, King‐Lee, Patrice, Dalton, Daniel P., Casalino, David D., Kittles, Rick A., Gann, Peter H., Schaeffer, Edward M., Murphy, Adam B.
Formato: Online Artículo Texto
Lenguaje:English
Publicado: John Wiley and Sons Inc. 2021
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8988695/
https://www.ncbi.nlm.nih.gov/pubmed/35474697
http://dx.doi.org/10.1002/bco2.91
_version_ 1784683019972378624
author Carbunaru, Samuel
Stinson, James
Babajide, Rilwan
Hollowell, Courtney M. P.
Yang, Ximing
Sekosan, Marin
Ferrer, Karen
Kajdacsy‐Balla, Andre
Abelleira, Josephine
Ruden, Maria
King‐Lee, Patrice
Dalton, Daniel P.
Casalino, David D.
Kittles, Rick A.
Gann, Peter H.
Schaeffer, Edward M.
Murphy, Adam B.
author_facet Carbunaru, Samuel
Stinson, James
Babajide, Rilwan
Hollowell, Courtney M. P.
Yang, Ximing
Sekosan, Marin
Ferrer, Karen
Kajdacsy‐Balla, Andre
Abelleira, Josephine
Ruden, Maria
King‐Lee, Patrice
Dalton, Daniel P.
Casalino, David D.
Kittles, Rick A.
Gann, Peter H.
Schaeffer, Edward M.
Murphy, Adam B.
author_sort Carbunaru, Samuel
collection PubMed
description OBJECTIVE: To compare Prostate Health Index (PHI) and prostate‐specific antigen (PSA) density as secondary tests after multiparametric magnetic resonance imaging (mpMRI) in improving the detection accuracy of Gleason grade group (GG) 2‐5 prostate cancer (PCa) and in decreasing unnecessary biopsies in a multiethnic biopsy‐naïve population. METHODS: From February 2017 to February 2020, we recruited consecutive biopsy‐naïve men in participating urology clinics for elevated PSA levels. They all had a PHI score, mpMRI, and prostate biopsy. Experienced genitourinary radiologists read all mpMRI studies based on PIRADS version 2.0. Logistic regression models were used to generate receiver operating characteristic curves. Models were tested for effect modification between Race (Black vs White) and both PHI and PSA density, and Race and PIRADS to determine if race impacted their prediction accuracy. Sensitivity, specificity, and predictive values of PHI and PSA density thresholds were calculated by PIRADS scores. The primary outcome was GG2‐5 PCa, that is, Gleason score ≥3 + 4. RESULTS: The study included 143 men, of which 65 (45.5%) were self‐reported Black. Median age was 62.0 years and 55 men (38.4%) had GG2‐5 PCa. Overall, 18.1% had PIRADS 1‐2, 32.9% had PIRADS 3, and 49.0% had PIRADS 4‐5. For the binary logistic regressions, the interactions between PIRADS and Race (P = .08), Log (PHI) and Race (P = .17), and Log (PSA density) and Race (P = .42) were not statistically significant. Within PIRADS 3 lesions, a PHI ≥49 prevented unnecessary biopsies in 55% of men and missed no GG2‐5 PCa, yielding a negative predictive value of 100%. There was no reliable PHI or PSA density threshold to avoid PCa biopsies in PIRADS 1‐2 or 4‐5. CONCLUSIONS: PHI and PSA density can be used after mpMRI to improve the detection of GG2‐5 PCa in a biopsy‐naïve cohort. PHI may be superior to PSA density in PIRADS 3 lesions by avoiding 55% of unnecessary biopsies. Using both PHI and PSA density in series may further increase specificity and lead to fewer unnecessary biopsies, but further larger studies are warranted to determine the optimal threshold of each biomarker.
format Online
Article
Text
id pubmed-8988695
institution National Center for Biotechnology Information
language English
publishDate 2021
publisher John Wiley and Sons Inc.
record_format MEDLINE/PubMed
spelling pubmed-89886952022-04-25 Performance of prostate health index and PSA density in a diverse biopsy‐naïve cohort with mpMRI for detecting significant prostate cancer Carbunaru, Samuel Stinson, James Babajide, Rilwan Hollowell, Courtney M. P. Yang, Ximing Sekosan, Marin Ferrer, Karen Kajdacsy‐Balla, Andre Abelleira, Josephine Ruden, Maria King‐Lee, Patrice Dalton, Daniel P. Casalino, David D. Kittles, Rick A. Gann, Peter H. Schaeffer, Edward M. Murphy, Adam B. BJUI Compass ORIGINAL ARTICLES OBJECTIVE: To compare Prostate Health Index (PHI) and prostate‐specific antigen (PSA) density as secondary tests after multiparametric magnetic resonance imaging (mpMRI) in improving the detection accuracy of Gleason grade group (GG) 2‐5 prostate cancer (PCa) and in decreasing unnecessary biopsies in a multiethnic biopsy‐naïve population. METHODS: From February 2017 to February 2020, we recruited consecutive biopsy‐naïve men in participating urology clinics for elevated PSA levels. They all had a PHI score, mpMRI, and prostate biopsy. Experienced genitourinary radiologists read all mpMRI studies based on PIRADS version 2.0. Logistic regression models were used to generate receiver operating characteristic curves. Models were tested for effect modification between Race (Black vs White) and both PHI and PSA density, and Race and PIRADS to determine if race impacted their prediction accuracy. Sensitivity, specificity, and predictive values of PHI and PSA density thresholds were calculated by PIRADS scores. The primary outcome was GG2‐5 PCa, that is, Gleason score ≥3 + 4. RESULTS: The study included 143 men, of which 65 (45.5%) were self‐reported Black. Median age was 62.0 years and 55 men (38.4%) had GG2‐5 PCa. Overall, 18.1% had PIRADS 1‐2, 32.9% had PIRADS 3, and 49.0% had PIRADS 4‐5. For the binary logistic regressions, the interactions between PIRADS and Race (P = .08), Log (PHI) and Race (P = .17), and Log (PSA density) and Race (P = .42) were not statistically significant. Within PIRADS 3 lesions, a PHI ≥49 prevented unnecessary biopsies in 55% of men and missed no GG2‐5 PCa, yielding a negative predictive value of 100%. There was no reliable PHI or PSA density threshold to avoid PCa biopsies in PIRADS 1‐2 or 4‐5. CONCLUSIONS: PHI and PSA density can be used after mpMRI to improve the detection of GG2‐5 PCa in a biopsy‐naïve cohort. PHI may be superior to PSA density in PIRADS 3 lesions by avoiding 55% of unnecessary biopsies. Using both PHI and PSA density in series may further increase specificity and lead to fewer unnecessary biopsies, but further larger studies are warranted to determine the optimal threshold of each biomarker. John Wiley and Sons Inc. 2021-06-15 /pmc/articles/PMC8988695/ /pubmed/35474697 http://dx.doi.org/10.1002/bco2.91 Text en © 2021 The Authors. BJUI Compass published by John Wiley & Sons Ltd on behalf of BJU International Company https://creativecommons.org/licenses/by/4.0/This is an open access article under the terms of the http://creativecommons.org/licenses/by/4.0/ (https://creativecommons.org/licenses/by/4.0/) License, which permits use, distribution and reproduction in any medium, provided the original work is properly cited.
spellingShingle ORIGINAL ARTICLES
Carbunaru, Samuel
Stinson, James
Babajide, Rilwan
Hollowell, Courtney M. P.
Yang, Ximing
Sekosan, Marin
Ferrer, Karen
Kajdacsy‐Balla, Andre
Abelleira, Josephine
Ruden, Maria
King‐Lee, Patrice
Dalton, Daniel P.
Casalino, David D.
Kittles, Rick A.
Gann, Peter H.
Schaeffer, Edward M.
Murphy, Adam B.
Performance of prostate health index and PSA density in a diverse biopsy‐naïve cohort with mpMRI for detecting significant prostate cancer
title Performance of prostate health index and PSA density in a diverse biopsy‐naïve cohort with mpMRI for detecting significant prostate cancer
title_full Performance of prostate health index and PSA density in a diverse biopsy‐naïve cohort with mpMRI for detecting significant prostate cancer
title_fullStr Performance of prostate health index and PSA density in a diverse biopsy‐naïve cohort with mpMRI for detecting significant prostate cancer
title_full_unstemmed Performance of prostate health index and PSA density in a diverse biopsy‐naïve cohort with mpMRI for detecting significant prostate cancer
title_short Performance of prostate health index and PSA density in a diverse biopsy‐naïve cohort with mpMRI for detecting significant prostate cancer
title_sort performance of prostate health index and psa density in a diverse biopsy‐naïve cohort with mpmri for detecting significant prostate cancer
topic ORIGINAL ARTICLES
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8988695/
https://www.ncbi.nlm.nih.gov/pubmed/35474697
http://dx.doi.org/10.1002/bco2.91
work_keys_str_mv AT carbunarusamuel performanceofprostatehealthindexandpsadensityinadiversebiopsynaivecohortwithmpmrifordetectingsignificantprostatecancer
AT stinsonjames performanceofprostatehealthindexandpsadensityinadiversebiopsynaivecohortwithmpmrifordetectingsignificantprostatecancer
AT babajiderilwan performanceofprostatehealthindexandpsadensityinadiversebiopsynaivecohortwithmpmrifordetectingsignificantprostatecancer
AT hollowellcourtneymp performanceofprostatehealthindexandpsadensityinadiversebiopsynaivecohortwithmpmrifordetectingsignificantprostatecancer
AT yangximing performanceofprostatehealthindexandpsadensityinadiversebiopsynaivecohortwithmpmrifordetectingsignificantprostatecancer
AT sekosanmarin performanceofprostatehealthindexandpsadensityinadiversebiopsynaivecohortwithmpmrifordetectingsignificantprostatecancer
AT ferrerkaren performanceofprostatehealthindexandpsadensityinadiversebiopsynaivecohortwithmpmrifordetectingsignificantprostatecancer
AT kajdacsyballaandre performanceofprostatehealthindexandpsadensityinadiversebiopsynaivecohortwithmpmrifordetectingsignificantprostatecancer
AT abelleirajosephine performanceofprostatehealthindexandpsadensityinadiversebiopsynaivecohortwithmpmrifordetectingsignificantprostatecancer
AT rudenmaria performanceofprostatehealthindexandpsadensityinadiversebiopsynaivecohortwithmpmrifordetectingsignificantprostatecancer
AT kingleepatrice performanceofprostatehealthindexandpsadensityinadiversebiopsynaivecohortwithmpmrifordetectingsignificantprostatecancer
AT daltondanielp performanceofprostatehealthindexandpsadensityinadiversebiopsynaivecohortwithmpmrifordetectingsignificantprostatecancer
AT casalinodavidd performanceofprostatehealthindexandpsadensityinadiversebiopsynaivecohortwithmpmrifordetectingsignificantprostatecancer
AT kittlesricka performanceofprostatehealthindexandpsadensityinadiversebiopsynaivecohortwithmpmrifordetectingsignificantprostatecancer
AT gannpeterh performanceofprostatehealthindexandpsadensityinadiversebiopsynaivecohortwithmpmrifordetectingsignificantprostatecancer
AT schaefferedwardm performanceofprostatehealthindexandpsadensityinadiversebiopsynaivecohortwithmpmrifordetectingsignificantprostatecancer
AT murphyadamb performanceofprostatehealthindexandpsadensityinadiversebiopsynaivecohortwithmpmrifordetectingsignificantprostatecancer