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MRI-based nomogram for the prediction of prostate cancer diagnosis: A multi-centre validated patient–physician decision tool

Lookup NU author(s): Dr Stuart McCracken, Jonathan Aning, Vincent Gnanapragasam


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© British Association of Urological Surgeons 2022. Objective: To update and externally validate a magnetic resonance imaging (MRI)-based nomogram for predicting prostate biopsy outcomes with a multi-centre cohort. Materials and methods: Prospective data from five UK-based centres were analysed. All men were biopsy naïve. Those with missing data, no MRI, or prostate-specific antigen (PSA) > 30 ng/mL were excluded. Logistic regression analysis was used to confirm predictors of prostate cancer outcomes including MRI-PIRADS (Prostate Imaging Reporting and Data System) score, PSA density, and age. Clinically significant disease was defined as International Society of Urological Pathology (ISUP) Grade Group ⩾ 2 (Gleason grade ⩾ 7). Biopsy strategy included transrectal and transperineal approaches. Nomograms were produced using logistic regression analysis results. Results: A total of 506 men were included in the analysis with median age 66 (interquartile range (IQR) = 60–69). Median PSA was 6.6 ng/mL (IQR = 4.72–9.26). PIRADS ⩾ 3 was reported in 387 (76.4%). Grade Group ⩾ 2 detection was 227 (44.9%) and 318 (62.8%) for any cancer. Performance of the MRI-based nomogram was an area under curve (AUC) of 0.84 (95% confidence interval (CI) = 0.81–0.88) for Grade Group ⩾ 2% and 0.85 (95% CI = 0.82–0.88) for any prostate cancer. Conclusion: We present external validation of a novel MRI-based nomogram in a multi-centre UK-based cohort, showing good discrimination in identifying men at high risk of having clinically significant disease. These findings support this risk calculator use in the prostate biopsy decision-making process. Level of evidence: 2c.

Publication metadata

Author(s): Chau EM, Russell B, Santaolalla A, Van Hemelrijck M, McCracken S, Page T, Liyanage SH, Aning J, Gnanapragasam VJ, Acher P

Publication type: Article

Publication status: Published

Journal: Journal of Clinical Urology

Year: 2022

Pages: E-Pub ahead of Print

Online publication date: 07/01/2022

Acceptance date: 19/11/2021

ISSN (print): 2051-4158

ISSN (electronic): 2051-4166

Publisher: SAGE Publications Ltd


DOI: 10.1177/20514158211065949


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