Details

Autor(en) / Beteiligte

• Emmett, Louise
• Papa, Nathan
• Hope, Thomas A
• Fendler, Wolfgang
• Calais, Jeremie
• Burger, Irene
• Eiber, Matthias
• Barbato, Francesco
• Moon, Daniel
• Counter, William
• John, Nikeith
• Xue, Alan
• Franklin, Anthony
• Thompson, James
• Rasiah, Kris
• Frydenberg, Mark
• Yaxley, John
• Buteau, James
• Agrawal, Shikha
• Ho, Bao
• Nguyen, Andrew
• Liu, Victor
• Lee, Jonathan
• Woo, Henry
• Hsiao, Edward
• Sutherland, Thomas
• Perry, Elyse
• Stricker, Phillip
• Hofman, Michael S
• Kasivisvanathan, Veeru
• Roberts, Matthew
• Murphy, Declan

Titel

Beyond Prostate Imaging Reporting and Data System: Combining Magnetic Resonance Imaging Prostate Imaging Reporting and Data System and Prostate-Specific Membrane Antigen-Positron Emission Tomography/Computed Tomography PRIMARY Score in a Composite (P) Score for More Accurate Diagnosis of Clinically Significant Prostate Cancer

Ist Teil von

• The Journal of urology, 2024-08, Vol.212 (2), p.299-309

Ort / Verlag

United States

Erscheinungsjahr

2024

Quelle

MEDLINE

Beschreibungen/Notizen

• The Prostate Imaging Reporting and Data System (PI-RADS) score is standard of care for clinically significant prostate cancer (csPCa) diagnosis. The PRIMARY score (prostate-specific membrane antigen [PSMA]-positron emission tomography [PET]/CT) also has high diagnostic accuracy for csPCa. This study aimed to develop an easily calculated combined (P) score for csPCa detection (International Society of Urological Pathology [ISUP] ≥2) incorporating separately read PI-RADS and PRIMARY scores, with external validation. Two datasets of men with suspected PCa, no prior biopsy, recent MRI and Ga-PSMA-11-PET/CT, and subsequent transperineal biopsy were evaluated. These included the development sample (n = 291, 56% csPCa) a prospective trial and the validation sample (n = 227, 67% csPCa) a multicenter retrospective database. Primary outcome was detection of csPCa (ISUP ≥2), with ISUP ≥ 3 cancer detection a secondary outcome. Score performance was evaluated by area under the curve, sensitivity, specificity, and decision curve analysis. The 5-point combined (P) score was developed in a prospective dataset. In the validation dataset, csPCa was identified in 0%, 20%, 52%, 96%, and 100% for P score 1 to 5. The area under the curve was 0.93 (95% CI: 0.90-0.96), higher than PI-RADS 0.89 (95% CI: 0.85-0.93, = .039) and PRIMARY score alone 0.84 (95% CI: 0.79-0.89, < .001). Splitting scores at 1/2 (negative) vs 3/4/5 (positive), P score sensitivity was 94% (95% CI: 89-97) compared to PI-RADS 89% (95% CI: 83-93) and PRIMARY score 86% (95% CI: 79-91). For ISUP ≥ 3, P score sensitivity was 99% (95% CI: 95-100) vs 94% (95% CI: 88-98) and 92% (95% CI: 85-97) for PI-RADS and PRIMARY scores respectively. A maximum standardized uptake value > 12 (P score 5) was ISUP ≥ 2 in all cases with 93% ISUP ≥ 3. The P score is easily calculated and improves accuracy for csPCa over both PI-RADS and PRIMARY scores. It should be considered when PSMA-PET is undertaken for diagnosis.