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Comparative Analysis of PSA Density and an MRI-Based Predictive Model to Improve the Selection of Candidates for Prostate Biopsy
Article

Comparison of Proclarix, PSA Density and MRI-ERSPC Risk Calculator to Select Patients for Prostate Biopsy after mpMRI

1
Department of Urology, Vall d’Hebron Hospital, 08035 Barcelona, Spain
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Prostate Cancer Research Group, Vall d’Hebron, Research Institute, 08035 Barcelona, Spain
3
Department of Surgery, Universitat Autònoma de Barcelona, 08193 Barcelona, Spain
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Department of Pathology, Vall d’Hebron Hospital, 08035 Barcelona, Spain
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Department of Morphological Sciences, Universitat Autònoma de Barcelona, 08193 Barcelona, Spain
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Department of Radiology, Vall d’Hebron Hospital, 08035 Barcelona, Spain
*
Author to whom correspondence should be addressed.
Academic Editor: Holger A. Sültmann
Cancers 2022, 14(11), 2702; https://doi.org/10.3390/cancers14112702
Received: 29 March 2022 / Revised: 26 May 2022 / Accepted: 27 May 2022 / Published: 30 May 2022
The selection of proper candidates for prostate biopsy after magnetic resonance imaging (MRI) has usually been studied in the overall population with suspected prostate cancer (PCa). However, the performance of these tools can change regarding the Prostate Imaging-Reporting and Data System (PI-RADS) categories. We compared three different tools: PSA density, MRI-ERSPC risk calculator and Proclarix in 567 men with suspected PCa (PSA > 3 ng/mL and/or abnormal rectal examination) in one academic institution. All patients underwent multiple transrectal ultrasound guided biopsies after a multiparametric MRI was performed. We concluded that in the overall population, MRI-ERSPC RC outperformed PSA density and Proclarix, whereas in patients with lesions PI-RADS < 3 Proclarix was better than the other tools. However, no tool guaranteed 100% detection of clinically significant PCa in PI-RADS 4 and 5.
Tools to properly select candidates for prostate biopsy after magnetic resonance imaging (MRI) have usually been analyzed in overall populations with suspected prostate cancer (PCa). However, the performance of these tools can change regarding the Prostate Imaging-Reporting and Data System (PI-RADS) categories due to the different incidence of clinically significant PCa (csPCa). The objective of the study was to analyze PSA density (PSAD), MRI-ERSPC risk calculator (RC), and Proclarix to properly select candidates for prostate biopsy regarding PI-RADS categories. We performed a head-to-head analysis of 567 men with suspected PCa, PSA > 3 ng/mL and/or abnormal rectal examination, in whom two to four core transrectal ultrasound (TRUS) guided biopsies to PI-RADS ≥ three lesions and/or 12-core TRUS systematic biopsies were performed after 3-tesla mpMRI between January 2018 and March 2020 in one academic institution. The overall detection of csPCa was 40.9% (6% in PI-RADS < 3, 14.8% in PI-RADS 3, 55.3% in PI-RADS 4, and 88.9% in PI-RADS 5). MRI-ERSPC model exhibited a net benefit over PSAD and Proclarix in the overall population. Proclarix outperformed PSAD and MRI-ERSPC RC in PI-RADS ≤ 3. PSAD outperformed MRI-ESRPC RC and Proclarix in PI-RADS > 3, although none of them exhibited 100% sensitivity for csPCa in this setting. Therefore, tools to properly select candidates for prostate biopsy after MRI must be analyzed regarding the PI-RADS categories. While MRI-ERSPC RC outperformed PSAD and Proclarix in the overall population, Proclarix outperformed in PI-RADS ≤ 3, and no tool guaranteed 100% detection of csPCa in PI-RADS 4 and 5. View Full-Text
Keywords: clinically significant prostate cancer; PSA density; Proclarix; MRI-ERSPC; magnetic resonance imaging clinically significant prostate cancer; PSA density; Proclarix; MRI-ERSPC; magnetic resonance imaging
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MDPI and ACS Style

Campistol, M.; Morote, J.; Triquell, M.; Regis, L.; Celma, A.; de Torres, I.; Semidey, M.E.; Mast, R.; Santamaría, A.; Planas, J.; Trilla, E. Comparison of Proclarix, PSA Density and MRI-ERSPC Risk Calculator to Select Patients for Prostate Biopsy after mpMRI. Cancers 2022, 14, 2702. https://doi.org/10.3390/cancers14112702

AMA Style

Campistol M, Morote J, Triquell M, Regis L, Celma A, de Torres I, Semidey ME, Mast R, Santamaría A, Planas J, Trilla E. Comparison of Proclarix, PSA Density and MRI-ERSPC Risk Calculator to Select Patients for Prostate Biopsy after mpMRI. Cancers. 2022; 14(11):2702. https://doi.org/10.3390/cancers14112702

Chicago/Turabian Style

Campistol, Miriam, Juan Morote, Marina Triquell, Lucas Regis, Ana Celma, Inés de Torres, María E. Semidey, Richard Mast, Anna Santamaría, Jacques Planas, and Enrique Trilla. 2022. "Comparison of Proclarix, PSA Density and MRI-ERSPC Risk Calculator to Select Patients for Prostate Biopsy after mpMRI" Cancers 14, no. 11: 2702. https://doi.org/10.3390/cancers14112702

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