Author:
Busetto Gian Maria,Del Giudice Francesco,Maggi Martina,De Marco Ferdinando,Porreca Angelo,Sperduti Isabella,Magliocca Fabio Massimo,Salciccia Stefano,Chung Benjamin I.,De Berardinis Ettore,Sciarra Alessandro
Abstract
Abstract
Purpose
To evaluate the diagnostic accuracy of SelectMDx and its association with multiparametric magnetic resonance (mpMRI) in predicting prostate cancer (PCa) and clinically significant PCa (csPCa) on prostate biopsies among men scheduled for initial prostate biopsy.
Methods
In this single-center prospective study, 52 men scheduled for initial prostate biopsy, based on elevated total PSA level (> 3 ng/ml) or abnormal digital rectal examination, were consecutively included. All subjects underwent SelectMDx, PSA determination and mpMRI.
Results
SelectMDx score was positive in 94.1 and 100% of PCa and csPCa, respectively, and in only 8.6% of negative cases at biopsy. The probability for a csPCa at the SelectMDx score was significantly (p = 0.002) higher in csPCa (median value 52.0%) than in all PCa (median value 30.0%). SelectMDx showed slightly lower sensitivity (94.1 versus 100.0%) but higher specificity (91.4%) than total PSA (17.1%), and the same sensitivity but higher specificity than mpMRI (80.0%) in predicting PCa at biopsy. The association of SelectMDx plus mpMRI rather than PSA density (PSAD) plus mpMRI showed higher specificity (both 91.4%) compared to the association of PSA plus mpMRI (85.7%). In terms of csPCa predictive value, SelectMDx showed higher specificity (73.3%) than PSA (13.3%) and mpMRI (64.4%); as for the association of SelectMDx plus mpMRI (75.6%) versus PSA plus mpMRI (68.9%), the association of PSAD plus mpMRI showed the highest specificity (80.0%).
Conclusion
Our results of SelectMDx can be confirmed as significant but their impact on clinical practice together with a cost-effectiveness evaluation should be investigated in a larger prospective multicenter analysis.
Publisher
Springer Science and Business Media LLC
Reference25 articles.
1. Sciarra A, Gentilucci A, Salciccia S et al (2018) Psychological and functional impact of different primary treatments for prostate cancer: a comparative prospective analysis. Urol Oncol S1078–1439(18):30121–30122
2. Mottet N, van den Bergh RCN, Briers E, Cornford P, De Santis M, Fanti S et al (2019) EAU-ESTRO-SIOG Guidelines on Prostate Cancer. https://uroweb.org/guidelines/prostate-cancer
3. Draisma G, Etzioni R, Tsodikov A, Mariotto A, Wever E, Gulati R et al (2009) Lead time and overdiagnosis in prostate-specific antigen screening: importance of methods and context. J Natl Cancer Inst 101(6):374–383. https://doi.org/10.1093/jnci/djp001
4. Panebianco V, Barchetti F, Sciarra A, Ciardi A, Indino EL, Papalia R et al (2015) Multiparametric magnetic resonance imaging vs. standard care in men being evaluated for prostate cancer: a randomized study. Urol Oncol. https://doi.org/10.1016/j.urolonc.2014.09.013
5. Kasivisvanathan V, Rannikko AS, Borghi M, Panebianco V, Mynderse LA, Vaarala MH et al (2018) MRI-targeted or standard biopsy for prostate-cancer diagnosis. N Engl J Med 378(19):1767–1777. https://doi.org/10.1056/NEJMoa1801993
Cited by
26 articles.
订阅此论文施引文献
订阅此论文施引文献,注册后可以免费订阅5篇论文的施引文献,订阅后可以查看论文全部施引文献