MP04-13 VALIDATION OF THE PROSTATE CANCER PREVENTION TRIAL RISK CALCULATOR 2.0 IN MULTIPARAMETRIC MRI ERA

Abstract

INTRODUCTION AND OBJECTIVES: The Prostate Cancer Prevention Trial Risk Calculator 2.0 (PCPTRC2.0) represents a widely used tool developed to identify men for PSA testing or prostate biopsy. PCPTRC2.0 has been assessed in previous trials with traditional methodologies for identifying prostate cancer (PCa). The accuracy of the PCPTRC2.0 in correctly identifying patients at risk for PCa has been called into question, particularly in patients undergoing MRI/US fusion prostate biopsies. We aim to assess the accuracy of the PCPTRC2.0 estimation in identifying PCa in an MRI-US fusion biopsy cohort. METHODS: A review of men studied prospectively with MRI/ US fusion biopsy was conducted. Between August 2007 and February 2014, 595 MRI/US fusion prostate biopsies were selected. Patients0 complete data was used to calculate their PCPTRC2.0 scores using the PCPTRC2.0 R-code. Risk of positive biopsy and high-grade (Gleason 7) cancer on biopsy was calculated for each patient. Receiver operating characteristic (ROC) curves were analyzed and areas under the curve (AUC) were compared using DeLong0s test. RESULTS: Of 595 men included in the study, cancer was detected in 39% (232) by systematic biopsy compared to 48% (287) on MRI-targeted biopsy alone. Median age was 62.3 years with a mean PSA of 12.0. The AUCs for overall cancer detection rate (CDR) were similar at 0.69 and 0.70 for systematic and MRI-targeted biopsy, respectively (p1⁄40.69) [Figure 1a]. For high-grade disease according to the PCPTRC2.0 calculator, AUCs increased to 0.71 and 0.73 for systematic and MRI-targeted biopsy, but remained not statistically different (p1⁄40.54) [Figure 1b]. CONCLUSIONS: PCPTRC2.0 represents a valid prostate cancer prediction tool in men undergoing multiparametric MRI and fusion-guided prostate biopsy. Source of Funding: None.