MP40-09 EXTERNAL VALIDATION OF A MULTIPARAMETRIC MAGNETIC RESONANCE IMAGING VOLUMETRIC MODEL TO PREDICT THE UTILITY OF SYSTEMATIC BIOPSIES AT THE TIME OF TARGETED BIOPSY

Abstract

You have accessJournal of UrologyCME1 Apr 2023MP40-09 EXTERNAL VALIDATION OF A MULTIPARAMETRIC MAGNETIC RESONANCE IMAGING VOLUMETRIC MODEL TO PREDICT THE UTILITY OF SYSTEMATIC BIOPSIES AT THE TIME OF TARGETED BIOPSY Antonella Ninivaggi, Ugo Falagario, Francesco Guzzi, Vito Mancini, Carlo Bettocchi, Gian Maria Busetto, Luigi Cormio, and Giuseppe Carrieri Antonella NinivaggiAntonella Ninivaggi More articles by this author , Ugo FalagarioUgo Falagario More articles by this author , Francesco GuzziFrancesco Guzzi More articles by this author , Vito ManciniVito Mancini More articles by this author , Carlo BettocchiCarlo Bettocchi More articles by this author , Gian Maria BusettoGian Maria Busetto More articles by this author , Luigi CormioLuigi Cormio More articles by this author , and Giuseppe CarrieriGiuseppe Carrieri More articles by this author View All Author Informationhttps://doi.org/10.1097/JU.0000000000003278.09AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookLinked InTwitterEmail Abstract INTRODUCTION AND OBJECTIVE: In this study we aimed to externally validate a nomogram based on MRI volumetric parameters and clinical information for deciding when SBx (Standard Biopsy) should be performed in addition to TBx (Target Biopsy)in men with suspicious prostate MRI. METHODS: We retrospectevely analysed a prospectevely mantained databes of 496 biopsy naïve men undergoing prostate biopsy with a pre-biopsy multiparametric Magnetic Resonance Imaging (mpMRI) at two institutions. Prostate MRI was performed according to PI-RADS recommendations including T1-wighted (T1WI) and T2-weighted images (T2WI), diffusion weighted images (DWI) with apparent diffusion coefficient (ADC) maps, and dyamic contrast enhances images (DCEI). Men with PIRADSsv 2.1 score of 3-5 were included. All patients underwent MRI-Ultrasound Fusion biopsy of each MRI-suspicious lesion and a fourteen-systematic biopsy according to our protocol. Lesion volume percentage was computed as the ratio of cancer volume on MRI divided the whole prostate volume. Outcomes of this study were non-clinically significant PCa (ncsPCa) (Gleason Grade Group 1) and clinically significant PCa (csPCa) (Gleason Grade Group >1). The model was evaluated with AUC (Area Under the Curve) decision curve analyses and a systematic analysis of model derived probability cut-offs in terms of number of ncsPCa diagnosis avoidance and number of csPCa diagnosed. RESULTS: The nomogram includes age, PSA value, prostate volume, PIRADSsv2.1 score, MRI-suspicion lesion volume percentage, and lesion location. The AUC was 0.73. Using different nomogram cut-offs (from 5% to 30%), 19-58% of men would avoided SBx while missing 0-10% of csPCA and avoiding detection of 6-31% of ncsPCa. These results are similar to those found in the multi-insitutional external validation study based on IMPROD trial (n=122) and MULTI-IMPROD trial (n=262). Decision Curve Analysis (DCA) shows that this nomogram increases the overall net clinical benefit when threshold probability is above 10%. CONCLUSIONS: The present study supports the potential utility of a model based on MRI volumetrics for the selection of men with a clinical suspicion of prostate cancer who would benefit of SBx in addition to TBx. Source of Funding: None © 2023 by American Urological Association Education and Research, Inc.FiguresReferencesRelatedDetails Volume 209Issue Supplement 4April 2023Page: e548 Advertisement Copyright & Permissions© 2023 by American Urological Association Education and Research, Inc.MetricsAuthor Information Antonella Ninivaggi More articles by this author Ugo Falagario More articles by this author Francesco Guzzi More articles by this author Vito Mancini More articles by this author Carlo Bettocchi More articles by this author Gian Maria Busetto More articles by this author Luigi Cormio More articles by this author Giuseppe Carrieri More articles by this author Expand All Advertisement PDF downloadLoading ...