PD11-08 A COMBINED BIOMARKER/MPMRI APPROACH PROVIDES ENHANCED CLINICAL INFORMATION PRIOR TO PROSTATE BIOPSY

Abstract

You have accessJournal of UrologyCME1 May 2022PD11-08 A COMBINED BIOMARKER/MPMRI APPROACH PROVIDES ENHANCED CLINICAL INFORMATION PRIOR TO PROSTATE BIOPSY Alexander Kretschmer, Johan Skog, Christian Fischer, Jason Alter, and Mikkel Noerholm Alexander KretschmerAlexander Kretschmer More articles by this author , Johan SkogJohan Skog More articles by this author , Christian FischerChristian Fischer More articles by this author , Jason AlterJason Alter More articles by this author , and Mikkel NoerholmMikkel Noerholm More articles by this author View All Author Informationhttps://doi.org/10.1097/JU.0000000000002537.08AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookLinked InTwitterEmail Abstract INTRODUCTION AND OBJECTIVE: The ExoDx Prostate (EPI) test has been well validated for prostate cancer (PC) biopsy decisions. Here we investigate combining MRI with EPI from patients pre-staged by MRI prior to biopsy (Bx). METHODS: Pre-Bx urine was collected from men with no history of PC, aged ≥50 years, with a PSA 2-10 ng/mL, who were previously staged with MRI. Bx was performed when PIRADs ≥3 at a single site (LMU). A subset of men had radical prostatectomy (RP). For analysis of MRI and biomarker models, the RP result when available, was utilized to enable more accurate tissue status. RESULTS: Of the 170 patient samples collected, MRI status was available for 168 patients, 160 had an EPI result, 143 underwent Bx and 40 men proceeded to RP. PIRADS scores encompassed PIRADS 1/2 in 24 (14%) patients, PIRADS 3 in 32 (19%), and PIRADS 4/5 in 112 (67%). Bx pathology indicated 35.2% ≥GG2 and 72.5% in the RP group. Both higher Gleason Grade groups (GG) and higher EPI Scores increased with higher PIRADS Score as shown in Figure 1. A new model was generated by combining the EPI score and MRI result (training (N=116) and test (N=29), resulting in an increased AUC (0.88) compared to either EPI (0.68) or MRI alone (0.75). CONCLUSIONS: The combination of MRI and EPI is better than either alone and suggests that this combined approach is more clinically useful when conducted before the Bx decision. Source of Funding: Study was funded by Exosome Diagnostics, Waltham, MA, USA © 2022 by American Urological Association Education and Research, Inc.FiguresReferencesRelatedDetails Volume 207Issue Supplement 5May 2022Page: e193 Advertisement Copyright & Permissions© 2022 by American Urological Association Education and Research, Inc.MetricsAuthor Information Alexander Kretschmer More articles by this author Johan Skog More articles by this author Christian Fischer More articles by this author Jason Alter More articles by this author Mikkel Noerholm More articles by this author Expand All Advertisement PDF DownloadLoading ...