Validation of an MRI-based prostate cancer prebiopsy Gleason score predictive nomogram
Gleason score grading is a cornerstone of risk stratification and management of patients with prostate cancer (PCa). In this work, we derive and validate a nomogram that uses prostate multiparametric magnetic resonance imaging (MP-MRI) and clinical patient characteristics to predict biopsy Gleason s...
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Veröffentlicht in: | Current urology 2022-03, Vol.16 (1), p.38-43 |
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creator | Lee, Adrianna Jiaying Wnorowski, Amelia Ye, Nancy Xu, Linhan Naslund, Michael Wood, Bradford J Merino, Maria J Turkbey, Baris Choyke, Peter L Pinto, Peter A Siddiqui, M Minhaj |
description | Gleason score grading is a cornerstone of risk stratification and management of patients with prostate cancer (PCa). In this work, we derive and validate a nomogram that uses prostate multiparametric magnetic resonance imaging (MP-MRI) and clinical patient characteristics to predict biopsy Gleason scores (bGS).
A predictive nomogram was derived from 143 men who underwent MP-MRI prior to any prostate biopsy and then validated on an independent cohort of 235 men from a different institution who underwent MP-MRI for PCa workup. Screen positive lesions were defined as lesions positive on T2W and DWI sequences on MP-MRI. Prostate specific antigen (PSA) density, number of screen positive lesions, and MRI suspicion were associated with PCa Gleason score on biopsy and were used to generate a predictive nomogram. The independent cohort was tested on the nomogram and the most likely bGS was noted.
The mean PSA in the validation cohort was 9.25ng/mL versus 6.8ng/mL in the original cohort (
= 0.001). The distribution of Gleason scores between the 2 cohorts were not significantly different (
= 0.7). In the original cohort of men, the most probable nomogram generated Gleason score agreed with actual pathologic bGS findings in 61% of the men. In the validation cohort, the most likely nomogram predicted bGS agreed with actual pathologic bGS 51% of the time. The nomogram correctly identified any PCa versus non-PCa 63% of the time and clinically significant (Gleason score ≥ 7) PCa 69% of the time. The negative predictive value for clinically significant PCa using this prebiopsy nomogram was 74% in the validation group.
A preintervention nomogram based on PSA and MRI findings can help narrow down the likely pathologic finding on biopsy. Validation of the nomogram demonstrated a significant ability to correctly identify the most likely bGS. This feasibility study demonstrates the potential of a prebiopsy prediction of bGS and based on the high negative predictive value, identification of men who may not need biopsies, which could impact future risk stratification for PCa. |
doi_str_mv | 10.1097/CU9.0000000000000069 |
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A predictive nomogram was derived from 143 men who underwent MP-MRI prior to any prostate biopsy and then validated on an independent cohort of 235 men from a different institution who underwent MP-MRI for PCa workup. Screen positive lesions were defined as lesions positive on T2W and DWI sequences on MP-MRI. Prostate specific antigen (PSA) density, number of screen positive lesions, and MRI suspicion were associated with PCa Gleason score on biopsy and were used to generate a predictive nomogram. The independent cohort was tested on the nomogram and the most likely bGS was noted.
The mean PSA in the validation cohort was 9.25ng/mL versus 6.8ng/mL in the original cohort (
= 0.001). The distribution of Gleason scores between the 2 cohorts were not significantly different (
= 0.7). In the original cohort of men, the most probable nomogram generated Gleason score agreed with actual pathologic bGS findings in 61% of the men. In the validation cohort, the most likely nomogram predicted bGS agreed with actual pathologic bGS 51% of the time. The nomogram correctly identified any PCa versus non-PCa 63% of the time and clinically significant (Gleason score ≥ 7) PCa 69% of the time. The negative predictive value for clinically significant PCa using this prebiopsy nomogram was 74% in the validation group.
A preintervention nomogram based on PSA and MRI findings can help narrow down the likely pathologic finding on biopsy. Validation of the nomogram demonstrated a significant ability to correctly identify the most likely bGS. This feasibility study demonstrates the potential of a prebiopsy prediction of bGS and based on the high negative predictive value, identification of men who may not need biopsies, which could impact future risk stratification for PCa.</description><identifier>ISSN: 1661-7649</identifier><identifier>EISSN: 1661-7657</identifier><identifier>DOI: 10.1097/CU9.0000000000000069</identifier><identifier>PMID: 35633863</identifier><language>eng</language><publisher>United States: Lippincott Williams & Wilkins</publisher><subject>Original</subject><ispartof>Current urology, 2022-03, Vol.16 (1), p.38-43</ispartof><rights>Copyright © 2022 The Authors. Published by Wolters Kluwer Health, Inc.</rights><rights>Copyright © 2022 The Authors. Published by Wolters Kluwer Health, Inc. 2022</rights><lds50>peer_reviewed</lds50><oa>free_for_read</oa><woscitedreferencessubscribed>false</woscitedreferencessubscribed><cites>FETCH-LOGICAL-c357t-bdc0a7875176e8847323aae24e200422fcdb3f3ad58d72bcd7e151eeeb53ce0a3</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktopdf>$$Uhttps://www.ncbi.nlm.nih.gov/pmc/articles/PMC9132180/pdf/$$EPDF$$P50$$Gpubmedcentral$$Hfree_for_read</linktopdf><linktohtml>$$Uhttps://www.ncbi.nlm.nih.gov/pmc/articles/PMC9132180/$$EHTML$$P50$$Gpubmedcentral$$Hfree_for_read</linktohtml><link.rule.ids>230,314,727,780,784,864,885,27924,27925,53791,53793</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/35633863$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Lee, Adrianna Jiaying</creatorcontrib><creatorcontrib>Wnorowski, Amelia</creatorcontrib><creatorcontrib>Ye, Nancy</creatorcontrib><creatorcontrib>Xu, Linhan</creatorcontrib><creatorcontrib>Naslund, Michael</creatorcontrib><creatorcontrib>Wood, Bradford J</creatorcontrib><creatorcontrib>Merino, Maria J</creatorcontrib><creatorcontrib>Turkbey, Baris</creatorcontrib><creatorcontrib>Choyke, Peter L</creatorcontrib><creatorcontrib>Pinto, Peter A</creatorcontrib><creatorcontrib>Siddiqui, M Minhaj</creatorcontrib><title>Validation of an MRI-based prostate cancer prebiopsy Gleason score predictive nomogram</title><title>Current urology</title><addtitle>Curr Urol</addtitle><description>Gleason score grading is a cornerstone of risk stratification and management of patients with prostate cancer (PCa). In this work, we derive and validate a nomogram that uses prostate multiparametric magnetic resonance imaging (MP-MRI) and clinical patient characteristics to predict biopsy Gleason scores (bGS).
A predictive nomogram was derived from 143 men who underwent MP-MRI prior to any prostate biopsy and then validated on an independent cohort of 235 men from a different institution who underwent MP-MRI for PCa workup. Screen positive lesions were defined as lesions positive on T2W and DWI sequences on MP-MRI. Prostate specific antigen (PSA) density, number of screen positive lesions, and MRI suspicion were associated with PCa Gleason score on biopsy and were used to generate a predictive nomogram. The independent cohort was tested on the nomogram and the most likely bGS was noted.
The mean PSA in the validation cohort was 9.25ng/mL versus 6.8ng/mL in the original cohort (
= 0.001). The distribution of Gleason scores between the 2 cohorts were not significantly different (
= 0.7). In the original cohort of men, the most probable nomogram generated Gleason score agreed with actual pathologic bGS findings in 61% of the men. In the validation cohort, the most likely nomogram predicted bGS agreed with actual pathologic bGS 51% of the time. The nomogram correctly identified any PCa versus non-PCa 63% of the time and clinically significant (Gleason score ≥ 7) PCa 69% of the time. The negative predictive value for clinically significant PCa using this prebiopsy nomogram was 74% in the validation group.
A preintervention nomogram based on PSA and MRI findings can help narrow down the likely pathologic finding on biopsy. Validation of the nomogram demonstrated a significant ability to correctly identify the most likely bGS. This feasibility study demonstrates the potential of a prebiopsy prediction of bGS and based on the high negative predictive value, identification of men who may not need biopsies, which could impact future risk stratification for PCa.</description><subject>Original</subject><issn>1661-7649</issn><issn>1661-7657</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2022</creationdate><recordtype>article</recordtype><recordid>eNpdUdtKw0AQXUTRWv0DkTz6Et1Lspu8CFK8FCqC2L4uk92JriTZupsK_r0prUWdl7meM8McQs4YvWS0VFeTeXlJ_5gs98iISclSJXO1v4uz8ogcx_g-TGRciENyJHIpRCHFiCwW0DgLvfNd4usEuuTxeZpWENEmy-BjDz0mBjqDYcixcn4Zv5L7BiEOiGh8wHXdOtO7T0w63_rXAO0JOaihiXi69WMyv7t9mTyks6f76eRmlhqRqz6trKGgCpUzJbEoMiW4AECeIac047w2thK1AJsXVvHKWIUsZ4hY5cIgBTEm1xve5apq0Rrs-gCNXgbXQvjSHpz-2-ncm371n7pkgrOCDgQXW4LgP1YYe926aLBpoEO_ippLxcqyyIZnjUm2GTXDX2LAereGUb2WRA-S6P-SDLDz3yfuQD8aiG-ZYIkw</recordid><startdate>20220301</startdate><enddate>20220301</enddate><creator>Lee, Adrianna Jiaying</creator><creator>Wnorowski, Amelia</creator><creator>Ye, Nancy</creator><creator>Xu, Linhan</creator><creator>Naslund, Michael</creator><creator>Wood, Bradford J</creator><creator>Merino, Maria J</creator><creator>Turkbey, Baris</creator><creator>Choyke, Peter L</creator><creator>Pinto, Peter A</creator><creator>Siddiqui, M Minhaj</creator><general>Lippincott Williams & Wilkins</general><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>7X8</scope><scope>5PM</scope></search><sort><creationdate>20220301</creationdate><title>Validation of an MRI-based prostate cancer prebiopsy Gleason score predictive nomogram</title><author>Lee, Adrianna Jiaying ; Wnorowski, Amelia ; Ye, Nancy ; Xu, Linhan ; Naslund, Michael ; Wood, Bradford J ; Merino, Maria J ; Turkbey, Baris ; Choyke, Peter L ; Pinto, Peter A ; Siddiqui, M Minhaj</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c357t-bdc0a7875176e8847323aae24e200422fcdb3f3ad58d72bcd7e151eeeb53ce0a3</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2022</creationdate><topic>Original</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Lee, Adrianna Jiaying</creatorcontrib><creatorcontrib>Wnorowski, Amelia</creatorcontrib><creatorcontrib>Ye, Nancy</creatorcontrib><creatorcontrib>Xu, Linhan</creatorcontrib><creatorcontrib>Naslund, Michael</creatorcontrib><creatorcontrib>Wood, Bradford J</creatorcontrib><creatorcontrib>Merino, Maria J</creatorcontrib><creatorcontrib>Turkbey, Baris</creatorcontrib><creatorcontrib>Choyke, Peter L</creatorcontrib><creatorcontrib>Pinto, Peter A</creatorcontrib><creatorcontrib>Siddiqui, M Minhaj</creatorcontrib><collection>PubMed</collection><collection>CrossRef</collection><collection>MEDLINE - Academic</collection><collection>PubMed Central (Full Participant titles)</collection><jtitle>Current urology</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Lee, Adrianna Jiaying</au><au>Wnorowski, Amelia</au><au>Ye, Nancy</au><au>Xu, Linhan</au><au>Naslund, Michael</au><au>Wood, Bradford J</au><au>Merino, Maria J</au><au>Turkbey, Baris</au><au>Choyke, Peter L</au><au>Pinto, Peter A</au><au>Siddiqui, M Minhaj</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Validation of an MRI-based prostate cancer prebiopsy Gleason score predictive nomogram</atitle><jtitle>Current urology</jtitle><addtitle>Curr Urol</addtitle><date>2022-03-01</date><risdate>2022</risdate><volume>16</volume><issue>1</issue><spage>38</spage><epage>43</epage><pages>38-43</pages><issn>1661-7649</issn><eissn>1661-7657</eissn><abstract>Gleason score grading is a cornerstone of risk stratification and management of patients with prostate cancer (PCa). In this work, we derive and validate a nomogram that uses prostate multiparametric magnetic resonance imaging (MP-MRI) and clinical patient characteristics to predict biopsy Gleason scores (bGS).
A predictive nomogram was derived from 143 men who underwent MP-MRI prior to any prostate biopsy and then validated on an independent cohort of 235 men from a different institution who underwent MP-MRI for PCa workup. Screen positive lesions were defined as lesions positive on T2W and DWI sequences on MP-MRI. Prostate specific antigen (PSA) density, number of screen positive lesions, and MRI suspicion were associated with PCa Gleason score on biopsy and were used to generate a predictive nomogram. The independent cohort was tested on the nomogram and the most likely bGS was noted.
The mean PSA in the validation cohort was 9.25ng/mL versus 6.8ng/mL in the original cohort (
= 0.001). The distribution of Gleason scores between the 2 cohorts were not significantly different (
= 0.7). In the original cohort of men, the most probable nomogram generated Gleason score agreed with actual pathologic bGS findings in 61% of the men. In the validation cohort, the most likely nomogram predicted bGS agreed with actual pathologic bGS 51% of the time. The nomogram correctly identified any PCa versus non-PCa 63% of the time and clinically significant (Gleason score ≥ 7) PCa 69% of the time. The negative predictive value for clinically significant PCa using this prebiopsy nomogram was 74% in the validation group.
A preintervention nomogram based on PSA and MRI findings can help narrow down the likely pathologic finding on biopsy. Validation of the nomogram demonstrated a significant ability to correctly identify the most likely bGS. This feasibility study demonstrates the potential of a prebiopsy prediction of bGS and based on the high negative predictive value, identification of men who may not need biopsies, which could impact future risk stratification for PCa.</abstract><cop>United States</cop><pub>Lippincott Williams & Wilkins</pub><pmid>35633863</pmid><doi>10.1097/CU9.0000000000000069</doi><tpages>6</tpages><oa>free_for_read</oa></addata></record> |
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title | Validation of an MRI-based prostate cancer prebiopsy Gleason score predictive nomogram |
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