Open AccessMRI-based nomogram for the prediction of prostate cancer diagnosis: A multi-centre validated patient–physician decision tool
Author(s) -
Edwin Chau,
Beth Russell,
Aida Santaolalla,
Mieke Van Hemelrijck,
Stuart McCracken,
Toby Page,
Sidath H. Liyanage,
Jonathan Aning,
Vincent Gnanapragasam,
Peter Acher
Publication year - 2022
Publication title -
journal of clinical urology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.192
H-Index - 10
eISSN - 2051-4166
pISSN - 2051-4158
DOI - 10.1177/20514158211065949
Subject(s) - nomogram , medicine , prostate cancer , interquartile range , logistic regression , confidence interval , cohort , prostate , biopsy , magnetic resonance imaging , prostate specific antigen , prostate biopsy , radiology , cancer
Objective: To update and externally validate a magnetic resonance imaging (MRI)-based nomogram for predicting prostate biopsy outcomes with a multi-centre cohort.Materials and methods: Prospective data from five UK-based centres were analysed. All men were biopsy naïve. Those with missing data, no MRI, or prostate-specific antigen (PSA) > 30 ng/mL were excluded. Logistic regression analysis was used to confirm predictors of prostate cancer outcomes including MRI-PIRADS (Prostate Imaging Reporting and Data System) score, PSA density, and age. Clinically significant disease was defined as International Society of Urological Pathology (ISUP) Grade Group ⩾ 2 (Gleason grade ⩾ 7). Biopsy strategy included transrectal and transperineal approaches. Nomograms were produced using logistic regression analysis results.Results: A total of 506 men were included in the analysis with median age 66 (interquartile range (IQR) = 60–69). Median PSA was 6.6 ng/mL (IQR = 4.72–9.26). PIRADS ⩾ 3 was reported in 387 (76.4%). Grade Group ⩾ 2 detection was 227 (44.9%) and 318 (62.8%) for any cancer. Performance of the MRI-based nomogram was an area under curve (AUC) of 0.84 (95% confidence interval (CI) = 0.81–0.88) for Grade Group ⩾ 2% and 0.85 (95% CI = 0.82–0.88) for any prostate cancer.Conclusion: We present external validation of a novel MRI-based nomogram in a multi-centre UK-based cohort, showing good discrimination in identifying men at high risk of having clinically significant disease. These findings support this risk calculator use in the prostate biopsy decision-making process.Level of evidence: 2c