Related Experiment Video
Updated: Jan 4, 2026
Use of Magnetic Resonance Imaging and Biopsy Data to Guide Sampling Procedures for Prostate Cancer Biobanking
Published on: October 10, 2019
Incorporating mpMRI biopsy data into established pre-RP nomograms: potential impact of an increasingly common
Joon Yau Leong1, Jaime O Herrera-Caceres2, Hanan Goldberg2
1Department of Urology, Sidney Kimmel Cancer Center, Thomas Jefferson University, Philadelphia PA, USA.
Background:
We examine the practical application of multiparametric MRI (mpMRI) prostate biopsy data using established pre-RP nomograms and its potential implications on RP intraoperative decision-making. We hypothesize that current nomograms are suboptimal in predicting outcomes with mpMRI targeted biopsy (TBx) data.
Materials And Methods:
Patients who underwent mpMRI-based TBx prior to RP were assessed using the MSKCC and Briganti nomograms with the following iterations: (1) Targeted (T) (targeted only), (2) Targeted and Systematic (TS) and (3) Targeted Augmented (TA) (targeted core data; assumed negative systematic cores for 12 total cores). Nomogram outcomes, lymph node involvement (LNI), extracapsular extension (ECE), organ-confined disease (OCD), seminal vesicle invasion (SVI), were compared across iterations. Clinically significant impact on management was defined as a change in LNI risk above or below 2% (Δ2) or 5% (Δ5).
Results:
A total of 217 men met inclusion criteria. Overall, the TA iteration had more conservative nomogram outcomes than the T. Moreover, TA better predicted RP pathology for all four outcomes when compared with the T. In the entire cohort, Δ2 and Δ5 were 16.6-25.8% and 20.3-39.2%, respectively. In the subset of 190 patients with targeted and systematic cores, TA was a better approximation of TS outcomes than T in 71% (MSKCC) and 82% (Briganti) of patients.
Conclusion:
In established pre-RP nomograms, mpMRI-based TBx often yield variable and discordant results when compared with systematic biopsies. Future nomograms must better incorporate mpMRI TBx core data. In the interim, augmenting TBx data may serve to bridge the gap.
Insights
Established prostate cancer nomograms struggle to accurately predict outcomes using multiparametric MRI (mpMRI) targeted biopsy (TBx) data. Augmenting TBx data may improve prediction accuracy for better surgical planning.
Area of Science:
- Urology
- Oncology
- Radiology
Background:
- Established prostate cancer nomograms are frequently used for pre-operative risk stratification.
- Multiparametric MRI (mpMRI) targeted biopsy (TBx) is increasingly utilized, but its integration into existing nomograms is challenging.
- Current nomograms may be suboptimal in predicting outcomes based on mpMRI TBx data.
Purpose of the Study:
- To evaluate the practical application of mpMRI TBx data in established pre-operative nomograms.
- To assess the implications of mpMRI TBx data on intraoperative decision-making during radical prostatectomy (RP).
- To determine if current nomograms accurately predict outcomes with mpMRI TBx data.
Main Methods:
- Retrospective analysis of 217 patients undergoing mpMRI-based TBx before RP.
- Application of MSKCC and Briganti nomograms using three iterations: Targeted (T), Targeted and Systematic (TS), and Targeted Augmented (TA).
- Comparison of nomogram outcomes (lymph node involvement, extracapsular extension, organ-confined disease, seminal vesicle invasion) across iterations.
Main Results:
- The Targeted Augmented (TA) iteration demonstrated more conservative nomogram outcomes and better prediction of RP pathology compared to the Targeted (T) iteration.
- Significant clinical impact on management was observed, with changes in lymph node involvement risk (Δ2 and Δ5) ranging from 16.6-39.2%.
- In patients with both targeted and systematic cores, TA approximated TS outcomes more accurately than T in 71-82% of cases.
Conclusions:
- mpMRI-based TBx data often yield variable and discordant results when incorporated into established pre-operative nomograms.
- Future nomograms require better integration of mpMRI TBx core data for improved accuracy.
- Augmenting targeted biopsy data can serve as an interim solution to bridge the gap in predictive accuracy.
More Related Videos
06:46Competing-Risk Nomogram for Predicting Cancer-Specific Survival in Multiple Primary Colorectal Cancer Patients after Surgery
Published on: September 27, 2024
12:22The Use of Reverse Phase Protein Arrays RPPA to Explore Protein Expression Variation within Individual Renal Cell Cancers
Published on: January 22, 2013
