The Mount Sinai Prebiopsy Risk Calculator for Predicting any Prostate Cancer and Clinically Significant Prostate...

Area of Science:

• Urology
• Medical Imaging
• Oncology

Background:

• European Association of Urology guidelines advocate for imaging, biomarkers, and risk calculators in prostate cancer risk assessment.
• Risk calculators integrating multiparametric MRI and prebiopsy variables enhance individualized decision-making for at-risk patients.
• Advanced neural networking improves the reliability of prostate cancer risk prediction tools.

Purpose of the Study:

• To develop a comprehensive, web-based risk prediction tool for prostate cancer (PCa) and clinically significant PCa (csPCa).
• The tool aims to assist biopsy-naïve men, those with prior negative biopsies, prior low-grade cancer, or negative MRI.
• Utilizes magnetic resonance imaging (MRI) and clinical data for risk assessment.

Main Methods:

• Prospective data from 1902 men undergoing biopsy at Mount Sinai (October 2013-September 2021) were analyzed.
• Univariable and multivariable analyses identified predictors including PSA, MRI scores, and biopsy status.
• Validation employed advanced neural networking (ANN), the PROMOD European cohort, and the ERSPC RC 3/4 calculator.

Main Results:

• The prediction model, incorporating clinical data, achieved an 81.9% AUC for predicting any PCa and csPCa.
• External validation showed strong performance: AUCs for any PCa were 0.82 (PROMOD), 0.70 (ERSPC RC), and 0.90 (ANN).
• External validation AUCs for csPCa were 0.82 (PROMOD), 0.78 (ERSPC RC), and 0.92 (ANN).

Conclusions:

• The Mount Sinai Prebiopsy Risk Calculator (MSP-RC) effectively predicts PCa and csPCa risk across various patient scenarios.
• Validated in European cohorts and ANN, the tool demonstrates broad applicability and efficiency.
• The free, online calculator aids clinicians in patient counseling and treatment decisions.