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Imaging Studies IV: Magnetic Resonance Imaging01:27

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Multiparametric MRI-based 5-year Risk Prediction Model for Biochemical Recurrence of Prostate Cancer after Radical

Stefano Luzzago1, Alberto Colombo1, Francesco A Mistretta1

  • 1From the Department of Urology (S.L., F.A.M., E.D.T., M.L.P., M.F., O.D.C., G.M.), Division of Radiology (A.C., S.A., P.E.S., F.Z., M.B.), Department of Experimental Oncology (S.R., S.V.), Division of Pathology (N.F.), and Precision Imaging and Research Unit, Department of Medical Imaging and Radiation Sciences (G.P.), European Institute of Oncology (IEO), IRCCS, Via Giuseppe Ripamonti 435, 20141 Milan, Italy; Department of Oncology and Hematology-Oncology (S.L., F.A.M., N.F., O.D.C., G.M., G.P.) and Postgraduate School in Radiodiagnostics (E.R., L.D.M., E.D., A.S., R.M.), University of Milan, Milan, Italy; and Radiology and Radiotherapy Unit, Department of Precision Medicine, University of Campania L. Vanvitelli, Naples, Italy (A.C.).

Radiology
|November 21, 2023
PubMed
Summary

A new prostate cancer risk tool, PIPEN, integrates multiparametric MRI (mpMRI) data to predict 5-year biochemical recurrence (BCR) after radical prostatectomy. This model offers improved accuracy over existing tools, stratifying patients into five distinct risk categories for better treatment planning.

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Area of Science:

  • Urology
  • Radiology
  • Oncology

Background:

  • Current prostate cancer risk prediction tools lack integration of multiparametric MRI (mpMRI) data.
  • This limits their accuracy in estimating the risk of biochemical recurrence (BCR) after treatment.

Purpose of the Study:

  • To develop and validate a novel risk prediction tool incorporating mpMRI findings.
  • The tool aims to assess the risk of 5-year BCR following radical prostatectomy for prostate cancer.

Main Methods:

  • A retrospective analysis of 1459 prostate cancer patients who underwent pre-operative mpMRI.
  • Development of a multivariable Cox regression model (PIPEN) using PSA density, ISUP grade group, PI-RADS category, EPE score, and nodes.
  • Internal validation using training (70%) and test (30%) sets, with comparison to existing risk calculators.

Main Results:

  • The PIPEN model demonstrated a superior C-index (0.74) compared to existing tools (0.70) in predicting 5-year BCR.
  • Five distinct risk categories were identified, showing significant differences in 5-year BCR-free survival rates (ranging from 92% to 26%).

Conclusions:

  • The developed five-item PIPEN model, incorporating mpMRI data, accurately predicts 5-year BCR risk after radical prostatectomy.
  • This tool provides a more precise risk stratification for prostate cancer patients, aiding clinical decision-making.