A novel nomogram to predict clinically significant prostate cancer in MR assisted lesion biopsies: Turkish...

Area of Science:

• Urology
• Oncology
• Radiology

Background:

• Multi-parametric MRI (mpMRI) is crucial for prostate cancer detection.
• Challenges exist in biopsy decisions for PI-RADS 3 lesions and managing PI-RADS 4/5 lesions.

Purpose of the Study:

• Develop a novel nomogram to predict clinically significant prostate cancer (csPCa).
• Enhance diagnostic accuracy for mpMRI-assisted lesion biopsies.

Main Methods:

• Retrospective case-control study using Turkish Urooncology Association Databases (UROCaD).
• Dataset included 2428 lesion biopsy data, split into training (1942) and validation (486) sets.
• Logistic regression and cross-validation were employed.

Main Results:

• Key predictors identified: PSA density, age, PI-RADS score, lesion length, and DRE findings.
• The TUA nomogram achieved an AUC of 0.836 (cross-validation), 0.827 (training), and 0.861 (validation).
• Demonstrated sensitivity of 75.6% and specificity of 74.8% at a cutoff of 24.9.

Conclusions:

• The TUA nomogram is a reliable tool for predicting csPCa in mpMRI-assisted biopsies.
• It can potentially improve patient management and reduce unnecessary biopsies.
• Supports informed decision-making for PI-RADS 3 and higher lesions.