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Usefulness of urinary biomarker-based risk score and multiparametric MRI for clinically significant prostate cancer detection in biopsy-naïve patients

  • 0Department of Radiology, Medical Academy, Lithuanian University of Health Sciences, Mickeviciaus str. 9, Kaunas, 44307, Lithuania. jurate.kemesiene@lsmu.lt.
Abdominal Radiology (new York) +

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January 25, 2025

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January 25, 2025

View abstract on PubMed

Summary

This summary is machine-generated.

Combining genetic urinary tests (GUT) and multiparametric MRI (mpMRI) significantly improves clinically significant prostate cancer detection. This approach reduces unnecessary biopsies more effectively than other methods.

Area Of Science

  • Urology
  • Radiology
  • Oncology

Background

  • Accurate diagnosis of clinically significant prostate cancer (csPCa) is crucial for biopsy-naïve patients.
  • Multiparametric magnetic resonance imaging (mpMRI) and genetic urinary tests (GUT) are emerging diagnostic tools.
  • Risk calculators like PCPTRC2 aid in risk stratification.

Purpose Of The Study

  • To evaluate the diagnostic accuracy of mpMRI, GUT, and PCPTRC2 for csPCa in biopsy-naïve men.
  • To compare the effectiveness of these modalities, individually and in combination, in identifying csPCa.
  • To assess the potential of these methods to reduce unnecessary prostate biopsies.

Main Methods

  • Prospective study of 208 biopsy-naïve men (2021-2024).
  • Procedures included mpMRI, GUT (analyzing PCA3, TMPRSS2-ERG fusion genes, age, PSA density), and ultrasound-guided biopsy.
  • Prostate cancer prevention trial risk calculator version 2.0 (PCPTRC2) was used for risk assessment.

Main Results

  • The combination of GUT and mpMRI demonstrated superior sensitivity (99.1%) compared to individual methods (GUT 84.4%, mpMRI 93.8%).
  • mpMRI combined with PCPTRC2 also showed high sensitivity (99.0%).
  • The mpMRI plus GUT combination allowed for a greater reduction in unnecessary biopsies (25%) compared to mpMRI plus PCPTRC2 (2.4%).

Conclusions

  • Combining GUT and mpMRI offers a highly sensitive approach for diagnosing csPCa.
  • This combination significantly reduces the rate of unnecessary biopsies with a minimal risk of missing csPCa.
  • GUT and mpMRI represent a valuable strategy for optimizing prostate cancer diagnosis and management.

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