JoVE - Journal of Visualized Experiments
JoVE Visualize
Contact Us

Role of the Stockholm3 Test in Guiding Confirmation Biopsy Decisions for Patients with Prostate Cancer on Active Surveillance

  • 0Department of Urology, VKV American Hospital, Istanbul, Türkiye.
European Urology Focus +

|

July 31, 2025

|

July 31, 2025

View abstract on PubMed

Summary

This summary is machine-generated.

The Stockholm3 test and multiparametric MRI (mpMRI) show high accuracy in predicting clinically significant prostate cancer (PC) in patients on active surveillance. A low Stockholm3 score and negative MRI may allow avoiding confirmatory biopsy.

Area Of Science

  • Urology
  • Oncology
  • Radiology

Background

  • Active surveillance (AS) for prostate cancer (PC) requires accurate risk stratification.
  • Distinguishing between indolent and clinically significant PC (csPC) is crucial for patient management.
  • The Stockholm3 test and multiparametric magnetic resonance imaging (mpMRI) are emerging tools for PC assessment.

Purpose Of The Study

  • To evaluate the correlation between Stockholm3 test results, mpMRI findings, and confirmation biopsy outcomes in patients with PC on AS.
  • To determine the sensitivity and negative predictive value (NPV) of the Stockholm3 test and mpMRI in predicting csPC.

Main Methods

  • A cohort of 26 patients on AS for International Society of Urological Pathology grade group (GG) 1 PC underwent repeat MRI and confirmation biopsy after a Stockholm3 test.
  • A Stockholm3 score cutoff of ≥15 was used to define higher risk of csPC.
  • Sensitivity and NPV of both tests for csPC prediction were assessed.

Main Results

  • The Stockholm3 test (cutoff ≥15) demonstrated 87.5% sensitivity and 90% NPV for predicting upgrading (GG >1 PC) on confirmatory biopsy.
  • mpMRI with PI-RADS score ≥4 had 87.5% sensitivity and 90% NPV for predicting csPC.
  • In patients with a Stockholm3 score <15, confirmatory biopsies mostly revealed GG 1 PC or benign histology.

Conclusions

  • The Stockholm3 test and mpMRI are valuable tools for risk stratification in patients with PC on AS.
  • A confirmatory biopsy is recommended for all patients with PI-RADS ≥4 lesions, regardless of Stockholm3 score.
  • Patients with negative MRI findings and a Stockholm3 score <15 may potentially avoid confirmatory biopsy.

Keywords: