Publications

Adam Kinnaird, Wayne Brisbane, Lorna Kwan, Alan Priester, Ryan Chuang, Danielle E Barsa, Merdie Delfin, Anthony Sisk, Daniel Margolis, Ely Felker, Jim Hu, Leonard S Marks

A prostate cancer risk calculator (PCRC-MRI): Use of clinical and magnetic resonance imaging data to predict biopsy outcome in North American men

Kinnaird- 02-13-2021-A-prostate-cancer-risk-calculator_CUAJ

PMID: 34672937

DOI: 10.5489/cuaj.7380

Abstract

Introduction: A functional tool to optimize patient selection for magnetic resonance imaging (MRI)-guided prostate biopsy (MRGB) is an unmet clinical need. We sought to develop a prostate cancer risk calculator (PCRC-MRI) that combines MRI and clinical characteristics to aid decision-making for MRGB in North American men.

Methods: Two prospective registries containing 2354 consecutive men undergoing MRGB (September 2009 to April 2019) were analyzed. Patients were randomized into five groups, with one group randomly assigned to be the validation cohort against the other four groups as the discovery cohort. The primary outcome was detection of clinically significant prostate cancer (csPCa) defined as Gleason grade group ≥2. Variables included age, ethnicity, digital rectal exam (DRE), prior biopsy, prostate-specific antigen (PSA), prostate volume, PSA density, and MRI score. Odds ratios were calculated from multivariate logistic regression comparing two models: one with clinical variables only (clinical) against a second combining clinical variables with MRI data (clinical+MRI).

Results: csPCa was present in 942 (40%) of the 2354 men available for study. The positive and negative predictive values for csPCa in the clinical+MRI model were 57% and 89%, respectively. The area under the curve of the clinical+MRI model was superior to the clinical model in discovery (0.843 vs. 0.707, p<0.0001) and validation (0.888 vs. 0.757, p<0.0001) cohorts. Use of PCRC-MRI would have avoided approximately 16 unnecessary biopsies in every 100 men. Of all variables examined, Asian ethnicity was the most protective factor (odds ratio [OR] 0.46 [0.29-0.75]) while MRI score 5 indicated greatest risk (OR15.8 [10.5-23.9]).

Conclusions: A risk calculator (PCRC-MRI), based on a large North American cohort, is shown to improve patient selection for MRGB, especially in preventing unnecessary biopsies. This tool is available at https://www.uclahealth.org/urology/prostate-cancer-risk-calculator and may help rationalize biopsy decision-making.

Enbridge Ride to Conquer Cancer 2018

APCaRI members participated in the Enbridge Ride to Conquer Cancer, benefiting the Alberta Cancer Foundation, again this year! The ride is a 2-day cycling adventure that covers 200 km along the majestic Rockies. Unfortunately,  the air was so smoky from fires that the air quality health index reached 10+.  The 1800 riders rode approximately 75 km, but had to stop due to potential negative health risks from the smoke.
Although the ride was shortened it was still an amazing experience for the APCaRI member-riders and the Cross Cancer riding team. Thank you again to the amazing team of volunteers that helped to organize, set-up and transport riders to Calgary!
Most importantly, over $8 M dollars was raised to support cutting-edge cancer research in Alberta! We are very thankful for the support we received, which will help us to beat prostate cancer.
If you didn’t get a chance to support one of our riders, please consider contributing to the team’s efforts at our DONATE page

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