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.

Clinical Validation Trial of ClarityDX Prostate, a made-in-Alberta blood test to improve the diagnosis of Prostate Cancer

John Lewis will be presenting a seminar entitled “Clinical Validation Trial of ClarityDX Prostate, a made-in-Alberta blood test to improve the diagnosis of Prostate Cancer” at the University of Alberta Urology Grand Rounds this Friday, Feb 8, at the NAUC Auditorium. Please come out and join us for this early morning seminar, your presence is appreciated!
John will discuss the progress in the discovery and clinical validation of novel biomarkers for prostate cancer detection and prognosis. He will also give an overview of the Alberta Prostate Cancer Registry and Biorepository recruitment and future plans, and an overview and goals of the upcoming ClarityDX Prostate blood test clinical validation trial.
Date: Friday, February 8, 2019
Time: 7:00 am – 8:00 am
Location: NAUC Auditorium (7th floor) in the Kaye Edmonton Clinic
See you on Friday!

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