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.

Post-Doctoral Fellow Dr. Lian Willetts shines light on the frontiers of discovery

Dr. Lian Willetts was awarded 2nd place in the Falling Walls Lab Finale in Berlin representing Dr. John Lewis’ lab by presenting: “Breaking the Walls of Prostate Cancer Metastasis”

Lab Falling Walls is an international competition that challenges graduate students to showcase how their research is redefining their respective fields and breaking down the walls to the next major scientific breakthrough. The University of Alberta is one of 20 approved international events, and the Sept. 30 event saw 16 outstanding examples of graduate research. Dr. Willetts was awarded 1st place during this night.

International Labs and the Finale in Berlin

Falling Walls Lab is a global scale event that takes place in different vibrant cities around the world throughout the year. The Falling Walls Lab Finale is held each year in Berlin on 8 November. The Finale gathers 100 participants, among them all winners of the international Labs.

- Catalina Vasquez