Emmett, Louise; Papa, Nathan; Hope, Thomas A; Fendler, Wolfgang; Calais, Jeremie; Burger, Irene; Eiber, Matthias; ... Murphy, Declan; + view all Emmett, Louise; Papa, Nathan; Hope, Thomas A; Fendler, Wolfgang; Calais, Jeremie; Burger, Irene; Eiber, Matthias; Barbato, Francesco; Moon, Daniel; Counter, William; John, Nikeith; Xue, Alan; Franklin, Anthony; Thompson, James; Rasiah, Kris; Frydenberg, Mark; Yaxley, John; Buteau, James; Agrawal, Shikha; Ho, Bao; Nguyen, Andrew; Liu, Victor; Lee, Jonathan; Woo, Henry; Hsiao, Edward; Sutherland, Thomas; Perry, Elyse; Stricker, Phillip; Hofman, Michael S; Kasivisvanathan, Veeru; Roberts, Matthew; Murphy, Declan; - view fewer (2024) Beyond Prostate Imaging Reporting and Data System: Combining Magnetic Resonance Imaging Prostate Imaging Reporting and Data System and Prostate-Specific Membrane Antigen–Positron Emission Tomography/Computed Tomography PRIMARY Score in a Composite (P) Score for More Accurate Diagnosis of Clinically Significant Prostate Cancer. The Journal of Urology (Supp) 10.1097/JU.0000000000004010. (In press).

Text Kasivisvanathan_Mauscript final accepted version.pdf Access restricted to UCL open access staff until 22 May 2025. Download (162kB)

Abstract

Purpose: The Prostate Imaging Reporting and Data System (PI-RADS) score is standard of care for clinically significant prostate cancer (csPCa) diagnosis. The PRIMARY score (prostate-specific membrane antigen [PSMA]–positron emission tomography [PET]/CT) also has high diagnostic accuracy for csPCa. This study aimed to develop an easily calculated combined (P) score for csPCa detection (International Society of Urological Pathology [ISUP] ≥2) incorporating separately read PI-RADS and PRIMARY scores, with external validation.// Materials and Methods: Two datasets of men with suspected PCa, no prior biopsy, recent MRI and 68Ga-PSMA-11-PET/CT, and subsequent transperineal biopsy were evaluated. The development sample (n = 291, 56% csPCa) a prospective trial and the validation sample (n = 227, 67% csPCa) a multicenter retrospective database. Primary outcome was detection of csPCa (ISUP ≥2), with ISUP ≥ 3 cancer detection a secondary outcome. Score performance was evaluated by area under the curve, sensitivity, specificity, and decision curve analysis.// Results: The 5-point combined (P) score was developed in a prospective dataset. In the validation dataset, csPCa was identified in 0%, 20%, 52%, 96%, and 100% for P score 1 to 5. The area under the curve was 0.93 (95% CI: 0.90-0.96), higher than PI-RADS 0.89 (95% CI: 0.85-0.93, P = .039) and PRIMARY score alone 0.84 (95% CI: 0.79-0.89, P < .001). Splitting scores at 1/2 (negative) vs 3/4/5 (positive), P score sensitivity was 94% (95% CI: 89-97) compared to PI-RADS 89% (95% CI: 83-93) and PRIMARY score 86% (95% CI: 79-91). For ISUP ≥ 3, P score sensitivity was 99% (95% CI: 95-100) vs 94% (95% CI: 88-98) and 92% (95% CI: 85-97) for PI-RADS and PRIMARY scores respectively. A maximum standardized uptake value > 12 (P score 5) was ISUP ≥ 2 in all cases with 93% ISUP ≥ 3.// Conclusions: The P score is easily calculated and improves accuracy for csPCa over both PI-RADS and PRIMARY scores. It should be considered when PSMA-PET is undertaken for diagnosis.

Download activity - last month

Export as XMLJSONCSV

Download activity - last 12 months

Export as CSVXMLJSON

Downloads by country - last 12 months

Export as XMLJSONCSV

Archive Staff Only

View Item