The prostate cancer prevention trial risk calculator 2.0 performs equally for standard biopsy and MRI/US fusion-guided biopsy

• Published in: Prostate cancer and prostatic diseases Vol. 20; no. 2; pp. 179 - 185
• Main Authors: Maruf, M, Fascelli, M, George, A K, Siddiqui, M M, Kongnyuy, M, DiBianco, J M, Muthigi, A, Valayil, S, Sidana, A, Frye, T P, Kilchevsky, A, Choyke, P L, Turkbey, B, Wood, B J, Pinto, P A
• Format: Journal Article
• Language: English
• Published: London Nature Publishing Group UK 01-06-2017; Nature Publishing Group
• Subjects: 692/308/53/2423; 692/53/2423; 692/699/2768/589/466; 692/699/67/2322; Aged; Biomedical and Life Sciences; Biomedicine; Biopsy; Cancer; Cancer Research; Care and treatment; Clinical trials; Diagnosis; Disease prevention; Early Detection of Cancer; Endoscopic Ultrasound-Guided Fine Needle Aspiration - methods; Health aspects; Health risks; Health screening; Humans; Image-Guided Biopsy - methods; Magnetic Resonance Imaging; Male; Mathematical analysis; Medical research; Medicine, Experimental; Middle Aged; original-article; Prevention; Prostate - diagnostic imaging; Prostate - pathology; Prostate cancer; Prostatic Neoplasms - diagnosis; Prostatic Neoplasms - diagnostic imaging; Prostatic Neoplasms - pathology; Risk Assessment; United States > US
• ISSN: 1365-7852; 1476-5608
• DOI: 10.1038/pcan.2016.46

Background:
The Prostate Cancer Prevention Trial Risk Calculator 2.0 (PCPTRC) is a widely used risk-based calculator used to assess a man’s risk of prostate cancer (PCa) before biopsy. This risk calculator was created from data of a patient cohort undergoing a 6-core sextant biopsy, and subsequently validated in men undergoing 12-core systematic biopsy (SBx). The accuracy of the PCPTRC has not been studied in patients undergoing magnetic resonance imaging/ultrasound (MRI/US) fusion-guided biopsy (FBx). We sought to assess the performance of the PCPTRC for straitifying PCa risk in a FBx cohort.
Methods:
A review of a prospective cohort undergoing MRI and FBx/SBx was conducted. Data from consecutive FBx/SBx were collected between August 2007 and February 2014, and PCPTRC scores using the PCPTRC2.0R-code were calculated. The risk of positive biopsy and high-grade cancer (Gleason ⩾7) on biopsy was calculated and compared with overall and high-grade cancer detection rates (CDRs). Receiver operating characteristic curves were generated and the areas under the curves (AUCs) were compared using DeLong’s test.
Results:
Of 595 men included in the study, PCa was detected in 39% (232) by SBx compared with 48% (287) on combined FBx/SBx biopsy. The PCPTRC AUCs for the CDR were similar (
P
=0.70) for SBx (0.69) and combined biopsy (0.70). For high-grade disease, AUCs for SBx (0.71) and combined biopsy (0.70) were slightly higher, but were not statistically different (
P
=0.55).
Conclusions:
In an MRI-screened population of men undergoing FBx, PCPTRC continues to represent a practical method of accurately stratifying PCa risk.