ArticleCancers2025
A Simple Nomogram to Predict Clinically Significant Prostate Cancer at MRI-Guided Biopsy in Patients with Mild PSA Elevation and Normal DRE.
Article in Cancers, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 1 paper.
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1 citing paper in PubMed.
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12 authors.
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No grant is acknowledged in the PubMed record.
Abstract
backgroundEvidence to help avoid unnecessary prostate biopsies is being actively pursued. Our goal was to develop and internally validate a nomogram for predicting clinically significant prostate cancer (csPC) in men with low suspicion of disease (prostate specific antigen [PSA] < 10 ng/mL, normal digital rectal examination [DRE]), in whom magnetic resonance imaging (MRI) findings are positive.
methodsPatients with no prior prostate cancer diagnosis who underwent MRI-ultrasound fusion biopsy of the prostate were retrospectively analyzed. Inclusion criteria were PSA < 10 ng/mL, normal DRE, Prostate Imaging Reporting And Data System (PIRADS) category ≥ 3, and no extraprostatic extension or seminal vesicle invasion reported on MRI. Associations between csPC diagnosis and patient or lesion characteristics were analyzed, and a multivariable model was developed. Internal validation of the model with 5-fold cross-validation and bootstrapping methods was performed.
resultsAmong 209 patients, 67 were diagnosed with csPC. Factors incorporated into the model for predicting csPC were age, 5-alpha reductase inhibitor use, PSA, prostate volume, PIRADS > 3, and lesion location in the peripheral zone. The model's ROC AUC was 0.86, with consistent performance at internal validation (0.84 with cross-validation, 0.82 with bootstrapping). With an empirical threshold of <10% csPC probability to omit biopsy, 72 (50.7%) unnecessary biopsies would have been avoided, at the cost of missing 2 (3.0%) csPC cases.
conclusionsOur nomogram might serve as a valuable tool in refining selection criteria in men considered for prostate biopsy. The major limitation of the study is its retrospective character. Prospective, external validation of the model is warranted.
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