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A urinary biomarker-based risk score correlates with multiparametric MRI for prostate cancer detection

(2017) PROSTATE. 77(14). p.1401-1407
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Abstract
Background: Prostate cancer (PCa) diagnostics would greatly benefit from more accurate, non-invasive techniques for the detection of clinically significant disease, leading to a reduction of over-diagnosis and over-treatment. The aim of this study was to determine the association between a novel urinary biomarker-based risk score (SelectMDx), multiparametric MRI (mpMRI) outcomes, and biopsy results for PCa detection. Methods: This retrospective observational study used data from the validation study of the SelectMDx score, in which urine was collected after digital rectal examination from men undergoing prostate biopsies. A subset of these patients also underwent a mpMRI scan of the prostate. The indications for performing mpMRI were based on persistent clinical suspicion of PCa or local staging after PCa was found upon biopsy. All mpMRI images were centrally reviewed in 2016 by an experienced radiologist blinded for the urine test results and biopsy outcome. The PI-RADS version 2 was used. Results: In total, 172 patients were included for analysis. Hundred (58%) patients had PCa detected upon prostate biopsy, of which 52 (52%) had high-grade disease correlated with a significantly higher SelectMDx score (P<0.01). The median SelectMDx score was significantly higher in patients with a suspicious significant lesion on mpMRI compared to no suspicion of significant PCa (P<0.01). For the prediction of mpMRI outcome, the area-under-the-curve of SelectMDx was 0.83 compared to 0.66 for PSA and 0.65 for PCA3. There was a positive association between SelectMDx score and the final PI-RADS grade. There was a statistically significant difference in SelectMDx score between PI-RADS 3 and 4 (P<0.01) and between PI-RADS 4 and 5 (P<0.01). Conclusions: The novel urinary biomarker-based SelectMDx score is a promising tool in PCa detection. This study showed promising results regarding the correlation between the SelectMDx score and mpMRI outcomes, outperforming PCA3. Our results suggest that this risk score could guide clinicians in identifying patients at risk for significant PCa and selecting patients for further radiological diagnostics to reduce unnecessary procedures.
Keywords
GENE 3 PCA3, PI-RADS GRADE, ACTIVE SURVEILLANCE, HEALTH INDEX, BIOPSY, SYSTEM, GUIDELINES, DIAGNOSIS, MEN, multiparametric MRI, prostate cancer, SelectMDx score

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Citation

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Chicago
Hendriks, Rianne J, Marloes MG van der Leest, Siebren Dijkstra, Jelle O Barentsz, Wim Van Criekinge, Christina A Hulsbergen-van de Kaa, Jack A Schalken, Peter FA Mulders, and Inge M van Oort. 2017. “A Urinary Biomarker-based Risk Score Correlates with Multiparametric MRI for Prostate Cancer Detection.” Prostate 77 (14): 1401–1407.
APA
Hendriks, R. J., van der Leest, M. M., Dijkstra, S., Barentsz, J. O., Van Criekinge, W., Hulsbergen-van de Kaa, C. A., Schalken, J. A., et al. (2017). A urinary biomarker-based risk score correlates with multiparametric MRI for prostate cancer detection. PROSTATE, 77(14), 1401–1407.
Vancouver
1.
Hendriks RJ, van der Leest MM, Dijkstra S, Barentsz JO, Van Criekinge W, Hulsbergen-van de Kaa CA, et al. A urinary biomarker-based risk score correlates with multiparametric MRI for prostate cancer detection. PROSTATE. 2017;77(14):1401–7.
MLA
Hendriks, Rianne J, Marloes MG van der Leest, Siebren Dijkstra, et al. “A Urinary Biomarker-based Risk Score Correlates with Multiparametric MRI for Prostate Cancer Detection.” PROSTATE 77.14 (2017): 1401–1407. Print.
@article{8557780,
  abstract     = {Background: Prostate cancer (PCa) diagnostics would greatly benefit from more accurate, non-invasive techniques for the detection of clinically significant disease, leading to a reduction of over-diagnosis and over-treatment. The aim of this study was to determine the association between a novel urinary biomarker-based risk score (SelectMDx), multiparametric MRI (mpMRI) outcomes, and biopsy results for PCa detection. 
Methods: This retrospective observational study used data from the validation study of the SelectMDx score, in which urine was collected after digital rectal examination from men undergoing prostate biopsies. A subset of these patients also underwent a mpMRI scan of the prostate. The indications for performing mpMRI were based on persistent clinical suspicion of PCa or local staging after PCa was found upon biopsy. All mpMRI images were centrally reviewed in 2016 by an experienced radiologist blinded for the urine test results and biopsy outcome. The PI-RADS version 2 was used. 
Results: In total, 172 patients were included for analysis. Hundred (58\%) patients had PCa detected upon prostate biopsy, of which 52 (52\%) had high-grade disease correlated with a significantly higher SelectMDx score (P{\textlangle}0.01). The median SelectMDx score was significantly higher in patients with a suspicious significant lesion on mpMRI compared to no suspicion of significant PCa (P{\textlangle}0.01). For the prediction of mpMRI outcome, the area-under-the-curve of SelectMDx was 0.83 compared to 0.66 for PSA and 0.65 for PCA3. There was a positive association between SelectMDx score and the final PI-RADS grade. There was a statistically significant difference in SelectMDx score between PI-RADS 3 and 4 (P{\textlangle}0.01) and between PI-RADS 4 and 5 (P{\textlangle}0.01). 
Conclusions: The novel urinary biomarker-based SelectMDx score is a promising tool in PCa detection. This study showed promising results regarding the correlation between the SelectMDx score and mpMRI outcomes, outperforming PCA3. Our results suggest that this risk score could guide clinicians in identifying patients at risk for significant PCa and selecting patients for further radiological diagnostics to reduce unnecessary procedures.},
  author       = {Hendriks, Rianne J and van der Leest, Marloes MG and Dijkstra, Siebren and Barentsz, Jelle O and Van Criekinge, Wim and Hulsbergen-van de Kaa, Christina A and Schalken, Jack A and Mulders, Peter FA and van Oort, Inge M},
  issn         = {0270-4137},
  journal      = {PROSTATE},
  language     = {eng},
  number       = {14},
  pages        = {1401--1407},
  title        = {A urinary biomarker-based risk score correlates with multiparametric MRI for prostate cancer detection},
  url          = {http://dx.doi.org/10.1002/pros.23401},
  volume       = {77},
  year         = {2017},
}

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