Multiparametric MRI SelectMDx Accuracy in the Diagnosis of Clinically Significant PCa in Men Enrolled in Active Surveillance

Overview

Journal In Vivo

Specialty Oncology

Date 2019 Dec 29

PMID 31882504

Citations 15

Authors

Pietro Pepe

Giuseppe Dibenedetto

Ludovica Pepe

Michele Pennisi

Affiliations

Soon will be listed here.

Abstract

Background/aim: To evaluate the diagnostic accuracy of the urinary SelectMDx test in the diagnosis of clinically significant prostate cancer (csPCa) in men enrolled in an active surveillance (AS) protocol.

Patients And Methods: From July 2015 to July 2018, 125 men with very low-risk PCa were enrolled in the AS protocol; all patients underwent confirmatory transperineal saturation biopsy (SPBx). In the presence of PI-RADS score ≥3, a targeted MRI/TRUS fusion-guided biopsy was added to SPBx. Post-digital rectal examination urine was collected in 45/125 (36%) patients before SPBx; the genetic urine analysis was performed using a biomarker-based risk score model, the SelectMDx, that measured mRNA levels of distal-less homeobox 1 (DLX1) and homeobox C6 (HOXC6).

Results: A total of 9/45 (20%) patients were reclassified as csPCa (7 cases=Grade Group 2; 2 cases=Grade Group 3); sensitivity, specificity, positive predictive value, negative predictive value and diagnostic accuracy of mpMRI vs. SelectMDx in the diagnosis of csPCa were equal to 66.6 vs. 55.6%, 87.7 vs. 65.8%, 54.5 vs. 27.8%, 92.3 vs. 87%, 84.9 vs. 70.3%, respectively.

Conclusion: SPBx combined with MRI/TRUS fusion biopsy significantly outperformed the diagnostic accuracy of SelectMDx (70.3%) in the diagnosis of csPCa in men enrolled in AS.

Citing Articles

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A meta-analysis for the diagnostic accuracy of SelectMDx in prostate cancer.

Wu H, Wu Y, He P, Liang J, Xu X, Ji C PLoS One. 2024; 19(2):e0285745.

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Xu G, Li J, Xiang L, Yang B, Chen Y, Sun Y Asian J Androl. 2022; 25(3):410-415.

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References

Leyten G, Hessels D, Jannink S, Smit F, de Jong H, Cornel E . Prospective multicentre evaluation of PCA3 and TMPRSS2-ERG gene fusions as diagnostic and prognostic urinary biomarkers for prostate cancer. Eur Urol. 2012; 65(3):534-42. DOI: 10.1016/j.eururo.2012.11.014. View

Alberts A, Roobol M, Verbeek J, Schoots I, Chiu P, Osses D . Prediction of High-grade Prostate Cancer Following Multiparametric Magnetic Resonance Imaging: Improving the Rotterdam European Randomized Study of Screening for Prostate Cancer Risk Calculators. Eur Urol. 2018; 75(2):310-318. DOI: 10.1016/j.eururo.2018.07.031. View

Tan G, Nason G, Ajib K, Woon D, Herrera-Caceres J, Alhunaidi O . Smarter screening for prostate cancer. World J Urol. 2019; 37(6):991-999. DOI: 10.1007/s00345-019-02719-5. View

Hamid A, Hoogland A, Smit F, Jannink S, van Rijt-van de Westerlo C, Jansen C . The role of HOXC6 in prostate cancer development. Prostate. 2015; 75(16):1868-76. DOI: 10.1002/pros.23065. View

Drost F, Nieboer D, Morgan T, Carroll P, Roobol M . Predicting Biopsy Outcomes During Active Surveillance for Prostate Cancer: External Validation of the Canary Prostate Active Surveillance Study Risk Calculators in Five Large Active Surveillance Cohorts. Eur Urol. 2019; 76(5):693-702. DOI: 10.1016/j.eururo.2019.07.041. View

Haese A, Trooskens G, Steyaert S, Hessels D, Brawer M, Vlaeminck-Guillem V . Multicenter Optimization and Validation of a 2-Gene mRNA Urine Test for Detection of Clinically Significant Prostate Cancer before Initial Prostate Biopsy. J Urol. 2019; 202(2):256-263. DOI: 10.1097/JU.0000000000000293. View

Pepe P, Garufi A, Priolo G, Candiano G, Pietropaolo F, Pennisi M . Prostate cancer detection at repeat biopsy: can pelvic phased-array multiparametric MRI replace saturation biopsy?. Anticancer Res. 2013; 33(3):1195-9. View

Pepe P, Pennisi M . Prostate Cancer Diagnosis and Management Across Twenty Years of Clinical Practice: A Single-center Experience on 2,500 Cases. Anticancer Res. 2019; 39(3):1397-1401. DOI: 10.21873/anticanres.13254. View

Robert G, Jannink S, Smit F, Aalders T, Hessels D, Cremers R . Rational basis for the combination of PCA3 and TMPRSS2:ERG gene fusion for prostate cancer diagnosis. Prostate. 2012; 73(2):113-20. DOI: 10.1002/pros.22546. View

10.

Pepe P, Garufi A, Priolo G, Pennisi M . Can MRI/TRUS fusion targeted biopsy replace saturation prostate biopsy in the re-evaluation of men in active surveillance?. World J Urol. 2015; 34(9):1249-53. DOI: 10.1007/s00345-015-1749-3. View

11.

Raja N, Russell C, George A . Urinary markers aiding in the detection and risk stratification of prostate cancer. Transl Androl Urol. 2018; 7(Suppl 4):S436-S442. PMC: 6178315. DOI: 10.21037/tau.2018.07.01. View

12.

Pepe P, Pepe G, Pepe L, Garufi A, Priolo G, Pennisi M . Cost-effectiveness of Multiparametric MRI in 800 Men Submitted to Repeat Prostate Biopsy: Results of a Public Health Model. Anticancer Res. 2018; 38(4):2395-2398. DOI: 10.21873/anticanres.12489. View

13.

Osses D, Roobol M, Schoots I . Prediction Medicine: Biomarkers, Risk Calculators and Magnetic Resonance Imaging as Risk Stratification Tools in Prostate Cancer Diagnosis. Int J Mol Sci. 2019; 20(7). PMC: 6480079. DOI: 10.3390/ijms20071637. View

14.

Kearns J, Lin D . Improving the Specificity of PSA Screening with Serum and Urine Markers. Curr Urol Rep. 2018; 19(10):80. DOI: 10.1007/s11934-018-0828-6. View

15.

Leyten G, Hessels D, Smit F, Jannink S, de Jong H, Melchers W . Identification of a Candidate Gene Panel for the Early Diagnosis of Prostate Cancer. Clin Cancer Res. 2015; 21(13):3061-70. DOI: 10.1158/1078-0432.CCR-14-3334. View

16.

Bhat A, Ritch C . Urinary biomarkers in bladder cancer: where do we stand?. Curr Opin Urol. 2019; 29(3):203-209. DOI: 10.1097/MOU.0000000000000605. View

17.

Pepe P, Garufi A, Priolo G, Galia A, Fraggetta F, Pennisi M . Is it Time to Perform Only Magnetic Resonance Imaging Targeted Cores? Our Experience with 1,032 Men Who Underwent Prostate Biopsy. J Urol. 2018; 200(4):774-778. DOI: 10.1016/j.juro.2018.04.061. View

18.

Dijkstra S, Govers T, Hendriks R, Schalken J, Van Criekinge W, Van Neste L . Cost-effectiveness of a new urinary biomarker-based risk score compared to standard of care in prostate cancer diagnostics - a decision analytical model. BJU Int. 2017; 120(5):659-665. DOI: 10.1111/bju.13861. View

19.

Pepe P, Cimino S, Garufi A, Priolo G, Russo G, Giardina R . Confirmatory biopsy of men under active surveillance: extended versus saturation versus multiparametric magnetic resonance imaging/transrectal ultrasound fusion prostate biopsy. Scand J Urol. 2017; 51(4):260-263. DOI: 10.1080/21681805.2017.1313310. View

20.

Zhao F, Vesprini D, Liu R, Olkhov-Mitsel E, Klotz L, Loblaw A . Combining urinary DNA methylation and cell-free microRNA biomarkers for improved monitoring of prostate cancer patients on active surveillance. Urol Oncol. 2019; 37(5):297.e9-297.e17. DOI: 10.1016/j.urolonc.2019.01.031. View