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risk calculator adjustment may reduce the need for repeat prostate biopsies

28 August 2018 12:23

Using a risk calculator, adjusted for MRI grade prostate cancer, can reduce the need for repeat prostate biopsies more than a third, according to researchers from the Netherlands.

Rotterdam a randomized study of screening for prostate cancer risk calculator (ERSPC-RC) helps prevent 20% to 33% of unnecessary biopsies with transrectal ultrasound guidance.

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Dr. R. Albert Arnut of the Erasmus Medical Center in Rotterdam University and his colleagues used data from 1353 men with clinical suspicion of prostate cancer, to build risk calculators, adjusted for multiparametric MRI results, age and evaluated their potential impact on the need for repeat biopsy prostate.

How to assess and age PIRADS improved ability to discriminate the original calculators risk for cancer, as well as for high-grade prostate cancer, the researchers report in European Urology.

At the threshold of risk to a biopsy of 10% or more, only 14% of biopsies could be avoided by risk calculators corrected MRI.

In contrast, using the same threshold for biopsy to earlier biopsies of men, 36% of repeat biopsies could be avoided by using the calculator with the correction of MRI, the lack of low-grade prostate cancer in 15% of men and high-grade prostate cancer in 4% of men are not killed.

"It is obvious that the percentage of potentially avoidable biopsies after an MRI depends on the composition of the cohort, and therefore, the degree of risk stratification before the MRI," - the researchers note. "Our cohort used to develop (risk calculators corrected MRI), consisted of men with a high clinical suspicion of prostate cancer, reflecting higher percentage of men with any class (51%, 491/961) and high-grade (36%, 345 / 961).

"However, the (adjusted risk calculator MRI), yet would avoid 36% of repeat biopsies in our cohort."

The authors add that external verification is still needed. Calculators are available on the Internet at http://www.prostatecancer-riskcalculator.com/, and calculators for correction of MRI are planned in the near future.

Source: https://www.medscape.com/viewarticle/901170

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