Potential role of a novel urinary biomarker-based risk score to select patients for multiparametric MRI for prostate cancer detection

SelectMDx risk scores correlate with multiparametric MRI outcomes


Hendriks RJ et al. J Urol 2017;197(Suppl):e424 (abs MP33-17)


What was studied?

This study assessed the association between SelectMDx and multiparametric (mp)MRI outcomes.


What were the main outcomes?

The median SelectMDx risk score was statistically significantly higher in men who had a suspicious lesion on mpMRI compared to those who had a normal MRI (P<0.01). Moreover, a positive correlation was found between the SelectMDx risk score and the PI-RADS classification. The difference in SelectMDx risk scores between the different PI-RADS groups was statistically significant (P<0.001).

(PI-RADS: Prostate Imaging Reporting and Data System)


What was concluded?

This study showed that SelectMDx risk scores correlate with mpMRI outcomes and PI-RADS grading. This suggests that SelectMDx can help to select patients for further diagnostics such as MRI and identify men at risk for clinically significant prostate cancer.


How was the study performed?

This was a retrospective cohort study that included 174 patients that were previously included in the SelectMDx validation study [1]. Urine was collected after a DRE for the SelectMDx test. Patients underwent a mpMRI for persistent suspicion of prostate cancer after negative biopsies or for staging after finding prostate cancer on biopsy.


[1]  Van Neste L et al. Eur Urol 2016;70:740-8


Want to read more?

Full publication recently released: Hendriks RJ et al. Prostate 2017. doi: 10.1002/pros.23401

Editor comment

The current study evaluates one of the potential applications of the SelectMDx score in the clinical scenario. Multiparametric (mp)MRI plays an important role in the identification of patients at higher risk of harbouring clinically significant disease at prostate biopsy. Nonetheless, the use of mpMRI in all men with increased PSA levels would result into unsustainable costs for the healthcare system. Moreover, a substantial proportion of men with increased PSA levels eventually have a negative mpMRI. The integration of information coming from biomarkers such as SelectMDx and clinical parameters might play an important role for the identification of patients who are candidates for mpMRI and prostate biopsy. In particular, mpMRI could be performed exclusively in men with a higher risk of prostate cancer according to biomarker scores and clinical parameters. The current study is one of the first studies to present evidence supporting the utility of the integration of information coming from mpMRI and biomarkers in clinical practice.

Photo Dr. Giorgio Gandaglia
Dr. Giorgio Gandaglia
Vita-Salute San Raffaele University, Milan, Italy

The role of biomarker tests is important since currently many patients get a MRI before biopsy although this is often unnecessary.

Photo Prof. Christian Stief
Prof. Christian Stief
Ludwig-Maximilians-University, Munich, Germany

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