SelectMDx risk scores correlate with multiparametric MRI outcomes
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 significant lesion on mp-MRI (PI-RADS 4-5) compared to those who had no suspicion of significant prostate cancer (PI-RADS 1-2-3) (P<0.01). Moreover, a positive correlation was found between the SelectMDx risk score and the PI-RADS grade 3-4-5. The difference in SelectMDx score between PI-RADS 3 and PI-RADS 4 and between PI-RADS 4 and PI-RADS 5 was statistically significant (P<0.01). For predicting the mp-MRI outcome, the AUC of SelectMDx was 0.83 compared to 0.66 for PSA and 0.65 for PCA3.
(PI-RADS: Prostate Imaging Reporting and Data System)
What was concluded?
This study showed that SelectMDx risk scores correlate with mp-MRI outcomes and PI-RADS grading, outperforming PCA3. 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 172 patients (84% with initial biopsy) that were previously included in the SelectMDx validation study1. Urine was collected after a DRE for the SelectMDx test. Patients underwent a mp-MRI for persistent suspicion of prostate cancer after negative biopsies or for staging after finding prostate cancer on biopsy. PI-RADS v2 was used for grading the lesions in all three mp-MRI sequences (T2-weighted imaging, diffusion-weighted imaging, and dynamic contrast-enhanced imaging) using a 3 T MR scanner. All mp-MRIs were centrally reviewed by one experienced radiologist blinded for SelectMDx and biopsy outcomes.