Using biomarkers in patients with positive multiparametric magnetic resonance imaging: 4Kscore predicts the presence of cancer outside the index lesion - UTU Research Portal

A1 Refereed original research article in a scientific journal

Using biomarkers in patients with positive multiparametric magnetic resonance imaging: 4Kscore predicts the presence of cancer outside the index lesion

Authors: Ugo Giovanni Falagario, Anna Lantz, Ivan Jambor, Alberto Martini, Parita Ratnani, Vinayak Wagaskar, Patrick-Julien Treacy, Alessandro Veccia, Carlo Andrea Bravi, Hafis O Bashorun, Deron Phillip, Sara Lewis, Kenneth Haines, Luigi Cormio, Giuseppe Carrieri, Ash Tewari

Publisher: WILEY

Publication year: 2020

Journal: International Journal of Urology

Journal name in source: INTERNATIONAL JOURNAL OF UROLOGY

Journal acronym: INT J UROL

Volume: 28

Issue: 1

Number of pages: 6

ISSN: 0919-8172

eISSN: 1442-2042

DOI: https://doi.org/10.1111/iju.14385

Abstract

Objectives To evaluate if the blood biomarker, 4Kscore, in addition to multiparametric magnetic resonance imaging information could identify patients who would benefit from undergoing only a targeted biopsy. Methods We retrospectively analyzed a population of 256 men with positive multiparametric magnetic resonance imaging who underwent standard + targeted biopsy at Mount Sinai Hospital, New York, NY, USA. 4Kscore (OPKO Health, Miami, FL, USA) was sampled from all patients before biopsy. Uni- and multivariable binary logistic regression analyses were carried out to predict clinically significant prostate cancer, defined as International Society of Urological Pathology grade group >= 2, in standard biopsy cores. The model with the best area under the curve was selected and internal validation was carried out using the leave-one-out cross-validation. Results The developed model showed an area under the curve of 0.86. Carrying out only targeted biopsy in patients with a model-derived probability <12.5% resulted in 39.5% (n = 101) fewer standard biopsies and a 33.9% (n = 20) reduction of detecting grade group 1 disease, while missing grade group >= 2 in 5.2% (n = 4) using standard biopsy only and 1.1% (n = 1) using standard biopsy + targeted biopsy. Conclusions 4Kscore in combination with multiparametric magnetic resonance imaging can help to reduce unnecessary standard biopsy and decrease detection of clinically insignificant prostate cancer.