Clinically Significant Prostate Cancer Early Detection using Risk-Organized Models (ROMs)

What is it about?

This study aimed to compare the current standard approach for early detection of clinically significant prostate cancer (csPCa) with a risk-organized model (ROM) designed to avoid unnecessary magnetic resonance imaging (mpMRI) exams and prostate biopsies. The ROM was designed for men with serum prostate-specific antigen (PSA) over 10.0 ng/mL and abnormal digital rectal examination (DRE), as well as for men in whom the risk of csPCa from the Barcelona-risk calculator 1 (BCN-RC 1) is lower than 12%. The study recruited 946 men with serum PSA > 3.0 ng/mL and/or abnormal DRE and found that the ROM would rule out 30.8% of mpMRI exams and 28.2% of prostate biopsies, while 6.7% of overall csPCa would be undetected. The study was funded by the Instituto de Salut Carlos III and the European Union.

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Why is it important?

The research focuses on the early detection of clinically significant prostate cancer (csPCa) through multiparametric magnetic resonance imaging (mpMRI) and the use of risk-organised models (ROMs) to avoid unnecessary exams and biopsies. Key Takeaways: 1. The traditional standard approach for early detection of csPCa involves MRI-targeted biopsies when PI-RADS lesions are ‚â•3 and systematic biopsy. 2. A new ROM has been designed to avoid mpMRI exams in men with serum PSA over 10.0 ng/mL and abnormal DRE, as well as rule out mpMRI exams when the risk of csPCa from the BCN-RC 1 is lower than 12%. 3. The study aimed to compare the current standard approach with the proposed ROM and found that the ROM would rule out 30.8% of mpMRI exams and 28.2% of prostate biopsies, while missing 6.7% of overall csPCa.