Journal of Urology最新文献

{"title":"Negative Predictive Value of a Prostate MRI in Black Men: Implications for Biopsy Decision-Making.","authors":"Sarah Sandlow, Samuel Carbunaru, Zequn Sun, Bernice Ofori, Yingzhe Liu, Eric Li, Courtney M P Hollowell, Patricia Vidal, Kent T Perry, Hiten D Patel, Ryan W Dobbs, David D Casalino, Cecil G Wood, Anugayathri Jawahar, Channa Amarasekera, Jeanne M Horowitz, Frank H Miller, Emrah Gumusgoz, Ximing J Yang, Bonnie Choy, Frances Manosca, Ulas Bagci, Edward M Schaeffer, Peter Gann, Dustin D French, Ashley E Ross, Shilajit D Kundu, Adam B Murphy","doi":"10.1097/JU.0000000000004498","DOIUrl":"10.1097/JU.0000000000004498","url":null,"abstract":"<p><strong>Purpose: </strong>Prostate Imaging Reporting and Data System (PIRADS) v2.1 scoring with multiparametric (mp) MRI has a pooled 90% negative predictive value (NPV). PSA density (PSAD) ≤ 0.15 ng/mL/cm³ has been shown to enhance mpMRI's NPV in non-Black men. Populations with higher disease prevalence are known to have lower NPVs. Given that Black men have higher prostate cancer prevalence, we evaluate sensitivity and NPV of mpMRI in Black vs non-Black men to assess possible mpMRI performance differences. As an exploratory objective, we investigate PSAD thresholds providing ≥ 90% sensitivity in Black men.</p><p><strong>Materials and methods: </strong>We prospectively recruited Black and non-Black men referred to outpatient urology clinics for abnormal PSA or prostate examination in 3 similar biomarker validation studies from 2017 to 2023 before MRI-informed diagnostic prostate biopsy. We combined the research cohorts with a retrospective clinical cohort of clinically similar Black and non-Black men from 1 academic institution who also underwent mpMRIs and MRI-informed biopsies. MRIs were scored using PIRADS version 2.0 or 2.1.</p><p><strong>Results: </strong>Our analysis included 286 Black men and 965 non-Black men with PSA ≤ 15.0 ng/mL. PIRADS < 3 had an NPV of 77.1% vs 87.6% and a sensitivity of 90.7% vs 96.3% for Gleason grade group 2 to 5 prostate cancer in Black vs non-Black men, respectively (both <i>P</i> < .05). Using PSAD ≥ 0.09 for Black men with PIRADS 1 to 2 lesions increased sensitivity to 92.9%.</p><p><strong>Conclusions: </strong>PIRADS < 3 has a lower NPV and sensitivity in Black men. For negative prostate MRIs, PSAD ≥ 0.09 may be a better threshold for safe biopsy deferral in Black men to maintain a ≥ 90% sensitivity.</p>","PeriodicalId":17471,"journal":{"name":"Journal of Urology","volume":" ","pages":"713-721"},"PeriodicalIF":5.9,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12064359/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143649566","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Reply by Authors.","authors":"Jiwei Huang, Xingyun Cai, Cheoklong Ng, Yuansheng Luo, Qiong Chen, Zaoyu Wang, Keying Qiao, Wen Kong, Jin Zhang, Yonghui Chen, Wei Zhang, Jiyang Zhang, Dadong Zhang, Guangyu Wu, Haige Chen, Wei Xue","doi":"10.1097/JU.0000000000004509","DOIUrl":"10.1097/JU.0000000000004509","url":null,"abstract":"","PeriodicalId":17471,"journal":{"name":"Journal of Urology","volume":" ","pages":"750"},"PeriodicalIF":5.9,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143657544","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Editorial Comment.","authors":"Aditya Sathe, Charles Peyton","doi":"10.1097/JU.0000000000004517","DOIUrl":"10.1097/JU.0000000000004517","url":null,"abstract":"","PeriodicalId":17471,"journal":{"name":"Journal of Urology","volume":" ","pages":"751-752"},"PeriodicalIF":5.9,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143657543","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Editorial Comment.","authors":"Axel Heidenreich","doi":"10.1097/JU.0000000000004492","DOIUrl":"10.1097/JU.0000000000004492","url":null,"abstract":"","PeriodicalId":17471,"journal":{"name":"Journal of Urology","volume":" ","pages":"763"},"PeriodicalIF":5.9,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143542519","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Letter: Two-Year Efficacy and Safety Outcomes of the Pivotal OASIS Study Using the Revi System for Treatment of Urgency Urinary Incontinence.","authors":"Yuekun Fang, Shengyi Chen, Chenxiao Huang, Bin Cheng","doi":"10.1097/JU.0000000000004486","DOIUrl":"10.1097/JU.0000000000004486","url":null,"abstract":"","PeriodicalId":17471,"journal":{"name":"Journal of Urology","volume":" ","pages":"792"},"PeriodicalIF":5.9,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143523785","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Letter: Adults With Spina Bifida Fare Worse Than Young Adults: A Systemic Vulnerability in Urinary Tract Infection-Related Hospital Care: Erratum.","authors":"Wei Rao, Liangping Zhang","doi":"10.1097/JU.0000000000004514","DOIUrl":"https://doi.org/10.1097/JU.0000000000004514","url":null,"abstract":"","PeriodicalId":17471,"journal":{"name":"Journal of Urology","volume":"213 6","pages":"818"},"PeriodicalIF":5.9,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144006585","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Editorial Comment.","authors":"Lynn Stothers","doi":"10.1097/JU.0000000000004488","DOIUrl":"10.1097/JU.0000000000004488","url":null,"abstract":"","PeriodicalId":17471,"journal":{"name":"Journal of Urology","volume":" ","pages":"776"},"PeriodicalIF":5.9,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143542509","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Infection and Inflammation of the Genitourinary Tract.","authors":"J Quentin Clemens","doi":"10.1097/JU.0000000000004428","DOIUrl":"10.1097/JU.0000000000004428","url":null,"abstract":"","PeriodicalId":17471,"journal":{"name":"Journal of Urology","volume":" ","pages":"807-808"},"PeriodicalIF":5.9,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143052981","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"An Artificial Intelligence Model Using Diffusion Basis Spectrum Imaging Metrics Accurately Predicts Clinically Significant Prostate Cancer.","authors":"Eric H Kim, Huaping Jing, Kainen L Utt, Joel M Vetter, R Cody Weimholt, Arnold D Bullock, Alexandra P Klim, Karla A Bergeron, Jason K Frankel, Zachary L Smith, Gerald L Andriole, Sheng-Kwei Song, Joseph E Ippolito","doi":"10.1097/JU.0000000000004456","DOIUrl":"10.1097/JU.0000000000004456","url":null,"abstract":"<p><strong>Purpose: </strong>Conventional prostate magnetic resonance imaging has limited accuracy for clinically significant prostate cancer (csPCa). We performed diffusion basis spectrum imaging (DBSI) before biopsy and applied artificial intelligence models to these DBSI metrics to predict csPCa.</p><p><strong>Materials and methods: </strong>Between February 2020 and March 2024, 241 patients underwent prostate MRI that included conventional and DBSI-specific sequences before prostate biopsy. We used artificial intelligence models with DBSI metrics as input classifiers and the biopsy pathology as the ground truth. The DBSI-based model was compared with available biomarkers (PSA, PSA density [PSAD], and Prostate Imaging Reporting and Data System [PI-RADS]) for risk discrimination of csPCa defined as Gleason score <u>></u> 7.</p><p><strong>Results: </strong>The DBSI-based model was an independent predictor of csPCa (odds ratio [OR] 2.04, 95% CI 1.52-2.73, <i>P</i> < .01), as were PSAD (OR 2.02, 95% CI 1.21-3.35, <i>P</i> = .01) and PI-RADS classification (OR 4.00, 95% CI 1.37-11.6 for PI-RADS 3, <i>P</i> = .01; OR 9.67, 95% CI 2.89-32.7 for PI-RADS 4-5, <i>P</i> < .01), adjusting for age, family history, and race. Within our dataset, the DBSI-based model alone performed similarly to PSAD + PI-RADS (AUC 0.863 vs 0.859, <i>P</i> = .89), while the combination of the DBSI-based model + PI-RADS had the highest risk discrimination for csPCa (AUC 0.894, <i>P</i> < .01). A clinical strategy using the DBSI-based model for patients with PI-RADS 1-3 could have reduced biopsies by 27% while missing 2% of csPCa (compared with biopsy for all).</p><p><strong>Conclusions: </strong>Our DBSI-based artificial intelligence model accurately predicted csPCa on biopsy and can be combined with PI-RADS to potentially reduce unnecessary prostate biopsies.</p>","PeriodicalId":17471,"journal":{"name":"Journal of Urology","volume":" ","pages":"777-785"},"PeriodicalIF":5.9,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12064362/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143052977","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Editorial Comment.","authors":"Shomik Sengupta","doi":"10.1097/JU.0000000000004503","DOIUrl":"10.1097/JU.0000000000004503","url":null,"abstract":"","PeriodicalId":17471,"journal":{"name":"Journal of Urology","volume":" ","pages":"728-729"},"PeriodicalIF":5.9,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143625084","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}