在前列腺活检的多参数磁共振成像中加入基于外泌体的前列腺智能成像的价值:回顾性分析

Uro Pub Date : 2024-05-08 DOI:10.3390/uro4020005
Noah King, Jacob Lang, Sree Jambunathan, Conner V Lombardi, Barbara Saltzman, Nadiminty Nagalakshmi, P. Sindhwani
{"title":"在前列腺活检的多参数磁共振成像中加入基于外泌体的前列腺智能成像的价值:回顾性分析","authors":"Noah King, Jacob Lang, Sree Jambunathan, Conner V Lombardi, Barbara Saltzman, Nadiminty Nagalakshmi, P. Sindhwani","doi":"10.3390/uro4020005","DOIUrl":null,"url":null,"abstract":"Introduction: Currently, there is limited evidence for the relationship of Exosome-based Prostate Intelliscore (EPI) and multiparametric magnetic resonance imaging (mpMRI) in stratifying risk for clinically significant prostate cancer. Using a retrospective cohort study design, we sought to characterize the relationship between these two noninvasive metrics and prostate biopsy outcome. Methods: Data were collected via electronic medical record for all patients who underwent EPI testing from 1 January 2019 to 3 February 2022 and had available medical records at a single mid-western university medical center. Positive test result was defined as >15.6 for EPI, ≥3 PI-RADS score and ≥3 + 4 Gleason Score for biopsy findings. Utility of EPI, mpMRI and combined use was characterized through calculation of sensitivity, specificity, positive predictive value, negative predictive value, and ROC analysis. Results: A total of 226 patients were identified as receiving EPI testing for risk stratification of clinically significant prostate cancer. Sensitivity for EPI was 91%, mpMRI was 90%, and the highest was combined use at 96%. With ROC analysis, AUC for EPI alone was 0.57 (95% CI, 0.47–0.67) and 0.78 (95% CI, 0.70–0.87) for mpMRI alone. With prior positive EPI result, AUC for combined use with mpMRI was 0.80 (95% CI, 0.71–0.89). Further subgroup analysis resulted in increased AUC values of EPI 0.67 (95% CI, 0.48–0.87), mpMRI 0.90 (95% CI, 0.76–1.0), and combined 0.90 (95% CI, 0.75–1.0) in the African American population. Discussion: We observed that the combined use of EPI and mpMRI led to an avoided biopsy in 43% of patients. Using both parameters increased the overall sensitivity and diagnostic accuracy in detecting clinically significant prostate cancer. The best test performance was observed in the African American cohort. Identifying optimal noninvasive tools to assess risk for prostate cancer is crucial to providing accurate and cost-effective care. Future study should utilize a prospective study design to further support the combined use of these metrics.","PeriodicalId":515815,"journal":{"name":"Uro","volume":" 27","pages":""},"PeriodicalIF":0.0000,"publicationDate":"2024-05-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":"{\"title\":\"The Value of Adding Exosome-Based Prostate Intelliscore to Multiparametric Magnetic Resonance Imaging in Prostate Biopsy: A Retrospective Analysis\",\"authors\":\"Noah King, Jacob Lang, Sree Jambunathan, Conner V Lombardi, Barbara Saltzman, Nadiminty Nagalakshmi, P. Sindhwani\",\"doi\":\"10.3390/uro4020005\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"Introduction: Currently, there is limited evidence for the relationship of Exosome-based Prostate Intelliscore (EPI) and multiparametric magnetic resonance imaging (mpMRI) in stratifying risk for clinically significant prostate cancer. Using a retrospective cohort study design, we sought to characterize the relationship between these two noninvasive metrics and prostate biopsy outcome. Methods: Data were collected via electronic medical record for all patients who underwent EPI testing from 1 January 2019 to 3 February 2022 and had available medical records at a single mid-western university medical center. Positive test result was defined as >15.6 for EPI, ≥3 PI-RADS score and ≥3 + 4 Gleason Score for biopsy findings. Utility of EPI, mpMRI and combined use was characterized through calculation of sensitivity, specificity, positive predictive value, negative predictive value, and ROC analysis. Results: A total of 226 patients were identified as receiving EPI testing for risk stratification of clinically significant prostate cancer. Sensitivity for EPI was 91%, mpMRI was 90%, and the highest was combined use at 96%. With ROC analysis, AUC for EPI alone was 0.57 (95% CI, 0.47–0.67) and 0.78 (95% CI, 0.70–0.87) for mpMRI alone. With prior positive EPI result, AUC for combined use with mpMRI was 0.80 (95% CI, 0.71–0.89). Further subgroup analysis resulted in increased AUC values of EPI 0.67 (95% CI, 0.48–0.87), mpMRI 0.90 (95% CI, 0.76–1.0), and combined 0.90 (95% CI, 0.75–1.0) in the African American population. Discussion: We observed that the combined use of EPI and mpMRI led to an avoided biopsy in 43% of patients. Using both parameters increased the overall sensitivity and diagnostic accuracy in detecting clinically significant prostate cancer. The best test performance was observed in the African American cohort. Identifying optimal noninvasive tools to assess risk for prostate cancer is crucial to providing accurate and cost-effective care. Future study should utilize a prospective study design to further support the combined use of these metrics.\",\"PeriodicalId\":515815,\"journal\":{\"name\":\"Uro\",\"volume\":\" 27\",\"pages\":\"\"},\"PeriodicalIF\":0.0000,\"publicationDate\":\"2024-05-08\",\"publicationTypes\":\"Journal Article\",\"fieldsOfStudy\":null,\"isOpenAccess\":false,\"openAccessPdf\":\"\",\"citationCount\":\"0\",\"resultStr\":null,\"platform\":\"Semanticscholar\",\"paperid\":null,\"PeriodicalName\":\"Uro\",\"FirstCategoryId\":\"1085\",\"ListUrlMain\":\"https://doi.org/10.3390/uro4020005\",\"RegionNum\":0,\"RegionCategory\":null,\"ArticlePicture\":[],\"TitleCN\":null,\"AbstractTextCN\":null,\"PMCID\":null,\"EPubDate\":\"\",\"PubModel\":\"\",\"JCR\":\"\",\"JCRName\":\"\",\"Score\":null,\"Total\":0}","platform":"Semanticscholar","paperid":null,"PeriodicalName":"Uro","FirstCategoryId":"1085","ListUrlMain":"https://doi.org/10.3390/uro4020005","RegionNum":0,"RegionCategory":null,"ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"","JCRName":"","Score":null,"Total":0}
引用次数: 0

摘要

简介:目前,关于基于外泌体的前列腺内窥镜(EPI)和多参数磁共振成像(mpMRI)在对有临床意义的前列腺癌进行风险分层方面的关系的证据还很有限。我们采用回顾性队列研究设计,试图描述这两种无创指标与前列腺活检结果之间的关系。研究方法我们通过电子病历收集了 2019 年 1 月 1 日至 2022 年 2 月 3 日期间接受 EPI 检测的所有患者的数据,这些患者在一家中西部大学医疗中心都有医疗记录。检测结果阳性的定义是 EPI >15.6,PI-RADS 评分≥3,活检结果的格里森评分≥3 + 4。通过计算灵敏度、特异性、阳性预测值、阴性预测值和 ROC 分析,确定 EPI、mpMRI 和联合使用的效用。结果:共确定 226 名患者接受了 EPI 检测,以对有临床意义的前列腺癌进行风险分层。EPI 的灵敏度为 91%,mpMRI 为 90%,联合使用的灵敏度最高,为 96%。通过 ROC 分析,单独使用 EPI 的 AUC 为 0.57(95% CI,0.47-0.67),单独使用 mpMRI 的 AUC 为 0.78(95% CI,0.70-0.87)。如果之前的 EPI 结果为阳性,则联合使用 mpMRI 的 AUC 为 0.80(95% CI,0.71-0.89)。进一步的亚组分析显示,在非裔美国人中,EPI 0.67(95% CI,0.48-0.87)、mpMRI 0.90(95% CI,0.76-1.0)和联合使用的 AUC 值分别为 0.90(95% CI,0.75-1.0)。讨论:我们观察到,联合使用 EPI 和 mpMRI 可使 43% 的患者避免活检。使用这两种参数提高了检测有临床意义的前列腺癌的总体灵敏度和诊断准确性。非裔美国人队列中的测试表现最佳。确定评估前列腺癌风险的最佳非侵入性工具对于提供准确和具有成本效益的治疗至关重要。未来的研究应采用前瞻性研究设计,以进一步支持这些指标的综合使用。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
The Value of Adding Exosome-Based Prostate Intelliscore to Multiparametric Magnetic Resonance Imaging in Prostate Biopsy: A Retrospective Analysis
Introduction: Currently, there is limited evidence for the relationship of Exosome-based Prostate Intelliscore (EPI) and multiparametric magnetic resonance imaging (mpMRI) in stratifying risk for clinically significant prostate cancer. Using a retrospective cohort study design, we sought to characterize the relationship between these two noninvasive metrics and prostate biopsy outcome. Methods: Data were collected via electronic medical record for all patients who underwent EPI testing from 1 January 2019 to 3 February 2022 and had available medical records at a single mid-western university medical center. Positive test result was defined as >15.6 for EPI, ≥3 PI-RADS score and ≥3 + 4 Gleason Score for biopsy findings. Utility of EPI, mpMRI and combined use was characterized through calculation of sensitivity, specificity, positive predictive value, negative predictive value, and ROC analysis. Results: A total of 226 patients were identified as receiving EPI testing for risk stratification of clinically significant prostate cancer. Sensitivity for EPI was 91%, mpMRI was 90%, and the highest was combined use at 96%. With ROC analysis, AUC for EPI alone was 0.57 (95% CI, 0.47–0.67) and 0.78 (95% CI, 0.70–0.87) for mpMRI alone. With prior positive EPI result, AUC for combined use with mpMRI was 0.80 (95% CI, 0.71–0.89). Further subgroup analysis resulted in increased AUC values of EPI 0.67 (95% CI, 0.48–0.87), mpMRI 0.90 (95% CI, 0.76–1.0), and combined 0.90 (95% CI, 0.75–1.0) in the African American population. Discussion: We observed that the combined use of EPI and mpMRI led to an avoided biopsy in 43% of patients. Using both parameters increased the overall sensitivity and diagnostic accuracy in detecting clinically significant prostate cancer. The best test performance was observed in the African American cohort. Identifying optimal noninvasive tools to assess risk for prostate cancer is crucial to providing accurate and cost-effective care. Future study should utilize a prospective study design to further support the combined use of these metrics.
求助全文
通过发布文献求助,成功后即可免费获取论文全文。 去求助
来源期刊
Uro
Uro
自引率
0.00%
发文量
0
×
引用
GB/T 7714-2015
复制
MLA
复制
APA
复制
导出至
BibTeX EndNote RefMan NoteFirst NoteExpress
×
提示
您的信息不完整,为了账户安全,请先补充。
现在去补充
×
提示
您因"违规操作"
具体请查看互助需知
我知道了
×
提示
确定
请完成安全验证×
copy
已复制链接
快去分享给好友吧!
我知道了
右上角分享
点击右上角分享
0
联系我们:info@booksci.cn Book学术提供免费学术资源搜索服务,方便国内外学者检索中英文文献。致力于提供最便捷和优质的服务体验。 Copyright © 2023 布克学术 All rights reserved.
京ICP备2023020795号-1
ghs 京公网安备 11010802042870号
Book学术文献互助
Book学术文献互助群
群 号:481959085
Book学术官方微信