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MRI-based nomogram for the prediction of prostate cancer diagnosis: A multi-centre validated patient–physician decision tool

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Santaolalla, A 
Van Hemelrijck, M 
McCracken, S 


jats:secjats:titleObjective:</jats:title>jats:p To update and externally validate a magnetic resonance imaging (MRI)-based nomogram for predicting prostate biopsy outcomes with a multi-centre cohort. </jats:p></jats:sec>jats:secjats:titleMaterials and methods:</jats:title>jats:p Prospective data from five UK-based centres were analysed. All men were biopsy naïve. Those with missing data, no MRI, or prostate-specific antigen (PSA) > 30 ng/mL were excluded. Logistic regression analysis was used to confirm predictors of prostate cancer outcomes including MRI-PIRADS (Prostate Imaging Reporting and Data System) score, PSA density, and age. Clinically significant disease was defined as International Society of Urological Pathology (ISUP) Grade Group ⩾ 2 (Gleason grade ⩾ 7). Biopsy strategy included transrectal and transperineal approaches. Nomograms were produced using logistic regression analysis results. </jats:p></jats:sec>jats:secjats:titleResults:</jats:title>jats:p A total of 506 men were included in the analysis with median age 66 (interquartile range (IQR) = 60–69). Median PSA was 6.6 ng/mL (IQR = 4.72–9.26). PIRADS ⩾ 3 was reported in 387 (76.4%). Grade Group ⩾ 2 detection was 227 (44.9%) and 318 (62.8%) for any cancer. Performance of the MRI-based nomogram was an area under curve (AUC) of 0.84 (95% confidence interval (CI) = 0.81–0.88) for Grade Group ⩾ 2% and 0.85 (95% CI = 0.82–0.88) for any prostate cancer. </jats:p></jats:sec>jats:secjats:titleConclusion:</jats:title>jats:p We present external validation of a novel MRI-based nomogram in a multi-centre UK-based cohort, showing good discrimination in identifying men at high risk of having clinically significant disease. These findings support this risk calculator use in the prostate biopsy decision-making process. </jats:p></jats:sec>jats:secjats:titleLevel of evidence:</jats:title>jats:p 2c </jats:p></jats:sec>


Peer reviewed: True


Prostate cancer, prostate biopsy, MRI, nomogram, risk calculator

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Journal of Clinical Urology

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SAGE Publications