scholarly journals Bioelectric Impedance Analysis Test Improves the Detection of Prostate Cancer in Biopsy Candidates: A Multifeature Decision Support System

2021 ◽  
Vol 11 ◽  
Author(s):  
Riccardo Bartoletti ◽  
Alberto Greco ◽  
Tommaso Di Vico ◽  
Jacopo Durante ◽  
Vincenzo Ficarra ◽  
...  
Keyword(s):  
Prostate Cancer ◽  
Prostate Biopsy ◽  
Specific Antigen ◽  
Digital Rectal Examination ◽  
Impedance Analysis ◽  
Benign Disease ◽  
Rank Test ◽  
The Novel ◽  
Bioelectric Impedance Analysis ◽  
Bioelectric Impedance

Prostate cancer (PCa) gold-standard diagnosis relies on prostate biopsy, which is currently overly recommended since other available noninvasive tools such as prostate-specific antigen (PSA) multiparametric MRI (mMRI) showed low diagnostic accuracy or high costs, respectively. The aim of the study was to determine the accuracy of a novel Bioelectric Impedance Analysis (BIA) test endorectal probe for the selection of patients candidate to prostate biopsy and in particular the clinical value of three different parameters such as resistance (R), reactance (Xc), and phase angle (PA) degree. One-hundred twenty-three consecutive candidates to prostate biopsy and 40 healthy volunteers were enrolled. PSA and PSA density (PSAD) determinations, Digital Rectal Examination (DRE), and the novel BIA test were analyzed in patients and controls. A 16-core prostate biopsy was performed after a mMRI test. The study endpoints were to determine accuracy of BIA test in comparison with PSA, PSAD levels, and mMRI and obtain prostate cancer (PCa) prediction by BIA test. The Mann-Whitney U-test, the Wilkoxon rank test, and the Holm-Bonferroni’s method were adopted for statistical analyses, and a computational approach was also applied to differentiate patients with PCa from those with benign disease. Combined PSA, PSAD, DRE, and trans-rectal ultrasound test failed to discern patients with PCa from those with benign disease (62.86% accuracy). mMRI PIRADS ≥3 showed a sensitivity of 83% and a specificity of 59%. The accuracy in discerning PCa increased up to 75% by BIA test (sensitivity 63.33% and specificity 83.75%). The novel finger probe BIA test is a cheap and reliable test that may help to improve clinical multifeature noninvasive diagnosis for PCa and reduce unnecessary biopsies.

scholarly journals Use of Bioelectric Impedance Analysis (BIA) as a new method to detect prostate cancer

2020 ◽  
Author(s):  
Riccardo Bartoletti ◽  
Alberto Greco ◽  
Tommaso Di Vico ◽  
Jacopo Durante ◽  
Vincenzo Ficarra ◽  
...  
Keyword(s):  
Prostate Biopsy ◽  
Digital Rectal Examination ◽  
Impedance Analysis ◽  
Rank Test ◽  
The Novel ◽  
Discrimination Accuracy ◽  
Bioelectric Impedance Analysis ◽  
Non Invasive ◽  
Detect Prostate Cancer ◽  
Total Psa

AbstractBackgroundTo determine the accuracy of a novel BIA test endorectal probe.MethodsOne hundred-forty consecutive patient candidates to prostate biopsy and 40 healthy volunteers were selected (NCT03428087). Total PSA and PSA density (PSAD) determinations, digital rectal examination (DRE), and the BIA test were analysed in patients and controls. A 16 cores trans rectal prostate biopsy was performed on all patients with clinical suspicion of PCa after a multiparametric MRI (mMRI) test. The study endpoints were to determine accuracy of BIA test in comparison to PSA, PSAD levels, and mMRI and obtain PCa prediction in candidates to prostate biopsy by BIA test. The Mann-Withney U test, the Wilkoxon rank test, and Holm-Bonferroni’s method were adopted for statistical analyses, and a computational approach was also applied to differentiate patients with PCa from those with benign disease (BPH).ResultsCombined DRE, TRUS, PSA, and PSAD alone failed to satisfactorily discern patients with PCa from those with BPH (62.86% of discrimination accuracy) and mMRI PIRADS ≥3 showed a sensitivity of 83% and a specificity of 59%. The accuracy in discerning PCa and BPH increased up to 75% by BIA test (sensitivity 63.33% and specificity 83.75%).ConclusionsThe BIA test is a simple, promising, cheap, and reliable test for PCa non-invasive diagnosis. The novel finger probe may improve PCa detection also in patients with low-risk PCa, thus reducing the need of useless biopsies.

scholarly journals Integrated predictive model for prostatic cancer using clinical, laboratory and ultrasound data

2016 ◽  
Vol 43 (6) ◽  
pp. 430-437
Author(s):  
GUSTAVO DAVID LUDWIG ◽  
HENRIQUE PERES ROCHA ◽  
LÚCIO JOSÉ BOTELHO ◽  
MAIARA BRUSCO FREITAS
Keyword(s):  
Prostate Cancer ◽  
Predictive Model ◽  
Prostate Biopsy ◽  
Clinical Laboratory ◽  
Prostate Volume ◽  
Specific Antigen ◽  
Digital Rectal Examination ◽  
Roc Curves ◽  
Rectal Examination ◽  
Psa Density

ABSTRACT Objective: to develop a predictive model to estimate the probability of prostate cancer prior to biopsy. Methods: from September 2009 to January 2014, 445 men underwent prostate biopsy in a radiology service. We excluded from the study patients with diseases that could compromise the data analysis, who had undergone prostatic resection or used 5-alpha-reductase inhibitors. Thus, we selected 412 patients. Variables included in the model were age, prostate specific antigen (PSA), digital rectal examination, prostate volume and abnormal sonographic findings. We constructed Receiver Operating Characteristic (ROC) curves and calculated the areas under the curve, as well as the model's Positive Predictive Value (PPV) . Results: of the 412 men, 155 (37.62%) had prostate cancer (PC). The mean age was 63.8 years and the median PSA was 7.22ng/ml. In addition, 21.6% and 20.6% of patients had abnormalities on digital rectal examination and image suggestive of cancer by ultrasound, respectively. The median prostate volume and PSA density were 45.15cm3 and 0.15ng/ml/cm3, respectively. Univariate and multivariate analyses showed that only five studied risk factors are predictors of PC in the study (p<0.05). The PSA density was excluded from the model (p=0.314). The area under the ROC curve for PC prediction was 0.86. The PPV was 48.08% for 95%sensitivity and 52.37% for 90% sensitivity. Conclusion: the results indicate that clinical, laboratory and ultrasound data, besides easily obtained, can better stratify the risk of patients undergoing prostate biopsy.

scholarly journals Correlation of Hypoechoic Lesions in Trans-rectal Ultrasound of Prostate with Histopathology in Prostate Cancer

2020 ◽  
Vol 42 (2) ◽  
pp. 76-79
Author(s):  
Dinesh Chataut ◽  
Babin Basnet ◽  
Benu Lohani ◽  
Sundar Suwal ◽  
Sharma Paudel ◽  
...  
Keyword(s):  
Prostate Cancer ◽  
Prostate Biopsy ◽  
Gold Standard ◽  
Detection Rate ◽  
Specific Antigen ◽  
Digital Rectal Examination ◽  
Elderly Male ◽  
Common Cancer ◽  
In Trans ◽  
Focus Detection

Introduction Prostate cancer is one of the most common cancer in elderly male. Suspicion of prostate cancer is based on increased Prostate Specific Antigen (PSA) level and abnormal digital rectal examination (DRE) findings. Transrectal ultrasonography (TRUS) can detect and localize hypoechoic lesions in prostate which are considered as suspicious for malignancy. TRUS can also guide for prostate biopsy, which is the gold standard for diagnosis of prostate cancer. The study was aimed to find out TRUS findings in suspected prostate cancer patients and correlate these findings with histopathological findings. MethodsProspective study was done in 66 males of age >40 years, sent for prostate biopsy in suspicion for prostate cancer (PSA >4 ng/ml, and/or abnormal DRE findings). Prostate was evaluated with TRUS and subsequently underwent TRUS guided six core biopsy of prostate. Total 396 cores of biopsy were taken. Histopathology reports were collected and correlated with the TRUS findings. ResultsTwenty three patients were positive for prostate cancer and 14 of them showed hypoechoic lesions in TRUS. Total 81 suspicious hypoechoic lesions were seen in prostate of all the patients and among them 42 lesions matched with histopathology report for cancer. Cancerous focus detection rate of TRUS was 51.85%. ConclusionTRUS is a supplementary tool in diagnosis of prostate cancer, however when used alone it has less sensitivity for detection of prostate cancer.

Urinary miR-183 and miR-205 do not surpass PCA3 in urine as predictive markers for prostate biopsy outcome despite their highly dysregulated expression in prostate cancer tissue

2015 ◽  
Vol 53 (7) ◽  
Author(s):  
Carsten Stephan ◽  
Monika Jung ◽  
Silke Rabenhorst ◽  
Ergin Kilic ◽  
Klaus Jung
Keyword(s):  
Prostate Cancer ◽  
Prostate Biopsy ◽  
Specific Antigen ◽  
Critical Evaluation ◽  
Sample Size Calculation ◽  
Digital Rectal Examination ◽  
Predictive Marker ◽  
Testing Procedure ◽  
Cancer Tissue ◽  
Few Data

AbstractMicroRNAs (miRNAs) have shown to be promising novel biomarkers in various cancers. We aimed to translate the results of an own previous tissue-based miRNA profile of prostate carcinoma (PCa) with upregulated miR-183 and downregulated miR-205 into a urine-based testing procedure for diagnosis of PCa.Urine sediments were prepared from urine samples collected after a standardized digital-rectal examination (DRE) of patients undergoing prostate biopsy with PSA (prostate-specific antigen) values <20 μg/L in consecutive order. According to the sample-size calculation (α=0.05, power=0.95), 38 patients each with PCa and without PCa were randomly enrolled in this study. PCA3 (prostate cancer associated 3) in urine as Food and Drug Administration-approved assay was determined as reference standard for comparison. The miRNAs were measured by RT-qPCR using TaqMan assays and normalized using different approaches.Both miRNAs were correlated to the mRNA PSA concentrations in the sediments indicating a relationship to the released prostate cells after DRE. However, they had no discriminating capacity between patients with and without PCa. In contrast, PCA3 clearly differentiated between these two patients groups. There was also no significant correlation between miRNAs and standard clinicopathologic variables like Gleason score and serum PSA.The data of our study show that miR-183 and miR-205 failed to detect early and aggressive PCa despite their highly dysregulated expression in cancer tissue. Our results and the critical evaluation of the few data of other studies raise serious doubts concerning the capability of urinary miRNAs to replace or improve PCA3 as predictive marker for prostate biopsy outcome.

scholarly journals Importance of prostate volume for detection of prostate cancer by first sextant biopsy in high-risk patients

Medicina ◽  
2007 ◽  
Vol 43 (4) ◽  
pp. 285 ◽  
Author(s):  
Kęstutis Vaičiūnas ◽  
Stasys Auškalnis ◽  
Aivaras Matjošaitis ◽  
Darius Trumbeckas ◽  
Mindaugas Jievaltas
Keyword(s):  
Prostate Cancer ◽  
High Risk ◽  
Transition Zone ◽  
Prostate Biopsy ◽  
Prostate Volume ◽  
Specific Antigen ◽  
Digital Rectal Examination ◽  
Transitional Zone ◽  
Antigen Level ◽  
Sextant Biopsy

The aim of this study was to evaluate the relevance of prostate gland volume, transitional zone volume, and transitional zone index for the detection of prostate cancer by the first sextant biopsy. Material and methods. A total of 121 men with high risk of prostate cancer were included in our study (prostate-specific antigen level higher than 4 ng/mL and/or pathological digital rectal examination). We consulted the patients in Outpatient Department of Kaunas University of Medicine Hospital during 2003–2006. Total prostate volume and transition zone volume were measured, and all patients underwent transrectal ultrasoundguided sextant biopsy of the prostate. According to histological results of prostate biopsy, patients were divided into two groups: benign group (benign prostate hyperplasia and high-grade intraepithelial neoplasia) and prostate cancer group. Statistical analysis was made by SPSS (Statistical Package for Social Sciences) 12.0.1 for Windows. Results. After histological examination, prostate cancer was detected in 20.7% of patients (n=25). Prostate cancer was found in 24.6% of patients with a total prostate volume of less than 60 cm3 and only in 8.2% of patients with a total prostate volume greater than 60 cm3 (P=0.026). Prostate cancer was found in 27.1% of patients with transition zone volume smaller than 30 cm3 and only in 7.5% of patients with transition zone volume greater than 30 cm3 (P=0.007). A statistically significant difference was found when patients were divided into the groups according to transition zone index: when transition zone index was lower than 0.45, prostate cancer was detected in 37.1% of patients, and when transition zone index was higher than 0.45, prostate cancer was observed in 9.1% of patients (P=0.001). The possibility to detect prostate cancer was 5.9 times higher in patients with transition zone index lower than 0.45. Conclusions. Prostate cancer detection rate by first sextant prostate biopsy in patients with elevated prostate-specific antigen level and/or pathological digital rectal examination was higher when total prostate volume was less than 60 cm3, transition zone was less than 30 cm3, and transition zone index was less than 0.45.

The Association of PSA-IGM and Total PSA Improves the Diagnosis of Prostate Cancer

2009 ◽  
Vol 24 (3) ◽  
pp. 212-212
Author(s):  
Danilo Zani ◽  
Silvia Costa ◽  
Lorenzo Gatti ◽  
Nicola Pesenti ◽  
Alberto Pettenò ◽  
...  
Keyword(s):  
Prostate Cancer ◽  
Diagnostic Accuracy ◽  
Prostate Biopsy ◽  
Specific Antigen ◽  
Digital Rectal Examination ◽  
Serum Levels ◽  
Immunoglobulin M ◽  
Diagnostic Tools ◽  
Psa Test ◽  
Total Psa

Background and aim The specific causes of prostate cancer (Pca) are unknown but the main risk factors of tumor development are associated with age, genetic factors, ethnicity, diet and lifestyle. Prostate cancer is rare in men under 45 years of age, but becomes more common with advancing age. The main diagnostic tools for demonstrating the presence of PCa include digital rectal examination, transrectal ultrasonography, and serum measurement of prostate specific antigen (PSA) followed by prostate biopsy for confirmation of the diagnosis. While the measurement of PSA levels has revolutionized the diagnosis of PCa, it has also increased its overdiagnosis due to the poor diagnostic accuracy. Scientific evidence indicates that biomarkers for different types of cancer such as liver and colorectal cancer circulate in the blood associated with immunoglobulin M (IgM) to form complexes that allow a better diagnosis in comparison to circulating free biomarkers. In prostate cancer it has been demonstrated that testing for serum levels of the PSA-IgM immune complex improves the diagnostic performance of total PSA. The aim of this study was to evaluate the diagnostic accuracy of PSA-IgM compared to total PSA for the selection of patients to be submitted to transrectal ultrasound-guided prostate biopsy. Patients and methods Serum samples from 67 male patients, 33 affected by PCa with a Gleason score from 5 to 7, and 34 affected by benign prostate hypertrophy (BPH), were collected by the Department of Urology of the Spedali Civili of Brescia. The samples were immediately snap frozen at −80°C. Serum levels of PSA-IgM were assessed using Prostate-IC (Xeptagen, Italy) while PSA levels were determined with the Immulite 2000 of Medical Systems S.p.A. Results Patients were stratified into 2 groups according to age; the first group consisted of 24 patients with PCa and 20 with BPH aged between 60 and 70 years and the second group consisted of 9 patients with PCa and 14 with BPH aged between 70 and 80 years. Serum levels of PSA and PSA-IgM were analyzed in the 2 groups using cutoff values of 4 ng/mL for PSA and 145 AU/mL for PSA-IgM. In the first group, 1 8 of 24 PCa patients were positive for PSA (75% sensitivity) with a specificity of 50% (10 of 20 BPH patients), and 1 0 of 24 PCa patients were positive with the PSA-IgM assay (42% sensitivity), which had a higher specificity (70%; 6 of 20 BPH patients). The combination of both biomarkers resulted in a sensitivity of 38% (9 of 24 patients with PCa) but showed a significant improvement in specificity up to 90%, since 18 of 20 patients with BPH were negative for at least one test. In the second group of patients aged 70 to 80 years, the PSA test had a sensitivity of 67% (6/9 PCa patients) and a specificity of 78% (3/14 BPH patients) compared with a sensitivity of 44% for the PSA-IgM test (4/9 PCa patients) with a specificity of 71% (4/14 BPH patients). The combination of PSA and PSA-IgM had a sensitivity of 30% (3/9) but the highest specificity (93%, 13/14 BPH patients). Conclusion The results of the study demonstrate the diagnostic value of the PSA-IgM assay compared with the total PSA test. The combination of PSA-IgM with total PSA was the best approach to reduce the number of false-positive results, thus improving the diagnosis of prostate cancer.

scholarly journals APTIMA PCA3 Molecular Urine Test: Development of a Method to Aid in the Diagnosis of Prostate Cancer

2006 ◽  
Vol 52 (6) ◽  
pp. 1089-1095 ◽  
Author(s):  
Jack Groskopf ◽  
Sheila MJ Aubin ◽  
Ina Lim Deras ◽  
Amy Blase ◽  
Sharon Bodrug ◽  
...  
Keyword(s):  
Prostate Cancer ◽  
Prostate Biopsy ◽  
Specific Antigen ◽  
Digital Rectal Examination ◽  
Prostate Cancer Risk ◽  
Area Under The Curve ◽  
Roc Curve Analysis ◽  
Cancer Risk Factors ◽  
Specimen Processing ◽  
Whole Urine

Abstract Background: Prostate cancer gene 3 (PCA3) encodes a prostate-specific mRNA that has shown promise as a prostate cancer diagnostic tool. This report describes the characterization of a prototype quantitative PCA3-based test for whole urine. Methods: Whole-urine specimens were collected after digital rectal examination from 3 groups: men scheduled for prostate biopsy (n = 70), healthy men (&lt;45 years of age with no known prostate cancer risk factors; n = 52), and men who had undergone radical prostatectomy (n = 21). PCA3 and prostate-specific antigen (PSA) mRNAs were isolated, amplified, and quantified by use of Gen-Probe DTS400® Systems. Prostate biopsy results were correlated with the PCA3/PSA mRNA ratio, and PSA mRNA concentrations were used to normalize PCA3 signals and confirm the yield of prostate-specific RNA. Assay precision, specimen stability, and mRNA yield were also evaluated. Results: The specimen informative rate (fraction of specimens yielding sufficient RNA for analysis) was 98.2%. In this clinical research study, ROC curve analysis of prebiopsy specimens yielded an area under the curve of 0.746; sensitivity was 69% and specificity 79%. Serum PSA assay specificity was 28% for this same group. PCA3 and PSA mRNAs were undetectable in postprostatectomy specimens except for one man with recurrent prostate cancer. Assay interrun CVs were ≤12%. Both mRNAs were stable in processed urine up to 5 days at 4 °C and after 5 freeze–thaw cycles. Conclusion: The APTIMA® PCA3 assay combines simple specimen processing with precise assays and existing instruments and could add specificity to the current algorithm for prostate cancer diagnosis.

scholarly journals Efficacy of lower cut off value of serum prostate specific antigen in diagnosis of prostate cancer

2013 ◽  
Vol 38 (3) ◽  
pp. 90-93 ◽  
Author(s):  
MM Rashid ◽  
AKMK Alam ◽  
AKMK Habib ◽  
H Rahman ◽  
AKMS Hossain ◽  
...  
Keyword(s):  
Prostate Cancer ◽  
Prostate Specific Antigen ◽  
Prostate Biopsy ◽  
Performance Status ◽  
Specific Antigen ◽  
Significant Proportion ◽  
Digital Rectal Examination ◽  
High Serum ◽  
Serum Prostate Specific Antigen ◽  
Sensitivity Specificity

Indications of prostate biopsy are high serum prostate specific antigen (PSA) value and or abnormal digital rectal examination (DRE) findings. Although serum PSA value of 4 ng/ml is the most commonly used threshold for recommending prostate biopsy, significant proportion of men harbor prostate cancer even when their serum PSA values are less than 4.0 ng/ml. Therefore present study was designed to determine the performance status of serum PSA in lower cut-off values. This hospital based prospective study was conducted in the Department of Urology of Bangabandhu Sheikh Mujib Medical University (BSMMU) and Comfort Nursing Home Pvt. Ltd, Dhaka from July 2009 to October 2010. Two hundred six male patients aged over 50 years having lower urinary tract symptoms (LUTS) and serum PSA more than 2.5 ng/ml were prepared for prostate biopsy. Trans rectal ultrasound (TRUS) guided biopsy was done. The test statistics used to analyze the data were descriptive statistics, sensitivity, specificity, positive and negative predictive value, ROC curve. For all analytical tests, the level of significance was set at 0.05 and p<0.05 was considered significant. In 2.5-4 serum PSA range, 28.26% (13 out of 46) of all malignancy were found, which would be missed if we take cut off value 4. At 2.5 PSA cut-off, Sensitivity 91.3%, Specificity 14.37%, PPV 23.46%, NPV 85.18%, Efficacy 31.55%. At 4 PSA cut-off value, Sensitivity 71.73%, Specificity 46.25%, PPV 27.73%, NPV 85.05%, Efficacy 51.94%. So it can be concluded that, for early diagnosis of prostate cancer cut-off value of serum PSA of 2.5 ng/ml can be recommended as an indication for prostate biopsy. DOI: http://dx.doi.org/10.3329/bmrcb.v38i3.14333 Bangladesh Med Res Counc Bull 2012; 38(3): 90-93 (December)

scholarly journals The use of prostate specific antigen density to predict clinically significant prostate cancer

2020 ◽  
Vol 10 (1) ◽  
Author(s):  
Igor Yusim ◽  
Muhammad Krenawi ◽  
Elad Mazor ◽  
Victor Novack ◽  
Nicola J. Mabjeesh
Keyword(s):  
Prostate Cancer ◽  
Prostate Specific Antigen ◽  
Prostate Biopsy ◽  
Prostate Volume ◽  
Characteristic Curve ◽  
Specific Antigen ◽  
Digital Rectal Examination ◽  
Prostate Adenocarcinoma ◽  
Prostate Specific Antigen Density ◽  
Clinically Significant

AbstractThe purpose of this study was to assess the predictive value of prostate specific antigen density (PSAD) for detection of clinically significant prostate cancer in men undergoing systematic transrectal ultrasound (TRUS)-guided prostate biopsy. We retrospectively analyzed data of men who underwent TRUS-guided prostate biopsy because of elevated PSA (≤ 20 ng/ml) or abnormal digital rectal examination. Receiver operating characteristic curve analysis to compare PSA and PSAD performance and chi-square automatic interaction detector methodologies were used to identify predictors of clinically significant cancer (Gleason score ≥ 7 or international society of urological pathology grade group ≥ 2). Nine-hundred and ninety-two consecutive men with a median age of 66 years (IQR 61–71) were included in the study. Median PSAD was 0.10 ng/ml2 (IQR 0.10–0.22). Prostate adenocarcinoma was diagnosed in 338 men (34%). Clinically significant prostate adenocarcinoma was diagnosed in 167 patients (50% of all cancers and 17% of the whole cohort). The AUC to predict clinically significant prostate cancer was 0.64 for PSA and 0.78 for PSAD (P < 0.001). The highest Youden's index for PSAD was at 0.20 ng/ml2 with 70% sensitivity and 79% specificity for the diagnosis of clinically significant cancer. Men with PSAD < 0.09 ng/ml2 had only 4% chance of having clinically significant disease. The detection rate of clinically significant prostate cancer in patients with PSAD between 0.09 and 0.19 ng/ml2 was significantly higher when prostate volume was less than 33 ml. In conclusion, PSAD was a better predictor than PSA alone of clinically significant prostate cancer in patients undergoing TRUS-guided biopsy. Patients with PSAD below 0.09 ng/ml2 were unlikely to harbor clinically significant prostate cancer. Combining PSAD in the gray zone (0.09–0.19) with prostate volume below 33 ml adds diagnostic value of clinically significant prostate cancer.

Nomograms based on the Tyrol screening data of 2,271 patients to predict prostate cancer biopsy positivity.

2011 ◽  
Vol 29 (7_suppl) ◽  
pp. 203-203
Author(s):  
P. Sooriakumaran ◽  
M. John ◽  
J. Bektic ◽  
G. Bartsch ◽  
M. Herman ◽  
...  
Keyword(s):  
Prostate Cancer ◽  
Prostate Biopsy ◽  
Predictive Accuracy ◽  
Prostate Volume ◽  
External Validation ◽  
Specific Antigen ◽  
Digital Rectal Examination ◽  
Predictive Ability ◽  
Free Psa ◽  
Better Than

203 Background: There are no published nomograms that predict prostate cancer in a screened population. We describe three nomograms that predict for prostate cancer on biopsy derived from a large screening population. Methods: Patients from the Tyrol screening study of known age, total prostate-specific antigen (tPSA), digital rectal examination (DRE), prostate volume, and percent free PSA (%fPSA), and who underwent an initial prostate biopsy from January 1992 to June 2004, were included (n=2271). Multivariable logistic regression models were used to develop the biopsy positivity predictive nomograms: nomogram 1- age, DRE, tPSA; nomogram 2- age, DRE, tPSA, prostate volume; nomogram 3- age, DRE, tPSA, prostate volume, %fPSA. The predictive accuracy of the models was assessed in terms of discrimination and calibration. External validation of the nomograms was performed by comparison with a urologically referred population of patients who underwent prostate biopsy (n=599). Results: All three nomograms discriminated well between biopsy positive and biopsy negative patients for both the screening and urologically referred cohorts (nomogram 3 better than nomogram 2 better than nomogram 1). All three nomograms were well calibrated internally, but the nomograms under-predicted the probability of a positive biopsy in the urologically referred cohort. Conclusions: Our nomogram based on age, total PSA, and DRE has a good predictive ability to differentiate between screened patients that will show cancer on initial prostate biopsy and those that will not. Adding prostate volume and percent free PSA improves this predictive power further. All three nomograms under-predict prostate cancer in a urologically referred cohort. These simple nomograms may be of value in counseling screened men with raised PSA and/or abnormal DRE regarding the need for biopsy. No significant financial relationships to disclose.

Sign in / Sign up

Export Citation Format

Share Document