Using IsoPSA With Prostate Imaging Reporting and Data System Score May Help Refine Biopsy Decision Making in Patients With Elevated PSA - 22/06/23
, Zaeem Lone 2, Andrew Wood 1, Nour Abdallah 1, Rebecca Campbell 1, Petar Bajic 1, Andrei Purysko 3, Jane K. Nguyen 4, Jihad Kaouk 1, Georges-Pascal Haber 1, Mohamed Eltemamy 1, Robert Stein 1, Samuel Haywood 1, Eric A Klein 1, Nima Almassi 1, Steven C. Campbell 1, Robert Abouassaly 1, #, Christopher J. Weight 1, #Abstract |
Objective |
To assess how IsoPSA, a structure-based serum assay which has been prospectively validated in detecting clinically significant prostate cancer (csPCa), can help the biopsy decision process when combined with the prostate imaging reporting and data systems (PI-RADS).
Materials and Methods |
This was a single-center retrospective review of prospectively collected data on patients receiving IsoPSA testing for elevated PSA (>4.0ng/mL). Patients were included if they had received an IsoPSA test and prostate MRI within 1 year of IsoPSA testing, and subsequently underwent prostate biopsy. Multivariable logistic regression was used to identify predictors of (csPCa, ie, GG ≥ 2) on biopsy. Predictive probabilities for csPCa at biopsy were generated using IsoPSA and various PI-RADS scores.
Results |
Two hundred and 7 patients were included. Twenty-two percent had csPCa. Elevated IsoPSA ratio (defined as ≥6.0) (OR: 5.06, P = .015) and a PI-RADS 4-5 (OR: 6.37, P <.001) were significant predictors of csPCa. The combination of elevated IsoPSA ratio and PI-RADS 4-5 lesion had the highest area under the curve (AUC) (AUC: 0.83, P <.001). The predicted probability of csPCa when a patient had a negative or equivocal MRI (PI-RADS 1-3) and a low IsoPSA ratio (≤6) was <5%.
Conclusion |
The combination of PI-RADS with IsoPSA ratios may help refine the biopsy decision-making process. In our cohort, a negative or equivocal MRI with a low IsoPSA may provide a low enough predicted probability to omit biopsy in such patients.
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| Financial Disclosure: All conflicts of interest, including specific financial interests and relationships and affiliations relevant to the subject matter or materials discussed in the manuscript (eg, employment/affiliation, grants or funding, consultancies, honoraria, stock ownership or options, expert testimony, royalties, or patents filed, received, or pending), are the following: Petar Bajic, Andrei Purysko, Jane Nguyen, Jihad Kaouk, Georges-Pascal Haber, Mohamed Eltemamy, Robert Stein, Samuel Haywood, Eric A. Klein, Nima Almassi, Steven C. Campbell, Robert Abouassaly, and Christopher Weight work or have worked at Cleveland Clinic which has an equity position in Cleveland Diagnostics, but none have a direct or indirect personal financial interest in the company. Eric Klein is a consultant for Cleveland Diagnostics. The remaining authors have nothing to disclose. |
Vol 176
P. 115-120 - juin 2023 Retour au numéro
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