Academic Journal

The Value of Adding Exosome-Based Prostate Intelliscore to Multiparametric Magnetic Resonance Imaging in Prostate Biopsy: A Retrospective Analysis

التفاصيل البيبلوغرافية
العنوان: The Value of Adding Exosome-Based Prostate Intelliscore to Multiparametric Magnetic Resonance Imaging in Prostate Biopsy: A Retrospective Analysis
المؤلفون: Noah King, Jacob Lang, Sree Jambunathan, Conner Lombardi, Barbara Saltzman, Nadiminty Nagalakshmi, Puneet Sindhwani
المصدر: Uro, Vol 4, Iss 2, Pp 50-59 (2024)
بيانات النشر: MDPI AG, 2024.
سنة النشر: 2024
المجموعة: LCC:Diseases of the genitourinary system. Urology
مصطلحات موضوعية: magnetic resonance imaging, MRI, prostate cancer, ExoDx, exosome-based prostate intelliscore, Diseases of the genitourinary system. Urology, RC870-923
الوصف: 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.
نوع الوثيقة: article
وصف الملف: electronic resource
اللغة: English
تدمد: 2673-4397
Relation: https://www.mdpi.com/2673-4397/4/2/5; https://doaj.org/toc/2673-4397
DOI: 10.3390/uro4020005
URL الوصول: https://doaj.org/article/657b7eaf344d44ddaf2a6f4133209912
رقم الانضمام: edsdoj.657b7eaf344d44ddaf2a6f4133209912
قاعدة البيانات: Directory of Open Access Journals
الوصف
تدمد:26734397
DOI:10.3390/uro4020005