Rotterdam mobile phone app including MRI data for the prediction of prostate cancer: A multicenter external validation |
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| Institution: | 1. Urology Department, “Villa Stuart” Private Hospital, Rome, Italy;2. Urology Department, “San Carlo di Nancy” Hospital, Rome, Italy;3. Department of Urology, Azienda Ospedaliera Careggi, Università di Firenze, Florence, Italy;4. UOC Urologia ASST Valle Olona, Busto Arsizio, Italy;5. Department of Urology, SS. Annunziata Hospital, Chieti, Italy;6. U.O.C. Urologia Ospedale Vittorio Emanuele, Catania, Italy;7. Department of Urology, San Bassiano Hospital, Bassano del Grappa, Italy;8. Department of Robotic Urological Surgery, Abano Terme Hospital, Abano Terme, Italy;9. Sapienza University of Rome, Department of Medico-Surgical Sciences and Biotechnologies, Urology Unit, Latina, Italy;10. Urologic Clinic, University Hospital, Ospedale Policlinico, Azienda Ospedaliera Universitaria Integrata, Verona, Italy;11. Urologia Ospedale San Raffaele Turro, Milano, Italy;12. Department of Urology, Ospedale Sant''Andrea-Università di Roma “Sapienza”, Rome, Italy;13. Department of Urology, Erasmus University Medical Center Rotterdam, The Netherlands;1. Department of Radiation Oncology, The Netherlands Cancer Institute, Amsterdam, the Netherlands;2. Department of Radiation Oncology, Radboud University Medical Center, Nijmegen, the Netherlands;3. Department of Biometrics, The Netherlands Cancer Institute, Amsterdam, the Netherlands;4. Department of Surgical Oncology, The Netherlands Cancer Institute, Amsterdam, the Netherlands;5. Department of Radiation Oncology, Leiden University Medical Center, Leiden, the Netherlands;6. Department of Radiology, Leiden University Medical Center, Leiden, the Netherlands;1. Department of Hepatobiliary Surgery, the First Affiliated Hospital of Harbin Medical University, Harbin, Heilongjiang, China;2. Key Laboratory of Hepatosplenic Surgery, Ministry of Education, Harbin Medical University, Harbin, Heilongjiang, China;3. Department of Hepatobiliary Pancreatic and Minimal Invasive Surgery, Zhejiang Provincial People''s Hospital, People''s Hospital of Hangzhou Medical College, Hangzhou, Zhejiang, China;4. School of Clinical Medicine, Hangzhou Medical College, Hangzhou, Zhejiang, China;5. Department of Hepatobiliary Surgery, Eastern Hepatobiliary Surgery Hospital, Second Military Medical University, Navy Medical University, Shanghai, China;6. The Second Department of Hepatobiliary Surgery, Meizhou People''s Hospital, Meizhou, Guangdong, China;7. Department of Hepatic Surgery, Tongji Hospital, Huazhong University of Science and Technology, Wuhan, Hubei, China;8. Department of General Surgery, Liuyang People''s Hospital, Liuyang, Hunan, China;9. Department of Hepatobiliary Surgery, Pu''er People''s Hospital, Pu''er, Yunnan, China;10. The First Department of General Surgery, the Fourth Hospital of Harbin, Harbin, Heilongjiang, China;11. Department of General Surgery, Ziyang First People''s Hospital, Ziyang, Sichuan, China;12. Department of Hepatobiliary Surgery, Fuyang People''s Hospital, Fuyang, Anhui, China;13. Key Laboratory of Tumor Molecular Diagnosis and Individualized Medicine of Zhejiang Province, Hangzhou, Zhejiang, China;1. Department of Pathology and Molecular Medicine, Queen''s University, 88 Stuart Street, Kingston, Ontario, K7L 3N6, Canada;2. Department of Radiology, MD Anderson Cancer Center, C. de Arturo Soria, 270, 28033, Madrid, Spain;3. Department of Surgery, Queen''s University, 76 Stuart Street, Kingston, Ontario K7L 2V7, Canada;4. School of Computing, Queen''s University, 76 Stuart Street, Kingston, Ontario K7L 2V7, Canada;5. Department of Surgery, University Health Network and Princess Margaret Hospital, University of Toronto, 610 University Ave, Toronto, Ontario M5G 2M9, Canada;1. Division of Aging, Brigham and Women''s Hospital, Boston, MA, USA;2. Division of Thoracic Surgery, Brigham and Women''s Hospital, Boston, MA, USA;3. Department of Data Science, Dana Farber Cancer Institute, Boston, MA, USA;4. Marcus Institute of Aging Research, Boston, MA, USA;5. Department of Radiation Oncology, Brigham and Women''s Hospital, Boston, MA, USA;6. Center for Esophageal and Gastric Cancer, Dana-Farber/Brigham and Women''s Cancer Center, Boston, MA, USA |
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| Abstract: | ObjectivesThe Rotterdam Prostate Cancer Risk calculator (RPCRC) has been validated in the past years. Recently a new version including multiparametric magnetic resonance imaging (mpMRI) data has been released. The aim of our study was to analyze the performance of the mpMRI RPCRC app.MethodsA series of men undergoing prostate biopsies were enrolled in eleven Italian centers. Indications for prostate biopsy included: abnormal Prostate specific antigen levels (PSA>4 ng/ml), abnormal DRE and abnormal mpMRI. Patients’ characteristics were recorded. Prostate cancer (PCa) risk and high-grade PCa risk were assessed using the RPCRC app. The performance of the mpMRI RPCRC in the prediction of cancer and high-grade PCa was evaluated using receiver operator characteristics, calibration plots and decision curve analysis.ResultsOverall, 580 patients were enrolled: 404/580 (70%) presented PCa and out of them 224/404 (55%) presented high-grade PCa. In the prediction of cancer, the RC presented good discrimination (AUC = 0.74), poor calibration (p = 0.01) and a clinical net benefit in the range of probabilities between 50 and 90% for the prediction of PCa (Fig. 1). In the prediction of high-grade PCa, the RC presented good discrimination (AUC = 0.79), good calibration (p = 0.48) and a clinical net benefit in the range of probabilities between 20 and 80% (Fig. 1).ConclusionsThe Rotterdam prostate cancer risk App accurately predicts the risk of PCa and particularly high-grade cancer. The clinical net benefit is wide for high-grade cancer and therefore its implementation in clinical practice should be encouraged. Further studies should assess its definitive role in clinical practice. |
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| Keywords: | Prostate cancer Medical app Magnetic resonance Nomogram |
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