PD45-06 ACCURACY OF THE MRI 5-POINT LIKERT SCORE TO PREDICT EXTRA-PROSTATIC EXTENSION AND SEMINAL VESICLE INVASION IN PATIENTS UNDERGOING RADICAL PROSTATECTOMY FOR PROSTATE CANCER AND DEVELOPMENT OF a NEW MRI-BASED NOMOGRAM

You have accessJournal of UrologyProstate Cancer: Staging II (PD45)1 May 2024PD45-06 ACCURACY OF THE MRI 5-POINT LIKERT SCORE TO PREDICT EXTRA-PROSTATIC EXTENSION AND SEMINAL VESICLE INVASION IN PATIENTS UNDERGOING RADICAL PROSTATECTOMY FOR PROSTATE CANCER AND DEVELOPMENT OF a NEW MRI-BASED NOMOGRAM Francesco Pellegrino, Ugo G. Falagario, Flavia Proietti, Aldo Brasetti, Anna Hagman, Alberto Briganti, Francesco Montorsi, Giuseppe Carrieri, Anna Lantz, Olof Akre, Markus Aly, Lars Egevad, Fredrik Jaderling, and Peter Wiklund Francesco PellegrinoFrancesco Pellegrino , Ugo G. FalagarioUgo G. Falagario , Flavia ProiettiFlavia Proietti , Aldo BrasettiAldo Brasetti , Anna HagmanAnna Hagman , Alberto BrigantiAlberto Briganti , Francesco MontorsiFrancesco Montorsi , Giuseppe CarrieriGiuseppe Carrieri , Anna LantzAnna Lantz , Olof AkreOlof Akre , Markus AlyMarkus Aly , Lars EgevadLars Egevad , Fredrik JaderlingFredrik Jaderling , and Peter WiklundPeter Wiklund View All Author Informationhttps://doi.org/10.1097/01.JU.0001008792.09108.b4.06AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookLinked InTwitterEmail Abstract INTRODUCTION AND OBJECTIVE: MRI has been shown to aid in the detection and local staging of prostate cancer (PCa). Although the PIRADS score is widely used in PCa detection, it only partially addresses the local stage of PCa. Specific guidelines and reporting systems for local staging of PCa using MRI are currently lacking. In this context, two 5-point Likert scales were proposed to predict the risk of extra-prostatic extension (EPE) and seminal vesicle invasion (SVI). We aimed to evaluate the accuracy of these two Likert scores and to incorporate them into a novel mpMRI-based prediction model for EPE and SVI. METHODS: We used a population of 474 patients undergoing radical prostatectomy after a positive MRI (PIRADS ≥3). The probability of EPE and SVI was reported using 5-point Likert scale by an expert radiologist. First, we evaluated the diagnostic accuracy of these Likert scores. Then we developed two prediction models for EPE and SVI including the Likert scales with other clinical characteristics (PIRADS 5, prostate volume, grade group at biopsy≥4, and percentage of the systematic cores involved by tumor). Finally, the clinical utility of the new models was tested using decision curve analyses. RESULTS: Overall, 146 (31%), 163 (34%), 126 (27%), and 39 (8.2%) patients had an EPE score of 1-2, 3, 4, and 5, respectively. Moreover, 400 (84%), 30 (6.3%), 23 (4.9%), and 21 (4.4%) patients had an SVI score of 1-2, 3, 4, and 5, respectively. At final pathology, 220 (46%) and 54 (11%) patients had EPE and SVI, respectively. Table 1 reports Likert score diagnostic characteristic. The odds ratio and specificity were elevated for both scores using score 3 as a cutoff. However, the accuracy was not optimal (≤0.7). Our new prediction models demonstrated an excellent accuracy after internal validation (≥0.77) and a higher net benefit than both a nominal scale (e.g. EPE yes vs no) and 5-point Likert scale. CONCLUSIONS: Likert scales predicting the risk of EPE and SVI at mpMRI have good diagnostic accuracy. Still, their clinical value is limited when used alone. On the other hand, multivariable prediction models including such Likert scales with other clinical characteristics showed excellent diagnostic accuracy and higher net clinical benefit. Source of Funding: No © 2024 by American Urological Association Education and Research, Inc.FiguresReferencesRelatedDetails Volume 211Issue 5SMay 2024Page: e969 Advertisement Copyright & Permissions© 2024 by American Urological Association Education and Research, Inc.Metrics Author Information Francesco Pellegrino More articles by this author Ugo G. Falagario More articles by this author Flavia Proietti More articles by this author Aldo Brasetti More articles by this author Anna Hagman More articles by this author Alberto Briganti More articles by this author Francesco Montorsi More articles by this author Giuseppe Carrieri More articles by this author Anna Lantz More articles by this author Olof Akre More articles by this author Markus Aly More articles by this author Lars Egevad More articles by this author Fredrik Jaderling More articles by this author Peter Wiklund More articles by this author Expand All Advertisement PDF downloadLoading ...