MRI-derived PRECISE scores for predicting pathologically-confirmed radiological progression in prostate cancer patients on active surveillance.

摘要: To assess the predictive value and correlation to pathological progression of Prostate Cancer Radiological Estimation Change in Sequential Evaluation (PRECISE) scoring system follow-up prostate cancer (PCa) patients on active surveillance (AS). A total 295 men enrolled an AS programme between 2011 2018 were included. Baseline multiparametric magnetic resonance imaging (mpMRI) was performed at entry guide biopsy. The mpMRI studies prospectively reported by two sub-specialist uroradiologists with 10 years 13 experience. PRECISE scores dichotomized cut-off 4, sensitivity, specificity, positive negative calculated. Diagnostic performance further quantified using area under receiver operating curve (AUC) which based results targeted MRI-US fusion Univariate analysis Cox regression baseline clinical parameters related disease AS. Progression rate cohort 13.9% (41/295) over a median 52 months. With category ≥ 4, showed PPV NPV for predicting 0.76, 0.89, 0.52 0.96, respectively. AUC 0.82 (95% CI = 0.74–0.90). Prostate-specific antigen density (PSA-D), Likert lesion score index size only significant predictors (each p < 0.05). good overall performance, high may help limit number biopsies required • 1–3 have could reduce need re-biopsy during surveillance. 4–5 moderate should trigger either close monitoring or re-biopsy. Three (PSA density, score) impact progression-free survival (PFS) time.