Validation of the Barcelona-MRI predictive model when PI-RADS v2.1 is used with transperineal prostate biopsies

• Published in: International Brazilian Journal of Urology Vol. 50; no. 5; pp. 595 - 604
• Main Authors: Morote, Juan, Paesano, Nahuel, Picola, Natàlia, Muñoz-Rodriguez, Jesús, Ruiz-Plazas, Xavier, Muñoz-Rivero, Marta V., Celma, Ana, Manuel, Gemma García-de, Miró, Berta, Servian, Pol, Abascal, José M.
• Format: Journal Article
• Language: English
• Published: Sociedade Brasileira de Urologia 01.09.2024
• Subjects: Diagnosis; Magnetic Resonance Imaging; Original; Prostatic Neoplasms
• ISSN: 1677-5538; 1677-6119
• DOI: 10.1590/s1677-5538.ibju.2024.0204

ABSTRACT Purpose: To validate the Barcelona magnetic resonance imaging predictive model (BCN-MRI PM) in men with pre-biopsy multiparametric MRI (mpMRI) reported with the Prostate Imaging Reporting and Data System (PI-RADS) v2.1, followed by transrectal and transperineal prostate biopsies. Materials and Methods: Prospective analysis of 3,264 men with PSA >3.0 ng/mL and/or abnormal digital rectal examination who were referred to ten participant centers in the csPCa early detection program of Catalonia (Spain), between 2021 and 2023. MpMRI was reported with the PI-RADS v2.1, and 2- to 4-core MRI-transrectal ultrasound (TRUS) fusion-targeted biopsy of suspected lesions and/or 12-core systematic biopsy were conducted. 2,295 (70.3%) individuals were referred to six centers for transrectal prostate biopsies, while 969 (39.7%) were referred to four centers for transperineal prostate biopsies. CsPCa was classified whenever the International Society of Urologic Pathology grade group was 2 or higher. Results: CsPCa was detected in 41% of transrectal prostate biopsies and in 45.9% of transperineal prostate biopsies (p <0.016). Both BCN-MRI PM calibration curves were within the ideal correlation between predicted and observed csPCa. Areas under the curve and 95% confidence intervals were 0.847 (0.830-0.857) and 0.830 (0.823-0.855), respectively (p = 0.346). Specificities corresponding to 95% sensitivity were 37.6 and 36.8%, respectively (p = 0.387). The Net benefit of the BCN-MRI PM was similar with both biopsy methods. Conclusions: The BCN-MRI PM has been successfully validated when mpMRI was reported with the PI-RADS v2.1 and prostate biopsies were conducted via the transrectal and transperineal route.