| Title: |
Evaluation of PSA and PSA Density in a Multiparametric Magnetic Resonance Imaging-Directed Diagnostic Pathway for Suspected Prostate Cancer: The INNOVATE Trial |
| Authors: |
Pye, H; Singh, S; Norris, JM; Carmona Echeverria, LM; Stavrinides, V; Grey, A; Dinneen, E; Pilavachi, E; Clemente, J; Heavey, S; Stopka-Farooqui, U; Simpson, BS; Bonet-Carne, E; Patel, D; Barker, P; Burling, K; Stevens, N; Ng, T; Panagiotaki, E; Hawkes, D; Alexander, DC; Rodriguez-Justo, M; Haider, A; Freeman, A; Kirkham, A; Atkinson, D; Allen, C; Shaw, G; Beeston, T; Brizmohun Appayya, M; Latifoltojar, A; Johnston, EW; Emberton, M; Moore, CM; Ahmed, HU; Punwani, S; Whitaker, HC |
| Source: |
Cancers , 13 (8) , Article 1985. (2021) |
| Publisher Information: |
MDPI AG |
| Publication Year: |
2021 |
| Collection: |
University College London: UCL Discovery |
| Subject Terms: |
Biomarkers; INNOVATE; multiparametric MRI; prostate cancer; diagnosis; PSA density |
| Description: |
OBJECTIVES: To assess the clinical outcomes of mpMRI before biopsy and evaluate the space remaining for novel biomarkers. METHODS: The INNOVATE study was set up to evaluate the validity of novel fluidic biomarkers in men with suspected prostate cancer who undergo pre-biopsy mpMRI. We report the characteristics of this clinical cohort, the distribution of clinical serum biomarkers, PSA and PSA density (PSAD), and compare the mpMRI Likert scoring system to the Prostate Imaging–Reporting and Data System v2.1 (PI-RADS) in men undergoing biopsy. RESULTS: 340 men underwent mpMRI to evaluate suspected prostate cancer. 193/340 (57%) men had subsequent MRI-targeted prostate biopsy. Clinically significant prostate cancer (csigPCa), i.e., overall Gleason ≥ 3 + 4 of any length OR maximum cancer core length (MCCL) ≥4 mm of any grade including any 3 + 3, was found in 96/195 (49%) of biopsied patients. Median PSA (and PSAD) was 4.7 (0.20), 8.0 (0.17), and 9.7 (0.31) ng/mL (ng/mL/mL) in mpMRI scored Likert 3,4,5 respectively for men with csigPCa on biopsy. The space for novel biomarkers was shown to be within the group of men with mpMRI scored Likert3 (178/340) and 4 (70/350), in whom an additional of 40% (70/178) men with mpMRI-scored Likert3, and 37% (26/70) Likert4 could have been spared biopsy. PSAD is already considered clinically in this cohort to risk stratify patients for biopsy, despite this 67% (55/82) of men with mpMRI-scored Likert3, and 55% (36/65) Likert4, who underwent prostate biopsy had a PSAD below a clinical threshold of 0.15 (or 0.12 for men aged |
| Document Type: |
article in journal/newspaper |
| File Description: |
text |
| Language: |
English |
| Relation: |
https://discovery.ucl.ac.uk/id/eprint/10126700/ |
| Availability: |
https://discovery.ucl.ac.uk/id/eprint/10126700/1/cancers-13-01985.pdf; https://discovery.ucl.ac.uk/id/eprint/10126700/ |
| Rights: |
open |
| Accession Number: |
edsbas.CF657E37 |
| Database: |
BASE |