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. 2024 Sep-Oct;50(5):595-604.
doi: 10.1590/S1677-5538.IBJU.2024.0204.

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

Juan Morote  1   2 , Nahuel Paesano  2   3 , Natàlia Picola  4 , Jesús Muñoz-Rodriguez  5 , Xavier Ruiz-Plazas  6 , Marta V Muñoz-Rivero  7 , Ana Celma  1 , Gemma García-de Manuel  8 , Berta Miró  9 , Pol Servian  10 , José M Abascal  11   12
Affiliations

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

Juan Morote et al. Int Braz J Urol. 2024 Sep-Oct.

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.

Keywords: Diagnosis; Magnetic Resonance Imaging; Prostatic Neoplasms.

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Conflict of interest statement

None declared.

Figures

Figure 1
Figure 1. Calibration curves of the BCN-MRI PM in transrectal prostate biopsies (A) and transperineal prostate biopsies (B).
Figure 2
Figure 2. Discrimination ability of the BCN-MRI PM for csPCa detection in transrectal prostate biopsies (A) and transperineal prostate biopsies (B
Figure 3
Figure 3. Net benefit of BCN-MRI PM application over biopsying all men through transrectal route (A) and transperineal route (B).
See this image and copyright information in PMC

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