For a study, researchers sought to analyze outcomes in patients with equivocal mpMRI and to determine the complementary efficacy of urine MyProstateScore (MPS) testing and multiparametric MRI (mpMRI).
Between 2015 and 2019, patients were subjected to mpMRI, urine collection, and prostate biopsy at the University of Michigan. The validated model based on serum PSA, urinary PCA3, and urinary TMPRSS2:ERG was used to determine MPS values from urine specimens. The AUC curve was used to assess the discriminative accuracy of PSA, PSAD, and MPS for GG≥2 cancer in the PI-RADS 3 cohort. A decision curve analysis was done to determine the net benefit of MPS vs. PSAD.
There were 540 individuals who had MPS and underwent mpMRI and biopsies. The frequency of GG≥2 cancer was 13% in PI-RADS 3, 56% in PI-RADS 4, and 87% in PI-RADS 5. In the total sample and when stratified by PI-RADS score, MPS was substantially greater in males with GG2≥cancer [median 44.9, IQR (29.4 -57.5)] than in those with negative or GG1 biopsies [median 29.2, IQR (14.8 -44.2); P<.001]. The AUC for predicting GG≥2 cancer in the PI-RADS 3 group (n = 121) was 0.55 for PSA, 0.62 for PSAD, and 0.73 for MPS. Across all relevant threshold probabilities, MPS offered the greatest net clinical benefit.
MPS was substantially related to GG≥2 cancer across all PI-RADS levels in patients who underwent mpMRI and biopsy. However, in the PI-RADS 3 group, MPS outperformed PSAD in excluding GG≥2 cancer.