Negative Predictive Value of a Prostate MRI in Black Men: Implications for Biopsy Decision-Making.

• Tác giả: Channa Amarasekera, Ulas Bagci, Samuel Carbunaru, David D Casalino, Bonnie Choy, Ryan W Dobbs, Dustin D French, Peter Gann, Emrah Gumusgoz, Courtney M P Hollowell, Jeanne M Horowitz, Anugayathri Jawahar, Shilajit D Kundu, Eric Li, Yingzhe Liu, Frances Manosca, Frank H Miller, Adam B Murphy, Bernice Ofori, Hiten D Patel, Kent T Perry, Ashley E Ross, Sarah Sandlow, Edward M Schaeffer, Zequn Sun, Patricia Vidal, Cecil G Wood, Ximing J Yang
• Ngôn ngữ: eng
• Ký hiệu phân loại: 920.71 Men
• Thông tin xuất bản: United States : The Journal of urology , 2025
• Bộ sưu tập: NCBI
• ID: 723446

Tóm tắt

 PURPOSE: Prostate Imaging Reporting and Data System (PIRADS) v2.1 scoring with multiparametric MRI (mpMRI) has a pooled 90% negative predictive value (NPV). PSA density (PSAD) ≤ 0.15 ng/mL/cm MATERIALS AND METHODS: We prospectively recruited Black and non-Black men referred to outpatient urology clinics for abnormal PSA or prostate examination in 3 similar biomarker validation studies from 2017 to 2023 before MRI-informed diagnostic prostate biopsy. We combined the research cohorts with a retrospective clinical cohort of clinically similar Black and non-Black men from 1 academic institution who also underwent mpMRIs and MRI-informed biopsies. MRIs were scored using PIRADS version 2.0 or 2.1. RESULTS: Our analysis included 286 Black men and 965 non-Black men with PSA ≤ 15.0 ng/mL. PIRADS <
  3 had an NPV of 77.1% vs 87.6% and a sensitivity of 90.7% vs 96.3% for GG2-5 PCa in Black vs non-Black men, respectively (both CONCLUSIONS: PIRADS <
  3 has a lower NPV and sensitivity in Black men. For negative prostate MRIs, PSAD ≥ 0.09 may be a better threshold for safe biopsy deferral in Black men to maintain a ≥ 90% sensitivity.