A multi-institutional study of 1,111 men with 4K score, multiparametric magnetic resonance imaging, and prostate biopsy

Thomas, Jamie; Atluri, Shrikanth; Zucker, Isaac; Reis, Isildinha M.; Kwon, Deukwoo; Kim, Eric; Tewari, Ashutosh; Patel, Vipul; Wagaskar, Vinayak; Konety, Badrinath R.; Czarniecki, Stefan; Thoreson, Gregory R.; Soodana‐Prakash, Nachiketh; Ritch, Chad R.; Nahar, Bruno; Gonzalgo, Mark L.; Kava, Bruce R.; Parekh, Dipen J.; Punnen, Sanoj

doi:10.1016/j.urolonc.2023.07.001

Cited by 3 publications

(2 citation statements)

References 19 publications

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“…Furthermore, if the result of 4Kscore is ≥20.0%, prostate biopsy is performed after the mpMRI examination. Given the ability of the 4Kscore combined with mpMRI to diagnose HGPCa and the ability of the 4Kscore to monitor disease progression ( 27 , 28 ), 4Kscore can be added to the monitoring methods for patients under AS in conjunction with mpMRI for the early detection of disease progression, which is in line with the current NCCN guidelines, encouraging the use of mpMRI to monitor the condition of patients under AS ( 3 ).…”

Section: Mpmri Combined With Biomarkers For the Diagnosis Of Hgpcamentioning

confidence: 88%

“…The 4Kscore is a predictive model of HGPCa risk that combines four different kinin-releasing enzymes in the blood: tPSA, fPSA, intact PSA (iPSA), and human kallikrein-related peptidase 2 (hk2), as in addition to three clinical variables (age, DRE, and previous biopsy results) to construct a risk prediction model for HGPCa ( 27 ). The 4Kscore showed high accuracy in diagnosing HGPCa in patients before biopsy and those under AS, with AUCs of 0.779 and 0.780, respectively ( 27 , 28 ).…”

Section: Biomarkers For the Diagnosis Of Hgpcamentioning

confidence: 99%

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Advances in multiparametric magnetic resonance imaging combined with biomarkers for the diagnosis of high-grade prostate cancer

Li,

Zha,

Wang

et al. 2024

Front. Surg.

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Clinical decisions based on the test results for prostate-specific antigen often result in overdiagnosis and overtreatment. Multiparametric magnetic resonance imaging (mpMRI) can be used to identify high-grade prostate cancer (HGPCa; Gleason score ≥3 + 4); however, certain limitations remain such as inter-reader variability and false negatives. The combination of mpMRI and prostate cancer (PCa) biomarkers (prostate-specific antigen density, Proclarix, TMPRSS2:ERG gene fusion, Michigan prostate score, ExoDX prostate intelliscore, four kallikrein score, select molecular diagnosis, prostate health index, and prostate health index density) demonstrates high accuracy in the diagnosis of HGPCa, ensuring that patients avoid unnecessary prostate biopsies with a low leakage rate. This manuscript describes the characteristics and diagnostic performance of each biomarker alone and in combination with mpMRI, with the intension to provide a basis for decision-making in the diagnosis and treatment of HGPCa. Additionally, we explored the applicability of the combination protocol to the Asian population.

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Section: Mpmri Combined With Biomarkers For the Diagnosis Of Hgpcamentioning

confidence: 88%

Section: Biomarkers For the Diagnosis Of Hgpcamentioning

confidence: 99%

Advances in multiparametric magnetic resonance imaging combined with biomarkers for the diagnosis of high-grade prostate cancer

Li,

Zha,

Wang

et al. 2024

Front. Surg.

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The Clinical Impact of the 4Kscore Test on Prostate Biopsy Decision Making in the Setting of MRI

Wang,

Vetter,

Kim

et al. 2024

JU Open Plus

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Introduction: Biomarkers are often used in conjunction with MRI to improve the specificity of prostate cancer screening. Our objective was to evaluate the real-world utility of the 4Kscore test in the setting of MRI. We explored the association of the 4Kscore test with the decision to pursue prostate biopsy and its contribution to the accurate detection of clinically significant prostate cancer. Methods: We retrospectively analyzed patients undergoing the 4Kscore test and MRI for consideration of prostate biopsy. Multivariable logistic regression was used to model the association of 4Kscore with the decision to pursue biopsy. Receiver-operating characteristic curves were used to calculate the AUC of 4Kscore alone, PSA with MRI, and 4Kscore with MRI for detection of Gleason Grade Group ≥ 2 (GG ≥ 2) prostate cancer. Results: Of 442 patients, 311 (70%) proceeded to biopsy. 4Kscore was associated with the decision to pursue biopsy for continuous (odds ratio [OR] 1.05 per 1-point increase in 4Kscore, 95% confidence interval [CI] 1.02-1.07; P < .001) and categorical (high-risk 4Kscore: OR 16.1, 6.62-39.3, P < .001; intermediate-risk 4Kscore: OR 6.89, 95% CI 3.15-15.1; P < .01) models. For the detection of GG ≥ 2 prostate cancer, the AUC of 4Kscore with MRI (AUC = 0.866) was superior to 4Kscore alone (AUC = 0.800, P < .001) and PSA with MRI (AUC = 0.792, P < .001). Conclusions: In patients with MRI, the 4Kscore is associated with the decision to pursue prostate biopsy and augments the accurate prediction of GG ≥ 2 prostate cancer. Our findings suggest 4Kscore provides independent information as an adjunct to MRI for real-world clinical decision making.

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Molecular diagnostics of prostate cancer: impact of molecular tests

Azzalini,

Bonin

2024

Asian Journal of Andrology

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Prostate cancer (PCa) is the second leading cause of cancer-related death among men. Prostate-specific antigen (PSA) testing is used in screening programs for early detection with a consequent reduction of PCa-specific mortality at the cost of overdiagnosis and overtreatment of the nonaggressive PCa. Recently, several assays have been commercially developed to implement PCa diagnosis, but they have not been included in both screening and diagnosis of PCa. This review aims to describe the actual and novel commercially available molecular biomarkers that can be used in PCa management to implement and tailor the screening and diagnosis of PCa.

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A multi-institutional study of 1,111 men with 4K score, multiparametric magnetic resonance imaging, and prostate biopsy

Cited by 3 publications

References 19 publications

Advances in multiparametric magnetic resonance imaging combined with biomarkers for the diagnosis of high-grade prostate cancer

Advances in multiparametric magnetic resonance imaging combined with biomarkers for the diagnosis of high-grade prostate cancer

The Clinical Impact of the 4Kscore Test on Prostate Biopsy Decision Making in the Setting of MRI

Molecular diagnostics of prostate cancer: impact of molecular tests

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