Table 3. Comparison of Biopsy Strategya.
| Significant Prostate Cancer Definition | Biopsies, No. (% [95% CI])b | Difference, % (95% CI) | P Value, McNemar Test | ||
|---|---|---|---|---|---|
| Standard (All Men) | Combined (modified PI-RADS 3-5) | Absolute | Relative | ||
| Men with biopsy performed | 1020 (100 [99 to 100]) | 715 (70 [67 to 73]) | –30 (–33 to –27) | –30 (–33 to –27) | <.001 |
| Biopsy cores, No. | 9268 | 7339c | –21 (–22 to –20) | –21 (–22 to –20) | <.001 |
| No prostate cancer on biopsy | 381 (37 [34 to 40]) | 146 (14 [12 to 17]) | –23 (–27 to –19) | –62 (–68 to –55) | <.001 |
| Primary definition of significant prostate cancerd | |||||
| Insignificant prostate cancer | 288 (28 [26 to 31]) | 173 (17 [15 to 19]) | –11 (–15 to –8) | –40 (–49 to –29) | <.001 |
| Significant prostate cancer | 351 (34 [32 to 37]) | 396 (39 [36 to 42]) | 4 (0.2 to 9) | 11 (0.6 to 21) | <.001 |
| Secondary definition of significant prostate cancere | |||||
| Insignificant prostate cancer | 262 (25 [23 to 29]) | 145 (14 [12 to 17]) | –11 (–15 to –8) | –45 (–54 to –34) | <.001 |
| Significant prostate cancer | 377 (37 [34 to 40]) | 424 (42 [39 to 45]) | 5 (0.4 to 9) | 11 (0.9 to 21) | <.001 |
| Tertiary definition of significant prostate cancerf | |||||
| Insignificant prostate cancer | 198 (19 [17 to 22]) | 115 (11 [9 to 13]) | –8 (–11 to –5) | –42 (–53 to –28) | <.001 |
| Significant prostate cancer | 441 (43 [40 to 46]) | 454 (45 [41 to 48]) | 1 ( to 3 to 6) | 3 (−7 to 12) | .11 |
Abbreviation: PI-RADS, Prostate Imaging Reporting and Data System.
Comparison of the diagnostic strategies of standard biopsies in all men vs combined (standard plus targeted) biopsies restricted to men with suspicious biparametric magnetic resonance imaging findings (modified PI-RADS score 3-5) using different definitions of significant prostate cancer.
The total number of patients (N = 1020) was used as the denominator for calculating all percentages.
Includes 6231 standard biopsies and 1108 targeted biopsies.
Gleason score of 4 + 3 or greater or maximum cancer-core length greater than 50% with a Gleason score of 3 + 4. The prevalence was 404 men (40% [95% CI, 37%-43%]).
Gleason score of 4 + 3 or greater or maximum cancer-core length greater than 50% with any PCa. The prevalence was 436 men (43% [95% CI, 40%-46%]).
Gleason score of 3 + 4 or greater. The prevalence was 475 men (47% [95% CI, 44%-50%]).