Scholarlink

Objectives <p>The Prostate Cancer Radiological Estimation of Change in Sequential Evaluation (PRECISE) recommendations assess radiological change in serial MRI during active surveillance (AS) for prostate cancer. PRECISE 1–2 indicates radiological regression, PRECISE 3 stability, and PRECISE 4–5 progression. Our aim was to test the PRECISE score as a predictive tool for disease progression in a multicentre international setting.</p> Materials and methods <p>This is a retrospective study in which we collected data from 22 international centres from December 2005 to July 2022, applying two entry criteria: (1) at least two scans (baseline and follow-up); (2) at least two biopsies (baseline and follow-up, the latter after the second scan). Local radiologists reported scans according to PRECISE. Sensitivity, specificity, positive predictive value (PPV) and negative predictive value (NPV) according to different biopsy thresholds and definitions of progression were calculated.</p> Results <p>A total of 1667 patients were included. Median follow-up was 4 years (IQR: 2.1–6.3). A total of 1248 (75%) patients underwent two MRIs and immediate subsequent biopsy, 300 (24%) of which had biopsy progression to Grade Group ≥ 2 and 77 (6%) to Grade Group ≥ 3. Patients with PRECISE 4–5 had 4.53-fold increased odds (95% CI: 3.37–6.12; <i>p</i> &lt; 0.001) of biopsy progression compared to PRECISE 1–3. Using a PRECISE ≥ 4 cutoff to perform follow-up biopsies, overall&#xa0;sensitivity, specificity, PPV and NPV were 57%, 79%, 46%, and 85% for the first follow-up scan.</p> Conclusion <p>The PRECISE recommendations could lead to timely identification of patients on AS who progress on MRI, prompting re-biopsy or treatment, and safe reduction of repeat biopsies for those with stable MRI and prostate-specific antigen kinetics.</p> Key Points <p><Emphasis Type="BoldItalic">Question</Emphasis> <i>Can the PRECISE scoring system for monitoring prostate cancer lesions on active surveillance on MRI predict disease progression and avoid unnecessary biopsies?</i></p> <p><Emphasis Type="BoldItalic">Findings</Emphasis> <i>The PRECISE score effectively predicts prostate cancer progression, with PRECISE 4–5 (progression) scores indicating 4.53-fold increased odds of biopsy progression compared to PRECISE 1–3 (regression/stability).</i></p> <p><Emphasis Type="BoldItalic">Clinical relevance</Emphasis> <i>This study validates PRECISE as a tool for managing patients on active surveillance. It can help clinicians identify those needing timely re-biopsy or treatment, while reducing unnecessary biopsies in patients with stable disease on imaging and PSA kinetics.</i></p> Graphical Abstract <p></p>

错误：搜索内容不能为空，请输入英文关键词
错误：关键词超出字数限制，请精简
高级检索

Multicentre validation of the PRECISE scoring system for prostate MRI during active surveillance

  • 期刊论文

  • 出版模式：

    开放获取

  • 发表日期：

    2026年5月4日

查看全文
  • Francesco Giganti,
  • Riccardo Leni,
  • Vinayak Wagaskar,
  • Giorgio Gandaglia,
  • Tristan Barrett,
  • Valeria Panebianco,
  • Francesco Sanguedolce,
  • Erik JRJ van der Hoeven,
  • Sangeet Ghai,
  • Jeremy Grummet,
  • Jasmin Gmeiner,
  • Jan Philipp Radtke,
  • Ryan D. Ward,
  • Ronaldo Hueb Baroni,
  • Francesco Porpiglia,
  • Juan Gomez Rivas,
  • Fabio Zattoni,
  • Raphaële Renard-Penna,
  • Claudia Kesch,
  • Marco Gatti,
  • Nicola Schieda,
  • Guillaume Ploussard,
  • Sara Lewis,
  • Giorgio Brembilla,
  • Christof Kastner,
  • Emanuele Messina,
  • Ash Tewari,
  • Caroline M. Moore,
  • Massimo Valerio,
  • Armando Stabile,
  • Veeru Kasivisvanathan,
  • Alex Freeman,
  • Aiman Haider,
  • Cameron Englman,
  • Clare Allen,
  • Mark Emberton,
  • Louise Dickinson,
  • Monali Fatterpekar,
  • Cristina Pasat-Karasik,
  • Parita Ratnani,
  • Alberto Briganti,
  • Francesco Barletta,
  • Simone Scuderi,
  • Leonardo Quarta,
  • Francesco Montorsi,
  • Nimalan Sanmugalingam,
  • Nikita Sushentsev,
  • Iztok Caglic,
  • Kang Lung Lee,
  • Antonella Borrelli,
  • Ludovica Laschena,
  • Martina Pecoraro,
  • Ailin Dehghanpour,
  • Arnas Rakauskas,
  • Naik Vietti Violi,
  • Jonathan Hernandez,
  • Joris G. Heetman,
  • Antonio Finelli,
  • Tho Pham,
  • Pawel Rajwa,
  • Pascal Baltzer,
  • Lars Schimmöller,
  • Matthias Boschheidgen,
  • Andrei S. Purysko,
  • Fernando Morbeck Coelho,
  • Enrico Checcucci,
  • Irene de la Parra,
  • Filippo Crimì,
  • Boris A. Hadaschik

摘要

Objectives

The Prostate Cancer Radiological Estimation of Change in Sequential Evaluation (PRECISE) recommendations assess radiological change in serial MRI during active surveillance (AS) for prostate cancer. PRECISE 1–2 indicates radiological regression, PRECISE 3 stability, and PRECISE 4–5 progression. Our aim was to test the PRECISE score as a predictive tool for disease progression in a multicentre international setting.

Materials and methods

This is a retrospective study in which we collected data from 22 international centres from December 2005 to July 2022, applying two entry criteria: (1) at least two scans (baseline and follow-up); (2) at least two biopsies (baseline and follow-up, the latter after the second scan). Local radiologists reported scans according to PRECISE. Sensitivity, specificity, positive predictive value (PPV) and negative predictive value (NPV) according to different biopsy thresholds and definitions of progression were calculated.

Results

A total of 1667 patients were included. Median follow-up was 4 years (IQR: 2.1–6.3). A total of 1248 (75%) patients underwent two MRIs and immediate subsequent biopsy, 300 (24%) of which had biopsy progression to Grade Group ≥ 2 and 77 (6%) to Grade Group ≥ 3. Patients with PRECISE 4–5 had 4.53-fold increased odds (95% CI: 3.37–6.12; p < 0.001) of biopsy progression compared to PRECISE 1–3. Using a PRECISE ≥ 4 cutoff to perform follow-up biopsies, overall sensitivity, specificity, PPV and NPV were 57%, 79%, 46%, and 85% for the first follow-up scan.

Conclusion

The PRECISE recommendations could lead to timely identification of patients on AS who progress on MRI, prompting re-biopsy or treatment, and safe reduction of repeat biopsies for those with stable MRI and prostate-specific antigen kinetics.

Key Points

Question Can the PRECISE scoring system for monitoring prostate cancer lesions on active surveillance on MRI predict disease progression and avoid unnecessary biopsies?

Findings The PRECISE score effectively predicts prostate cancer progression, with PRECISE 4–5 (progression) scores indicating 4.53-fold increased odds of biopsy progression compared to PRECISE 1–3 (regression/stability).

Clinical relevance This study validates PRECISE as a tool for managing patients on active surveillance. It can help clinicians identify those needing timely re-biopsy or treatment, while reducing unnecessary biopsies in patients with stable disease on imaging and PSA kinetics.

Graphical Abstract