The prostate cancer prevention trial risk calculator 2.0 performs equally for standard biopsy and MRI/US fusion-guided biopsy

Background:the prostate cancer prevention trial risk calculator 2.0 (pcptrc) is a widely used risk-based calculator used to assess a man’s risk of prostate cancer (pca) before biopsy. this risk calculator was created from data of a patient cohort undergoing a 6-core sextant biopsy, and subsequently validated in men undergoing 12-core systematic biopsy (sbx). the accuracy of the pcptrc has not been studied in patients undergoing magnetic resonance imaging/ultrasound (mri/us) fusion-guided biopsy (fbx). we sought to assess the performance of the pcptrc for straitifying pca risk in a fbx cohort.methods:a review of a prospective cohort undergoing mri and fbx/sbx was conducted. data from consecutive fbx/sbx were collected between august 2007 and february 2014, and pcptrc scores using the pcptrc2.0r-code were calculated. the risk of positive biopsy and high-grade cancer (gleason ⩾7) on biopsy was calculated and compared with overall and high-grade cancer detection rates (cdrs). receiver operating characteristic curves were generated and the areas under the curves (aucs) were compared using delong’s test.results:of 595 men included in the study, pca was detected in 39% (232) by sbx compared with 48% (287) on combined fbx/sbx biopsy. the pcptrc aucs for the cdr were similar (p=0.70) for sbx (0.69) and combined biopsy (0.70). for high-grade disease, aucs for sbx (0.71) and combined biopsy (0.70) were slightly higher, but were not statistically different (p=0.55).conclusions:in an mri-screened population of men undergoing fbx, pcptrc continues to represent a practical method of accurately stratifying pca risk.