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@ARTICLE{Boschheidgen:284932,
      author       = {M. Boschheidgen and P. Albers$^*$ and H.-P. Schlemmer$^*$
                      and S. Hellms and D. Bonekamp$^*$ and A. Sauter and B.
                      Hadaschik$^*$ and A. Krilaviciute$^*$ and J. P. Radtke and
                      P. Seibold$^*$ and J. Lakes and C. Arsov and J. E. Gschwend
                      and K. Herkommer and M. Makowski and M. A. Kuczyk and F.
                      Wacker and N. Harke and J. Debus and S. A. Körber and A.
                      Benner$^*$ and G. Kristiansen and F. L. Giesel and G. Antoch
                      and R. Kaaks$^*$ and N. Becker$^*$ and L. Schimmöller},
      title        = {{M}ultiparametric {M}agnetic {R}esonance {I}maging in
                      {P}rostate {C}ancer {S}creening at the {A}ge of 45 {Y}ears:
                      {R}esults from the {F}irst {S}creening {R}ound of the
                      {PROBASE} {T}rial.},
      journal      = {European urology},
      volume       = {85},
      number       = {2},
      issn         = {0302-2838},
      address      = {Amsterdam [u.a.]},
      publisher    = {Elsevier Science},
      reportid     = {DKFZ-2023-02132},
      pages        = {105-111},
      year         = {2024},
      note         = {2024 Feb;85(2):105-111},
      abstract     = {Magnetic resonance imaging (MRI) has been suggested as a
                      tool for guiding biopsy recommendations in prostate cancer
                      (PC) screening.To determine the performance of
                      multiparametric MRI (mpMRI) in young men at age 45 yr who
                      participated in a PC screening trial (PROBASE) on the basis
                      of baseline prostate-specific antigen (PSA).Participants
                      with confirmed PSA ≥3 ng/ml were offered mpMRI followed by
                      MRI/transrectal ultrasound fusion biopsy (FBx) with targeted
                      and systematic cores. mpMRI scans from the first screening
                      round for men randomised to an immediate PSA test in PROBASE
                      were evaluated by local readers and then by two reference
                      radiologists (experience >10 000 prostate MRI examinations)
                      blinded to the histopathology. The PROBASE trial is
                      registered as ISRCTN37591328 OUTCOME MEASUREMENTS AND
                      STATISTICAL ANALYSIS: The local and reference Prostate
                      Imaging-Data and Reporting System (PI-RADS) scores were
                      compared, and the sensitivity, negative predictive value
                      (NPV), and accuracy were calculated for both readings for
                      different cutoffs (PI-RADS 3 vs 4).Of 186 participants, 114
                      underwent mpMRI and FBx. PC was detected in 47 $(41\%),$ of
                      whom 33 $(29\%)$ had clinically significant PC (csPC;
                      International Society of Urological Pathology grade group
                      ≥2). Interobserver reliability between local and reference
                      PI-RADS scores was moderate (k = 0.41). At a cutoff of
                      PI-RADS 4, reference reading showed better performance for
                      csPC detection (sensitivity $79\%,$ NPV $91\%,$ accuracy of
                      $85\%)$ than local reading (sensitivity $55\%,$ NPV $80\%,$
                      accuracy $68\%).$ Reference reading did not miss any PC
                      cases for a cutoff of PI-RADS <3. If PI-RADS ≥4 were to be
                      used as a biopsy cutoff, mpMRI would reduce negative
                      biopsies by $68\%$ and avoid detection of nonsignificant PC
                      in $71\%$ of cases.Prostate MRI in a young screening
                      population is difficult to read. The MRI accuracy of for
                      csPC detection is highly dependent on reader experience, and
                      double reading might be advisable. More data are needed
                      before MRI is included in PC screening for men at age 45
                      yr.Measurement of prostate specific antigen (PSA) is an
                      effective screening test for early detection of prostate
                      cancer (PC) and can reduce PC-specific deaths, but it can
                      also lead to unnecessary biopsies and treatment. Magnetic
                      resonance imaging (MRI) after a positive PSA test has been
                      proposed as a way to reduce the number of biopsies, with
                      biopsy only recommended for men with suspicious MRI
                      findings. Our results indicate that MRI accuracy is moderate
                      for men aged 45 years but can be increased by a second
                      reading of the images by expert radiologists. For broad
                      application of MRI in routine screening, double reading may
                      be advisable.},
      keywords     = {Magnetic resonance imaging, Interventional (Other) /
                      Multiparametric magnetic resonance imaging (Other) /
                      Prostatic neoplasms (Other) / Screening (Other)},
      cin          = {C130 / E010 / ED01 / C060 / C020},
      ddc          = {610},
      cid          = {I:(DE-He78)C130-20160331 / I:(DE-He78)E010-20160331 /
                      I:(DE-He78)ED01-20160331 / I:(DE-He78)C060-20160331 /
                      I:(DE-He78)C020-20160331},
      pnm          = {313 - Krebsrisikofaktoren und Prävention (POF4-313)},
      pid          = {G:(DE-HGF)POF4-313},
      typ          = {PUB:(DE-HGF)16},
      pubmed       = {pmid:37863727},
      doi          = {10.1016/j.eururo.2023.09.027},
      url          = {https://inrepo02.dkfz.de/record/284932},
}