PT - JOURNAL ARTICLE AU - PEPE, PIETRO AU - DIBENEDETTO, GIUSEPPE AU - PEPE, LUDOVICA AU - PENNISI, MICHELE TI - Multiparametric MRI <em>Versus</em> SelectMDx Accuracy in the Diagnosis of Clinically Significant PCa in Men Enrolled in Active Surveillance AID - 10.21873/invivo.11786 DP - 2020 Jan 01 TA - In Vivo PG - 393--396 VI - 34 IP - 1 4099 - http://iv.iiarjournals.org/content/34/1/393.short 4100 - http://iv.iiarjournals.org/content/34/1/393.full SO - In Vivo2020 Jan 01; 34 AB - Background/Aim: To evaluate the diagnostic accuracy of the urinary SelectMDx test in the diagnosis of clinically significant prostate cancer (csPCa) in men enrolled in an active surveillance (AS) protocol. Patients and Methods: From July 2015 to July 2018, 125 men with very low-risk PCa were enrolled in the AS protocol; all patients underwent confirmatory transperineal saturation biopsy (SPBx). In the presence of PI-RADS score ≥3, a targeted MRI/TRUS fusion-guided biopsy was added to SPBx. Post-digital rectal examination urine was collected in 45/125 (36%) patients before SPBx; the genetic urine analysis was performed using a biomarker-based risk score model, the SelectMDx, that measured mRNA levels of distal-less homeobox 1 (DLX1) and homeobox C6 (HOXC6). Results: A total of 9/45 (20%) patients were reclassified as csPCa (7 cases=Grade Group 2; 2 cases=Grade Group 3); sensitivity, specificity, positive predictive value, negative predictive value and diagnostic accuracy of mpMRI vs. SelectMDx in the diagnosis of csPCa were equal to 66.6 vs. 55.6%, 87.7 vs. 65.8%, 54.5 vs. 27.8%, 92.3 vs. 87%, 84.9 vs. 70.3%, respectively. Conclusion: SPBx combined with MRI/TRUS fusion biopsy significantly outperformed the diagnostic accuracy of SelectMDx (70.3%) in the diagnosis of csPCa in men enrolled in AS.