704 844
MRI for ECE prediction, finding an AUC of 0.69 for clinical
model alone, 0.72 for clinical model + nonspecialized-
reading MRI and 0.91 for the two previous elements +
specialized (dedicated radiologist) MRI reading. In our study,
all the radiologists involved in final MRI readings were
consultants with a consolidated experience in genitourinary
pathology, and the incremental benefit was already evident
at first reading.
Our study has several limitations, including the retro-
spective nature, the high percentage of high-risk patients in
the cohort, the long study period, and the lack of use of the
Prostate Imaging Reporting and Data System system
[9] .A
detailed discussion of these aspects can be found in
Supplementary Data 2.
In conclusion, MRI provides additional predictive value
to clinical-based models alone, but it is possible that our
findings underestimate the true diagnostic accuracy of MRI
and its added value. As such, prospective investigations
with Prostate Imaging Reporting and Data System and
multiparametric MRI use are warranted to clarify the ability
of MRI to improve clinical prediction in this setting.
Author contributions
:
[3_TD$DIFF]
R.
[4_TD$DIFF]
Jeffrey Karnes had full access to all the data in the
study and takes responsibility for the integrity of the data and the accuracy
of the data analysis.
Study concept and design:
Morlacco, Karnes, Sharma, Froemming.
Acquisition of data:
Morlacco, Carlson, Rangel, Sharma, Viers.
Analysis and interpretation of data:
Morlacco, Rangel, Carlson, Froem-
ming
[5_TD$DIFF]
, Karnes.
Drafting of the manuscript:
Morlacco, Karnes, Viers, Sharma, Froemming.
Critical revision of the manuscript for important intellectual content:
Morlacco, Sharma, Viers, Rangel, Carlson, Froemming, Karnes.
Statistical analysis:
Rangel, Carlson, Morlacco.
Obtaining funding:
None.
Administrative, technical, or material support:
None.
Supervision:
Karnes, Froemming.
Other:
None.
Financial disclosures:
[3_TD$DIFF]
R.
[4_TD$DIFF]
Jeffrey Karnes certifies that all conflicts of
interest, including specific financial interests and relationships and
affiliations relevant to the subject matter or materials discussed in the
manuscript (eg, employment/affiliation, grants or funding, consultan-
cies, honoraria, stock ownership or options, expert testimony, royalties,
or patents filed, received, or pending), are the following: None.
Funding/Support and role of the sponsor:
This publication was made
possible by Clinical and Translational Science Award Grant Number UL1
TR000135 from the National Center for Advancing Translational
Sciences, a component of the National Institutes of Health. Its contents
are solely the responsibility of the authors and do not necessarily
represent the official view of National Institutes of Health.
Appendix A. Supplementary data
Supplementary data associated with this article can be
found, in the online version, at
http://dx.doi.org/10.1016/j. eururo.2016.08.015.
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