When you think of Italy, what stands out in your mind? Perhaps it’s landmarks like the Colosseum, Trevi Fountain, or Leaning Tower of Pisa. Maybe you think of designers like Armani, Versace or Zegna. No doubt Ferrari cars spring to mind, as well as the mystique of Venice or the Renaissance wonders of Florence. And who can forget the tastes of Italian cuisine, from hearty hot pasta dishes to cooling lemon granita on a sweltering summer day.
Italian culture is characterized by a combination of elements that please the senses. Thus, when returning travelers are asked if one thing stood out, they may well find themselves undecided. However, being selective about a single decisive factor for detecting prostate cancer (PCa) came easily to a group of 15 Italian researchers. They were collaborators on a study to “develop and validate a clinical decision support system” based on a model of combined predictive factors vs. a single stand-alone factor.[i] The factors they chose were age, PSA, microRNA (miRNA), and MRI for the detection of PCa and clinically significant PCa.
They tested each variable alone and in combination with the others to evaluate which model offered the best PCa prediction in biopsy-naïve patients. Their study included 122 patients whose age and PSA were recorded, followed by prostate MRI, an assessment of two particular miRNAs that are PCa biomarkers, and biopsy. Biopsy results were correlated with detection findings of all other models alone and in combination.
When solo models and combinations were compared, MRI outcomes were the best detectors of both PCa and clinically significant PCa with high rates of sensitivity and negative predictive values:
- For PCa, sensitivity was 90%, negative predictive value was 93%
- For clinically significant PCa, sensitivity was 91% and negative predictive value was 95%.
Furthermore, the authors noted that the use of miRNAs “did not improve classification performances compared to MRI stand-alone results.” To underscore the importance of MRI as an outstanding single predictor of PCa, the team concluded, “Clinical decision support systems including MRI improve the detection of both prostate cancer and clinically significant prostate cancer with respect to PSA test and/or microRNA.”
For most of us, if we have to point to one thing about Italy that strikes us above all others, it may be a tough choice. Thankfully, for the Italian clinical researchers in the study, MRI was a “no-brainer” standout.
NOTE: This content is solely for purposes of information and does not substitute for diagnostic or medical advice. Talk to your doctor if you are experiencing pelvic pain, or have any other health concerns or questions of a personal medical nature.
References
[i] Mazzetti S, Defeudis A, Nicoletti G, Chiorino G et al. Development and validation of a clinical decision support system based on PSA, microRNAs, and MRI for the detection of prostate cancer. Eur Radiol. 2024 Jan 4.
About Dr. Dan Sperling
Dan Sperling, MD, DABR, is a board certified radiologist who is globally recognized as a leader in multiparametric MRI for the detection and diagnosis of a range of disease conditions. As Medical Director of the Sperling Prostate Center, Sperling Medical Group and Sperling Neurosurgery Associates, he and his team are on the leading edge of significant change in medical practice. He is the co-author of the new patient book Redefining Prostate Cancer, and is a contributing author on over 25 published studies. For more information, contact the Sperling Prostate Center.
