ABSTRACT
Objective
To compare test performance of multiparametric magnetic resonance imaging (mpMRI)
for detection of prostate cancer (PCa) in African-American men (AAM) and white men
(WM) using the Prostate Imaging Reporting and Data System in unmatched groups as well
as a cohort matched for clinical factors.
Methods
We examined our database of men who underwent prostate mpMRI prior to biopsy between
October 2014 and June 2017 (n = 601; 60 AAM, 541 WM). Test performance was defined using Prostate Imaging Reporting
and Data System classification 4 or 5 considered test positive and Gleason grade group
2 or greater from any biopsy core considered outcome positive. A subset analysis was
performed using a propensity score caliper matching algorithm to match AAM to WM in
a 1:2 ratio using the variables age, PSA, and PSA density.
Results
No significant differences in test performance were found with similar sensitivity
(86.7% vs 83.6, P = 1.00), specificity (45.9% vs 49.1%, P = .71), positive predictive value (50.0% vs 46.9%), and negative predictive value
(85.0% vs 84.8%, P = 1.00) for AAM and WM. Similar results were noted in our matched comparison. The
rate of upgrading between targeted and systematic biopsy cores did not statistically
differ between AAM and WM in both unmatched (12.2% vs. 15.8%, P = .66) and matched (12.2% vs 12.8%, P = .92) comparisons.
Conclusion
Our findings provide supporting evidence that AAM have similar outcomes to WM in PCa
detection using mpMRI. We suggest that mpMRI should not be withheld or offered preferentially
on the basis of race when used for the detection of PCa.
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Article info
Publication history
Published online: August 13, 2019
Accepted:
August 5,
2019
Received:
June 28,
2019
Footnotes
Conflicts of Interest: None.
Identification
Copyright
© 2019 Elsevier Inc. All rights reserved.
