Assay-specific artificial neural networks for five different PSA assays and populations with PSA 2-10 ng/ml in 4,480 men.
Use of percent free PSA (%fPSA) and artificial neural networks (ANNs) can eliminate unnecessary prostate biopsies. In a total of 4,480 patients from five centers with PSA concentrations in the range of 2-10 ng/ml an IMMULITE PSA-based ANN (iANN) was compared with other PSA assay-adapted ANNs (nANNs) to investigate the impact of different PSA assays. ANN data were generated with PSA, fPSA (assays from Abbott, Beckman, DPC, Roche or Wallac), age, prostate volume, and DRE status. In 15 different ROC analyses, the area under the curve (AUC) in the PSA ranges 2-4, 2-10, and 4-10 ng/ml for the nANN was always significantly larger than the AUC for %fPSA or PSA. The nANN and logistic regression models mostly also performed better than the iANN. Therefore, for each patient population, PSA assay-specific ANNs should be used to optimize the ANN outcome in order to reduce the number of unnecessary biopsies.
Stephan
Carsten
C
Department of Urology, Charité-Universitätsmedizin Berlin, CCM, Berlin, Germany. carsten.stephan@charite.de
Xu
Chuanliang
C
Cammann
Henning
H
Graefen
Markus
M
Haese
Alexander
A
Huland
Hartwig
H
Semjonow
Axel
A
Diamandis
Eleftherios P
EP
Remzi
Mesut
M
Djavan
Bob
B
Wildhagen
Mark F
MF
Blijenberg
Bert G
BG
Finne
Patrik
P
Stenman
Ulf-Hakan
UH
Jung
Klaus
K
Meyer
Hellmuth-Alexander
HA
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D014408:Biomarkers, Tumor / Q000097:blood; D006801:Humans; D008297:Male; D008403:Mass Screening / Q000295:instrumentation* / Q000379:methods; D008875:Middle Aged; D016571:Neural Networks, Computer; D017430:Prostate-Specific Antigen / Q000097:blood*; D011471:Prostatic Neoplasms / Q000097:blood* / Q000175:diagnosis* / Q000453:epidemiology; D012372:ROC Curve; D012307:Risk Factors; D012680:Sensitivity and Specificity
D014408:Biomarkers, Tumor; D017430:Prostate-Specific Antigen