Prostate cancer lesion specific risk calculator

Calculate the risk of prostate cancer within a lesion after prostate MRI.

Estimate your prostate cancer risk within an MRI lesion with our simplified online calculator. Developed from a study of 193 targeted lesions (PIRADS 3+), this tool helps assess the likelihood of any cancer and significant prostate cancer (Gleason Grade Group 3+) within a specific MRI-detected lesion. Simplified from a published model (Mukherjee et al., BJR 2024), this calculator provides a risk estimate but should not replace professional medical advice or be used for treatment decisions. Learn more about the methodology and limitations below.

The following calculator approximates the risk of finding prostate cancer within an MRI lesion rather than the prostate as a whole. It has been developed from a dataset of 193 lesions which were targeted by transperineal biopsy after MRI prostate. A lesion is defined as being PIRADs 3 or greater. This is a simplified version of a published model; High-grade prostate cancer demonstrates preferential growth in the cranio-caudal axis and provides discrimination of disease grade in an MRI parametric model Mukherjee et al., British Journal of Radiology, Volume 97, Issue 1155, March 2024, Pages 574–582. This published model was validated internally on a second cohort but has not undergone external validation. The simplified models shown here has not been validation on a separate cohort. The wider applicability of such models is unknown as patient characteristic, health systems and diagnostic processes will affect model parameters. Pirads Scores interpretation may vary between radiographers and the lowest target ADC measurements within a lesion may be vary between MRI scanners

The simple calculator omits the minimum lesion ADC score, though this readily measurable it is not typically quoted in most MRI prostate reports.

The output is for the risk of any cancer within a target lesion and the risk of significant prostate cancer (defined as grade group 3 or more, i.e., Gleason primary pattern 4) within a lesion. The simple calculator performs with an area under ROC curve of 0.84 for the prediction of significant cancer and 0.78 for the prediction of cancer. The advanced calculator performs with an area under ROC curve of 0.88 for the prediction of significant cancer and 0.84 for the prediction of cancer within the test cohort.

The model is for guidance only and should not be used as a basis for treatment decisions, and is no substitute for a medical evaluation