The MRI-Adapted Prostate Cancer Risk Tool (MAPCaRT)
What is MAPCaRT?
The MRI-Adapted Prostate Cancer Risk Tool (MAPCaRT)1 is a pre-radical prostatectomy patient risk stratification tool that can help predict prostate cancer recurrence and assist in clinical decision-making.
Using accessible clinicopathologic data, the MAPCaRT calculator generates a risk score score from 0 to 11 allowing classification of men into the low (scores 0-2), intermediate (scores 3-5) or high (scores 6+) risk group.
The MAPCaRT calculator for MRI-targeted biopsies provides the associated biochemical recurrence-free probabilities. The MAPCaRT calculator for systematic only biopsies gives both the biochemical recurrence-free survival probabilities and event-free survival probabilities. An event is defined as metastasis or cancer-specific death.
Who should use MAPCaRT?
This tool is intended to assist clinicians in making disease management decisions for men who have undergone MRI-targeted prostate biopsy and/or systematic prostate biopsy.
Why was MAPCaRT developed?
MAPCaRT was developed to adapt to the advent of multiparametric MRI and to include a strong pathologic predictor of adverse clinical outcomes that has not yet been included in contemporary prostate cancer risk stratification tools, namely the presence of cribriform carcinoma (CC) and/or intraductal carcinoma (IDC) of the prostate.
How was MAPCaRT developed?
MAPCaRT is a modified and enhanced version of the Cancer of the Prostate Risk Assessment (CAPRA) tool.2 Compared to the original CAPRA tool, MAPCaRT includes the presence of cribriform/intraductal carcinoma (CC/IDC), and when assessing MRI-targeted biopsies, it uses the radiological stage and employs the aggregate core count method for targeted lesions.
MAPCaRT was developed based on a multi-institutional cohort of >1500 men who underwent systematic only prostate biopsies and/or MRI-targeted prostate biopsies. Rigorous statistical analyses were performed to validate the clinicopathologic variables included in MAPCaRT and to determine point attribution. Our study showed MAPCaRT to have overall superior model performance for predicting biochemical recurrence-free survival and event-free survival, with greater net clinical benefit.
MAPCaRT calculator for MRI-targeted prostate biopsy*
*Can be used for MRI-targeted only biopsy, or for combined MRI-targeted and systematic biopsy
MAPCaRT calculator for systematic only prostate biopsy
Abbreviations: BCR = biochemical recurrence; CC = cribriform pattern 4 carcinoma; IDC = intraductal carcinoma; PSA = prostate-specific antigen
References:
1. Nguyen NNJ, Liu K, Lajkosz K, Bernardino R, Yin LB, Hollemans E, Kroon LJ, Fleshner N, van Leenders GJLH, Iczkowski KA, van der Kwast TH, Downes MR. MRI-Adapted Prostate Cancer Risk Tool [Manuscript submitted for publication].
2. Cooperberg MR, Pasta DJ, Elkin EP, et al. The University of California, San Francisco Cancer of the Prostate Risk Assessment score: a straightforward and reliable preoperative predictor of disease recurrence after radical prostatectomy [published correction appears in J Urol. 2006 Jun;175(6):2369]. J Urol. 2005;173(6):1938-1942. doi:10.1097/01.ju.0000158155.33890.e7
Disclaimer:
Predictions made by this tool do not replace medical advice from your physician. The authors from this research study do not provide any warranties with regards to the accuracy and timeliness of the MAPCaRT risk stratification tool, and assume no responsibility or liability for any clinical decision deriving from its use. The hospitals and universities with whom the authors are affiliated do not endorse or claim the validity of the MAPCaRT score. No patient or health information that is being inputted or outputted using this online calculator will be stored in our system.