ExoDx Score Does Not Apply to Urology
The ExoDx score referenced in your question appears to be for lung nodule evaluation and is not applicable to urology. However, there is a completely separate ExoDx test specifically designed for urology called ExoDx Prostate (IntelliScore), which is used for prostate cancer risk assessment 1, 2.
Clarification of Two Distinct ExoDx Tests
ExoDx for Lung Nodules
- The evidence provided discusses lung nodule evaluation using various risk stratification models and imaging approaches, but does not mention any ExoDx test for pulmonary nodules 3
- Lung nodule risk assessment relies on clinical prediction models (such as the Mayo Clinic model), imaging characteristics (size, spiculation, upper lobe location), and functional imaging with PET-CT 3
- The American College of Chest Physicians recommends using validated clinical prediction models that incorporate age, smoking history, cancer history, nodule diameter, spiculation, and location for pulmonary nodules ≥8 mm 3
ExoDx Prostate (IntelliScore) for Urology
- This is a completely different test that analyzes urine exosomal RNA expression to assess prostate cancer risk prior to biopsy 2, 4
- The ExoDx Prostate test measures expression levels of three biomarkers (ERG, PCA3, and SPDEF) from first-catch urine samples 4
- It is specifically indicated for men ≥50 years old with PSA levels of 2-10 ng/mL who are being considered for initial prostate biopsy 2, 5, 4
- The test discriminates high-grade prostate cancer (Gleason score ≥7) from low-grade cancer and benign disease with an AUC of 0.73-0.77, superior to standard of care alone 2
Clinical Application in Urology
- The ExoDx Prostate test can reduce unnecessary biopsies by approximately 27% while missing only 5% of high-risk Gleason score 7 disease 2
- In clinical practice, 68% of urologists reported that the ExoDx Prostate test influenced their biopsy decision, with 63% of patients with negative scores being recommended to defer biopsy 5
- The test outperforms multivariate risk calculators (PCPT and ERSPC) in predicting post-prostatectomy pathology outcomes, particularly for men with Gleason grade 1 at biopsy who are potential active surveillance candidates 6, 4
Important Caveat
If you are asking about a lung nodule evaluation score being used in urology, the answer is definitively no—these are organ-specific diagnostic tools that cannot be cross-applied. The lung nodule risk models incorporate pulmonary-specific variables like spiculation, upper lobe location, and nodule characteristics that have no relevance to urologic malignancies 3.