2036 low suspicion lesions on multiparametric magnetic resonance imaging do not signify high risk cancer

You have accessJournal of UrologyImaging/Radiology: Uroradiology I1 Apr 20122036 LOW SUSPICION LESIONS ON MULTIPARAMETRIC MAGNETIC RESONANCE IMAGING DO NOT SIGNIFY HIGH RISK CANCER Dmitry Volkin, Nitin Yerram, Jeffery Nix, An Hoang, Srinivas Vourganti, Faisal Ahmed, Gopal Gupta, Art Rastinehad, Jochen Kruecker, Sameul Kadoury, Julie Locklin, Stacey Gates, Sheng Xu, Maria Merino, W. Marston Linehan, Ismail Baris Turkbey, Peter L. Choyke, Bradford J. Wood, and Peter A. Pinto Dmitry VolkinDmitry Volkin Bethesda, MD More articles by this author , Nitin YerramNitin Yerram Bethesda, MD More articles by this author , Jeffery NixJeffery Nix Bethesda, MD More articles by this author , An HoangAn Hoang Bethesda, MD More articles by this author , Srinivas VourgantiSrinivas Vourganti Bethesda, MD More articles by this author , Faisal AhmedFaisal Ahmed Bethesda, MD More articles by this author , Gopal GuptaGopal Gupta Bethesda, MD More articles by this author , Art RastinehadArt Rastinehad Bethesda, MD More articles by this author , Jochen KrueckerJochen Kruecker Briarcliff Manor, NY More articles by this author , Sameul KadourySameul Kadoury Briarcliff Manor, NY More articles by this author , Julie LocklinJulie Locklin Bethesda, MD More articles by this author , Stacey GatesStacey Gates Bethesda, MD More articles by this author , Sheng XuSheng Xu Briarcliff Manor, NY More articles by this author , Maria MerinoMaria Merino Bethesda, MD More articles by this author , W. Marston LinehanW. Marston Linehan Bethesda, MD More articles by this author , Ismail Baris TurkbeyIsmail Baris Turkbey Bethesda, MD More articles by this author , Peter L. ChoykePeter L. Choyke Bethesda, MD More articles by this author , Bradford J. WoodBradford J. Wood Bethesda, MD More articles by this author , and Peter A. PintoPeter A. Pinto Bethesda, MD More articles by this author View All Author Informationhttps://doi.org/10.1016/j.juro.2012.02.2200AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookTwitterLinked InEmail INTRODUCTION AND OBJECTIVES Multiparametric magnetic resonance imaging (mpMRI) is an emerging tool for clinicians to improve prostate cancer detection. While high suspicion lesions correlate strongly with the presence of cancer, the importance of low suspicion lesions has not been well characterized. We report the biopsy findings of patients with only low suspicion lesions. METHODS We retrospectively reviewed all patients who underwent a 3 Tesla mpMRI of the prostate with endorectal coil from March 2007 to July 2011. Two radiologists independently reviewed and graded all suspicious lesions into low, moderate, or high risk groups. Lesions were stratified based on T2-weighted, spectroscopic, dynamic contrast enhanced (DCE) and diffusion weighted (DWI) MRI sequences. Low suspicion lesions are defined by a maximum of two positive parameters on mpMRI. Patients with only low suspicion lesions who subsequently underwent a random 12 core US biopsy + mpMRI/US fusion targeted biopsy were analyzed. RESULTS Of 800 patients who received mpMRI of the prostate, 92 patients (12%) had only low suspicion lesions on mpMRI. Mean age and PSA in this cohort were 59.7 years (36-81) and 7.84 ng/ml (0.3-64.7), respectively. All 92 patients underwent mpMRI/US fusion biopsy plus a 12-core TRUS random biopsy. Sixty-two of these patients (67%) had no cancer detected. Of the remaining thirty patients (33%) who were diagnosed with cancer on biopsy, twenty-two patients had Gleason 6 disease and eight patients had Gleason 7 (3+4) disease. Ten patients went on to radical prostatectomy and no one was pathologically upgraded to high risk cancer. Thus, for low suspicion lesions, 90% had either Gleason 6 or no cancer on biopsy while 100% had no primary Gleason 4 on their biopsy. CONCLUSIONS While mpMRI has become the most widely used imaging modality for lesion detection outside of ultrasound, its findings still need further characterization. Our results validate the belief that low suspicion lesions on mpMRI do not signify high risk cancer and thus, these patients gain minimal benefit from the addition of MRI/US guided fusion biopsy to their care. However, mpMRI alone may play a future role in following patients with only low risk disease in lieu of annual biopsies. © 2012 by American Urological Association Education and Research, Inc.FiguresReferencesRelatedDetails Volume 187Issue 4SApril 2012Page: e821-e822 Advertisement Copyright & Permissions© 2012 by American Urological Association Education and Research, Inc.MetricsAuthor Information Dmitry Volkin Bethesda, MD More articles by this author Nitin Yerram Bethesda, MD More articles by this author Jeffery Nix Bethesda, MD More articles by this author An Hoang Bethesda, MD More articles by this author Srinivas Vourganti Bethesda, MD More articles by this author Faisal Ahmed Bethesda, MD More articles by this author Gopal Gupta Bethesda, MD More articles by this author Art Rastinehad Bethesda, MD More articles by this author Jochen Kruecker Briarcliff Manor, NY More articles by this author Sameul Kadoury Briarcliff Manor, NY More articles by this author Julie Locklin Bethesda, MD More articles by this author Stacey Gates Bethesda, MD More articles by this author Sheng Xu Briarcliff Manor, NY More articles by this author Maria Merino Bethesda, MD More articles by this author W. Marston Linehan Bethesda, MD More articles by this author Ismail Baris Turkbey Bethesda, MD More articles by this author Peter L. Choyke Bethesda, MD More articles by this author Bradford J. Wood Bethesda, MD More articles by this author Peter A. Pinto Bethesda, MD More articles by this author Expand All Advertisement Advertisement PDF downloadLoading ...