Pd43-03 risk of prostate cancer diagnosis following a low-suspicious prostate mri or benign mri-targeted biopsies: a 3-year follow-up study of men with prior negative transrectal ultrasound guided biopsies

You have accessJournal of UrologyProstate Cancer: Detection & Screening VI1 Apr 2017PD43-03 RISK OF PROSTATE CANCER DIAGNOSIS FOLLOWING A LOW-SUSPICIOUS PROSTATE MRI OR BENIGN MRI-TARGETED BIOPSIES: A 3-YEAR FOLLOW-UP STUDY OF MEN WITH PRIOR NEGATIVE TRANSRECTAL ULTRASOUND GUIDED BIOPSIES Lars Boesen, Nis Nørgaard, Vibeke Løgager, Ingegerd Balslev, and Henrik S. Thomsen Lars BoesenLars Boesen More articles by this author , Nis NørgaardNis Nørgaard More articles by this author , Vibeke LøgagerVibeke Løgager More articles by this author , Ingegerd BalslevIngegerd Balslev More articles by this author , and Henrik S. ThomsenHenrik S. Thomsen More articles by this author View All Author Informationhttps://doi.org/10.1016/j.juro.2017.02.1908AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookTwitterLinked InEmail INTRODUCTION AND OBJECTIVES Multiparametric MRI (mp-MRI) is a non-invasive imaging technique that is increasingly used to stratify patients and lesions according to suspicion and risk of having significant prostate cancer (sPCa). Whereas, high suspicious findings on mp-MRI often appear to be PCa, a low-suspicious mp-MRI is assumed to predict the absence of sPCa. However, the clinical outcome after a low-suspicious mp-MRI or benign mp-MRI targeted biopsies of a suspicious lesion in a longer term is uncertain. The objective was to assess the clinical impact and the time-varying risk of being diagnosed with sPCa following either a low-suspicious mp-MRI or benign mp-MRI targeted biopsies (mp-MRI-bx) in men with prior negative transrectal ultrasound biopsies (TRUS-bx). METHODS 289 patients were included and underwent mp-MRI followed by re-TRUS-bx and mp-MRI-bx of suspicious lesions at baseline. Of these, 194 patients had either a low suspicious mp-MRI or benign mp-MRI-bx and were selected for this analysis. Men diagnosed with PCa by re-TRUS-bx were classified as mp-MRI false-negative. Men without cancer were followed for at least three years to assess how many had another re-biopsy and a subsequent diagnosis of PCa within follow-up (see flow diagram). The negative predictive values (NPV) of mp-MRI and mp-MRI-bx for ruling out any PCa, significant grade (Gleason score≥7) PCa and clinical sPCa were calculated. RESULTS PCa was detected in 38/194 (20%) patients during the entire follow-up period of median 44 (range 36-59) months. The overall NVP of mp-MRI and mp-MRI-bx to rule out any PCa and significant grade PCa was 80% (156/194) and 95% (185/194), respectively. In addition, the NPV of clinical sPCa was 88% (170/194) caused by 15 patients with Gleason score 6 cancer having a PSA-density > 0.15 ng/ml/cc. No patients with low suspicious mp-MRI features had significant grade PCa detected CONCLUSIONS A low suspicious mp-MRI in patients with previous negative TRUS-bx has a high NPV for ruling out sPCa in a longer term. Thus, immediate repeated biopsies have only diminutive clinical impact and could be avoided even in men with persistent elevated PSA-levels. © 2017FiguresReferencesRelatedDetails Volume 197Issue 4SApril 2017Page: e818 Advertisement Copyright & Permissions© 2017MetricsAuthor Information Lars Boesen More articles by this author Nis Nørgaard More articles by this author Vibeke Løgager More articles by this author Ingegerd Balslev More articles by this author Henrik S. Thomsen More articles by this author Expand All Advertisement Advertisement PDF downloadLoading ...