Pd65-11 Does Pi-rads V2 Scores Predict Adverse Surgical Pathology at Radical Prostatectomy?
Year: 2017
Type: article
Study design: Observational Study
Abstract: You have accessJournal of UrologyProstate Cancer: Markers II1 Apr 2017PD65-11 DOES PI-RADS V2 SCORES PREDICT ADVERSE SURGICAL PATHOLOGY AT RADICAL PROSTATECTOMY? Hao Nguyen, Antonio Westphalen, Ameli Niloufar, Michael Leapman, Janet Cowan, Jeff Simko, Katsuto Shinohara, and Peter Carroll Hao NguyenHao Nguyen More articles by this author , Antonio WestphalenAntonio Westphalen More articles by this author , Ameli NiloufarAmeli Niloufar More articles by this author , Michael LeapmanMichael Leapman More articles by this author , Janet CowanJanet Cowan More articles by this author , Jeff SimkoJeff Simko More articles by this author , Katsuto ShinoharaKatsuto Shinohara More articles by this author , and Peter CarrollPeter Carroll More articles by this author View All Author Informationhttps://doi.org/10.1016/j.juro.2017.02.2961AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookTwitterLinked InEmail INTRODUCTION AND OBJECTIVES In recent years, multi-parametric MRI (mpMRI) has gained increased acceptance and utilization as a diagnostic and staging tool for early - stage prostate cancer. Reporting systems, in particular the Prostate Imaging - Reporting and Data System (PI-RADS), now in its second version, has been advanced as means to standardize the grading and reporting of MRI findings. However, it remains to be determined whether PI-RADS scores independently predict the risk of adverse pathology, i.e. high-grade and/or high-stage disease. Objective: To evaluate the association of surgical pathological findings assessed on whole-mount pathology analysis and pre-operative mpMRI suspicion assessed using PI-RADS v2 scores. METHODS We retrospectively analyzed 121 patients who had radical prostatectomy within 12 months of their staging endorectal 3T mpMRI. We examined the association of the PI-RADS v2 scores with adverse surgical pathology, defined as advanced pathologic stage (≥ pT3a) or high-grade disease (primary Gleason pattern ≥ 4) or both, using frequency tables (diagnostic accuracy and chi-square) and logistic regression models. RESULTS Of 121 patients, 73 (60%) had adverse surgical pathology; 9 men (7%) had high-grade, 64 (29%) had ≥ pT3 disease, and 29 (24%) had both high-grade and high-stage disease. 106 (88%) had PI-RADS mpMRI score 4 or 5 findings, of whom, 65% had adverse pathology compared to 15 (12%) patients with PI-RADS ≤3, of whom 27% had adverse pathology. Conversely, 95% (69/73) of patients with adverse pathology had positive MR studies (PI-RADS score 4 or 5). Accordingly, mpMRI PI-RADS 4 or 5 demonstrated 95% sensitivity (95% CI 87-98), 23% specificity (95% CI 12-37), 65% PPV (95% CI 55-74), 73% NPV (95% CI 45-92), and 66% accuracy (95% CI 57-75) for the detection of adverse surgical pathology. In the multivariable logistic regression analysis, adjusted for PSA density and age, PI-RADS score 4 or 5 (odds ratio (OR) 4.1, 95% CI 1.2-14.2, p=0.027) and clinical CAPRA score (OR 1.4, 95% CI 1.0-1.9, p=0.026) were significantly and independently associated with higher risk of adverse pathology. This study is limited by its retrospective nature. CONCLUSIONS PI-RADS v2 score 4 or 5 on mpMRI is highly sensitive for the detection and prediction of adverse pathology. PI-RADS v2 may help improve the detection and staging of prostate cancer and allow for tailored intervention. © 2017FiguresReferencesRelatedDetails Volume 197Issue 4SApril 2017Page: e1270 Advertisement Copyright & Permissions© 2017MetricsAuthor Information Hao Nguyen More articles by this author Antonio Westphalen More articles by this author Ameli Niloufar More articles by this author Michael Leapman More articles by this author Janet Cowan More articles by this author Jeff Simko More articles by this author Katsuto Shinohara More articles by this author Peter Carroll More articles by this author Expand All Advertisement Advertisement PDF downloadLoading ...
Source: The Journal of Urology
Language: English
Subfield: Pulmonary and Respiratory Medicine
Field: Medicine
Domain: Health Sciences
Open Access status: bronze
OpenAlex ID: W2604454869