Mp38-04 Is an Upgraded Pirads 4 Equivalent to a True Pirads 4? a Validation of Pirads Version 2 in a Prospective Cohort of Men Undergoing Mri-us Fusion Biopsy of the Prostate
Year: 2017
Type: article
Study design: Observational Study
Abstract: the outcome of 12-core transrectal ultrasound (TRUS) guided prostate biopsy.Herein, we aim to decipher the predictive value of mp-MRI in detection and exclusion of prostate cancer using TRUS prostate biopsy.METHODS: UK multicentre study.Data from 592 patients scheduled to undergo mp-MRI and/or 12-core TRUS-guided prostate biopsy from January till September 2016 was reviewed retrospectively from a prospective database.Mp-MRIs were reported using the Prostate Imaging Reporting and Data System (PI-RADS).Only patients who had pre biopsy mp-MRIs followed by prostate biopsy were included in the study.108 patient were excluded as they did not have mp-MRI or biopsy due to contraindications.RESULTS: Prebiopsy mp-MRIs followed by a 12-core TRUSguided prostate biopsy were completed in 484 patients.The sensitivity and specificity of mp-MRI for prostate cancer detected on prostate biopsy were 92.6% and 74.4%, respectively.The negative predictive and positive predictive values of mp-MRI for prostate cancer detected on biopsy were 89.7% and 80.8%, respectively.129 patients had a PI-RADS score of 5 on mp-MRI, with prostate cancer detected in 92%(n¼119) of patients on biopsy.The incidence of Gleason scores 6,7,8 and 9 in patients with PI-RADS 5 were 15.9%(n¼19), 51.2%(n¼61), 6.7%(n¼8) and 26%(n¼31), respectively.117 patients had a PI-RADS score of 4 on mp-MRI, with prostate cancer detected in 53.8%(n¼63) of patients on biopsy.The incidence of Gleason scores 6,7,8 and 9 in patients with PI-RADS 4 were 60%(n¼36), 33.3% (n¼21), 4.7% (n¼3) and 1.5% (n¼1), respectively.153 patients had a PI-RADS score of 3 on mp-MRI, with prostate cancer detected in 29% (n¼45) of patients on biopsy.The incidence of Gleason scores 6,7 and 9 cancers in patients with PI-RADS score of 3 were 68% (n¼31), 26.6% (n¼12) and 4.4% (n¼2), respectively.Overall there was a statistically significant association between patients with PIRADS scores 3 and cancer positive biopsies (p¼0.001).CONCLUSIONS: Mp-MRI has a high predictive value for both diagnosing and excluding prostate cancer.Patients with PI-RADS scores 3 had a significant association with detection of prostate cancer on biopsy.These findings could aid in guiding follow-up protocols in men suspected of prostate cancer.
Source: The Journal of Urology
Language: English
Subfield: Pulmonary and Respiratory Medicine
Field: Medicine
Domain: Health Sciences
Open Access status: bronze
OpenAlex ID: W2604746833