Pd61-05 Outcomes of Repeat Mri-us Fusion-targeted Biopsy in Men With Initially Low Risk or Negative Fusion Biopsy
Year: 2017
Type: article
Study design: Observational Study
Abstract: You have accessJournal of UrologyProstate Cancer: Staging II1 Apr 2017PD61-05 OUTCOMES OF REPEAT MRI-US FUSION-TARGETED BIOPSY IN MEN WITH INITIALLY LOW RISK OR NEGATIVE FUSION BIOPSY Xiaosong Meng, Andrew Rosenkrantz, Fang-Ming Deng, Richard Huang, James Wysock, Marc Bjurlin, William C. Huang, Herbert Lepor, and Samir S. Taneja Xiaosong MengXiaosong Meng More articles by this author , Andrew RosenkrantzAndrew Rosenkrantz More articles by this author , Fang-Ming DengFang-Ming Deng More articles by this author , Richard HuangRichard Huang More articles by this author , James WysockJames Wysock More articles by this author , Marc BjurlinMarc Bjurlin More articles by this author , William C. HuangWilliam C. Huang More articles by this author , Herbert LeporHerbert Lepor More articles by this author , and Samir S. TanejaSamir S. Taneja More articles by this author View All Author Informationhttps://doi.org/10.1016/j.juro.2017.02.2764AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookTwitterLinked InEmail INTRODUCTION AND OBJECTIVES While the value of MRI-US Fusion-targeted biopsy (MRF-TB) in the identification of occult, clinically significant prostate cancer (csPCa), has been well described, the accuracy of targeting using available fusion platforms is not as clear. As the need for repeat biopsy among men with negative or low risk MRF-TB remains to be defined, we evaluated the outcomes of repeat MRF-TB among men with initially negative or low risk MRF-TB. METHODS Between 6/2012 and 9/2016, 1,584 consecutive men undergoing pre-biopsy prostate MRI followed by MRF-TB and systematic biopsy (SB) were enrolled in prospective date registry. 195 men underwent repeat MRI and MRF-TB for continued suspicion of csPCa. 76 men were excluded from analysis due to outside facility or 1.5T MRI, hip implant or interval focal therapy. Upgrade was defined as an increase in Gleason score (GS) from 3+3 to ≥3+4 or from 3+4 to ≥4+3 among men with PCa noted on first MRF-TB, or any cancer among men with no cancer on first MRF-TB. Biopsy outcomes were stratified per MRI findings and progression. RESULTS 119 men (mean age 65.9±7.7 years, mean PSA 5.8±4.5 ng/mL) underwent repeat MRF-TB. The median interval between initial and repeat biopsy was 17.1±8.9 months. On repeat biopsy, 50% (59) had concordant GS, 17% (20) were downgraded, and 34% (40) were upgraded. Of the 40 upgrades, 42% (17) were due to an increase in GS and 58% (23) were due to newly detected PCa, as illustrated in Table 1. PI-RADS score was predictive of the likelihood of upgrade on repeat MRF-TB (Table 2). 53% of men with PI-RADS 4 and 5 demonstrated upgrade on repeat biopsy compared to 26% of men with PI-RADS 3. 82% (9/11) of upgrades in men with PI-RADS 1 and 2 were due to newly detected GS 6 disease. CONCLUSIONS 53% of men with PI-RADS 4 and 5 lesions were upgraded on repeat MRF-TB, suggesting a need for repeat sampling among men with low risk or negative MRF-TB and persistent PI-RADS 4 and 5 regions noted on follow-up MRI. Among men with PI-RADS 1 or 2 on repeat imaging, continued observation may be reasonable given the low likelihood (5%) of csPCa on repeat MRF-TB. © 2017FiguresReferencesRelatedDetails Volume 197Issue 4SApril 2017Page: e1189 Advertisement Copyright & Permissions© 2017MetricsAuthor Information Xiaosong Meng More articles by this author Andrew Rosenkrantz More articles by this author Fang-Ming Deng More articles by this author Richard Huang More articles by this author James Wysock More articles by this author Marc Bjurlin More articles by this author William C. Huang More articles by this author Herbert Lepor More articles by this author Samir S. Taneja More articles by this author Expand All Advertisement Advertisement PDF downloadLoading ...
Source: The Journal of Urology
Authors: Xiaosong Meng, Andrew Rosenkrantz, Fang-Ming Deng, Richard Huang, James Wysock, Marc Bjurlin, William C. Huang, Herbert Lepor, Samir S. Taneja
Language: English
Subfield: Pulmonary and Respiratory Medicine
Field: Medicine
Domain: Health Sciences
Open Access status: bronze
OpenAlex ID: W2605250267