Pd37-04 a Hypoechoic Ultrasound Region of Interest Predicts a Greater Likelihood of Clinically Significant Cancer on Mri-us Fusion Targeted Biopsy
Year: 2018
Type: article
Study design: Observational Study
Abstract: You have accessJournal of UrologyImaging/Radiology: Uroradiology III1 Apr 2018PD37-04 A HYPOECHOIC ULTRASOUND REGION OF INTEREST PREDICTS A GREATER LIKELIHOOD OF CLINICALLY SIGNIFICANT CANCER ON MRI-US FUSION TARGETED BIOPSY Benjamin Press, Andrew Rosenkrantz, Richard Huang, and Samir S Taneja Benjamin PressBenjamin Press More articles by this author , Andrew RosenkrantzAndrew Rosenkrantz More articles by this author , Richard HuangRichard Huang 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.2018.02.1739AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookTwitterLinked InEmail INTRODUCTION AND OBJECTIVES Prostate cancer (PCa) is often seen as a hypoechoic region (HER) on ultrasound (US). We sought to determine whether the presence of a HER at the site of MRI - ultrasound fusion targeted prostate biopsy (MRF-TB) results in improved PCa detection and predicts clinically significant PCa on biopsy. METHODS Between July 2011 and June 2017, 1058 men underwent MRF-TB and systematic biopsy (SB) by a single surgeon after pre-biopsy multi-parametric MRI (mpMRI) was read by a single radiologist to denote regions of interest (ROI). Prostate US was graded for the presence of HER at the site of MRI ROI by the surgeon as 0, 1, 2 representing none, poorly demarcated, or well demarcated HER, respectively. Men without standardized MRI or US grading were excluded. The interaction of MRI suspicion score (mSS) and US grade (USG), as well as prediction of cancer detection rate (CDR) were evaluated by univariate, multivariate analysis, McNemar, and Kruskal-Wallis tests. RESULTS 768 men met inclusion criteria. Overall and Gleason Score (GS) ≥7 CDR were 61.9% and 39.1%, respectively. Figure 1 shows interaction of mSS and USG. For MRF-TB and SB combined, CDR for USG 0, 1, 2 were 46.9%, 61.6% 75.0% (p < 0.001) for any cancer and 22.3%, 37.8%, 60.3% (p < 0.001) for GS ≥7, respectively. For MRF-TB only, GS ≥7 CDR for USG 0,1,2 was 13.2%, 24.9%, 52.0% (p <0.001), respectively. USG was not predictive the likelihood of cancer missed by MRI-TB. On univariate analysis, among mSS 2-4, USG was predictive of GS ≥7 CDR (Table 1). Multivariable regression performed revealed that only PSAD and mSS were predictors of PCa. CONCLUSIONS Men with a well demarcated HER at the time of MRF-TB have a higher risk of GS ≥7 Pca, than men without. The likelihood of a HER increases with mSS, but USG does not independently predict the likelihood of GS ≥7 PCa. Among men with low suspicion MRI, USG may allow determination of the necessity for biopsy, and may assure accurate targeting of men with small MRI ROI. © 2018FiguresReferencesRelatedDetails Volume 199Issue 4SApril 2018Page: e732 Advertisement Copyright & Permissions© 2018MetricsAuthor Information Benjamin Press More articles by this author Andrew Rosenkrantz More articles by this author Richard Huang 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: Benjamin Press, Andrew Rosenkrantz, Richard Huang, Samir S Taneja
Language: English
Subfield: Pulmonary and Respiratory Medicine
Field: Medicine
Domain: Health Sciences
Open Access status: bronze
OpenAlex ID: W2796346991