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Open AccessArticle

Utilization of Multiparametric MRI of Prostate in Patients under Consideration for or Already in Active Surveillance: Correlation with Imaging Guided Target Biopsy

1
Department of Radiology, Virginia Commonwealth University Health System, Main Hospital, 3rd Floor, 401 North 12th Street, Richmond, VA 23298, USA
2
School of Medicine, Virginia Commonwealth University Health System, Main Hospital, 401 North 12th Street, Richmond, VA 23298, USA
3
Department of Biological Sciences, Virginia Polytechnic Institute and State University, Blacksburg, VA 24060, USA
4
Department of Biostatistics, Virginia Commonwealth University Health System, 401 North 12th Street, Richmond, VA 23298, USA
5
Department of Urology, Virginia Commonwealth University Health System, 401 North 12th Street, Richmond, VA 23298, USA
*
Author to whom correspondence should be addressed.
Diagnostics 2020, 10(7), 441; https://doi.org/10.3390/diagnostics10070441
Received: 20 May 2020 / Revised: 24 June 2020 / Accepted: 25 June 2020 / Published: 29 June 2020
(This article belongs to the Special Issue Diagnostic Biomarkers in Prostate Cancer 2020)
This study sought to assess the value of multiparametric magnetic resonance image (mp-MRI) in patients with a prostate cancer (PCa) Gleason score of 6 or less under consideration for or already in active surveillance and to determine the rate of upgrading by target biopsy. Three hundred and fifty-four consecutive men with an initial transrectal ultrasound-guided (TRUS) biopsy-confirmed PCa Gleason score of 6 or less under clinical consideration for or already in active surveillance underwent mp-MRI and were retrospectively reviewed. One hundred and nineteen of 354 patients had cancer-suspicious regions (CSRs) at mp-MRI. Each CSR was assigned a Prostate Imaging Reporting and Data System (PI-RADS) score based on PI-RADS v2. One hundred and eight of 119 patients underwent confirmatory imaging-guided biopsy for CSRs. Pathology results including Gleason score (GS) and percentage of specimens positive for PCa were recorded. Associations between PI-RADS scores and findings at target biopsy were evaluated using logistic regression. At target biopsy, 81 of 108 patients had PCa (75%). Among them, 77 patients had upgrading (22%, 77 of 354 patients). One hundred and forty-six CSRs in 108 patients had PI-RADS 3 n = 28, 4 n = 66, and 5 n = 52. The upgraded rate for each category of CSR was for PI-RADS 3 (5 of 28, 18%), 4 (47 of 66, 71%) and 5 (49 of 52, 94%). Using logistic regression analysis, differences in PI-RADS scores from 3 to 5 are significantly associated with the probability of disease upgrade (20%, 73%, and 96% for PI-RADS score of 3, 4, and 5, respectively). Adding mp-MRI to patients under consideration for or already in active surveillance helps to identify undiagnosed PCa of a higher GS or higher volume resulting in upgrading in 22%. View Full-Text
Keywords: prostate cancer; active surveillance; multiparametric MRI; PI-RADS score; imaging-guided target prostate biopsy prostate cancer; active surveillance; multiparametric MRI; PI-RADS score; imaging-guided target prostate biopsy
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Yu, J.; Fulcher, A.S.; Winks, S.; Turner, M.A.; Behl, W.; Ware, A.L.; Mukhopadhyay, N.D.; Kim, C.; Jackson, C.; Bajaj, H.S.; Hampton, L.J. Utilization of Multiparametric MRI of Prostate in Patients under Consideration for or Already in Active Surveillance: Correlation with Imaging Guided Target Biopsy. Diagnostics 2020, 10, 441.

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