SES AUA 2021: Does MRI Demonstrate Racial Differences in Prostate Cancer Lesions by Zone?

( African American men have an increased risk of diagnosis and mortality for prostate cancer, but it remains unclear if this is due to cancer biology, anterior tumor location, or access to novel diagnostic tools for identifying localized cancer. MRI fusion biopsy represents the new standard of care for accurate diagnosis of localized prostate cancer but the cost associated with MRI technology has limited adoption in a community practice setting. At the 2021 virtual Southeastern Section of the American Urological Association annual meeting, Dr. Christopher Koller and colleagues presented results of a diverse cohort of veterans with equal access to care and a single-payer system to evaluate the diagnosis of prostate cancer in this patient cohort. 

This study assessed a prospectively maintained institutional review board-approved database of men undergoing prostate biopsy for untreated prostate cancer at the South Louisiana Veterans Administration Medical Center in New Orleans, LA. All consecutive patients were included from October 2017 to February 2020, and data was prospectively collected. 

There were 246 consecutive patients identified that underwent MRI fusion biopsy using the Uronav ® platform for evaluation of localized, untreated prostate cancer. Of these men, 166 (67%) were African American and 80 (33%) were non-African American. There were similar distributions of PSA, PSA density, and a number of targetable lesions between the African American and non- African American cohort:


Importantly, there was no statistical significance in lesion location on MRI between race groups nor was there a difference in cancer detection, particularly focusing on anterior lesions. Moreover, the rate of positive (≥GG1) and clinically significant (≥GG2) lesions were found to be similar between cohorts:


Dr. Koller concluded his presentation with the following concluding statements:

  • In an African American dominated cohort of veterans, there was a similar distribution of location for MRI targeted lesions
  • Similarly, the rates of tumor detection and aggressiveness of disease were comparable between the groups
  • In this single payer, veteran population, there were no specific biologic differences inherent to tumor detection between African American and non-African American patients
  • MRI fusion technology appears to have similar outcomes and cancer detection in African American and non-African American cohorts

Presented by: Christopher Koller, MD, Urology Resident, University of Tulane School of Medicine, New Orleans, LA

Co-Authors: Jacob W. Greenberg1, Thomas M. Shelton, MD1, William M. Hughes, MD1, Ganesh Sanekommu, MD1, Jonathan L. Silberstein, MD, MBA2, L. Spencer Krane, MD1
1. Tulane University School of Medicine, 2. Memorial Health System

Written by: Zachary Klaassen, MD, MSc – Urologic Oncologist, Assistant Professor of Urology, Georgia Cancer Center, Augusta University/Medical College of Georgia, Twitter: @zklaassen_md during the 85th Annual Southeastern Section of the American Urological Association, April 23-24, 2021

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