Effect of Lesion Location on Prostate Cancer Detection Rate with Magnetic Resonance Imaging Targeted Biopsy in African Americans

The updated Prostate Imaging Reporting and Data System version 2 (PI-RADSTM v2) defines different grading parameters for lesions located in the peripheral zone (PZ) versus the transitional zone (TZ) and has contributed to the implementation of magnetic resonance imaging targeted biopsy (MRI-TB). This study evaluated the efficacy of MRI-TB between African American patients with additional consideration for lesion location on MRI.

A retrospective review of MRI-TB was performed at a single institution treating a racially diverse population. A single radiology group read the prostate mpMRI and followed PI-RADSTM v2 algorithms to categorize lesions.

A total of 214 lesions from 125 men were included in the analysis, 162 (75.7%) in the PZ and 52 (24.3%) in the TZ. There were 64 lesions from African American patients and 150 from White patients, with location distributed proportionately. The 48 anterior lesions (22.4%) had a higher PI-RADSTM v2 score and trended towards larger size. The overall cancer detection rate (CDR) was 50% and did not differ significantly between prostatic zones (p = 0.5468) or racial groups (p = 0.2294). The cancer upgrade rate (CUR) was 41 percent and also did not differ significantly between prostatic zones (p = 0.5134) or racial groups (p = 0.2365). Anterior lesions had higher CDR (p = 0.0117) and trended towards higher CUR (p = 0.0781).

This study provides evidence that MRI-TB is equally effective with African American and White men and does not preferentially identify prostate cancer in either the PZ or TZ.

The Journal of urology. 2018 Oct 11 [Epub ahead of print]

Eric Walton, Grace Yaguchi, Jacob Keeley, Mustafa Deebajah, Mani Menon, James Peabody, Ali Dabaja, Shaheen Alanee

Wayne State University School of Medicine, Detroit, MI., Vattikuti Urology Institute, Henry Ford Hospital, Detroit, MI.