Nearly 12% of patients in the United States with intermediate-risk prostate cancer (PCa) opt for surveillance as their initial management strategy. Patients with aggressive histologic variants, such as cribriform and intraductal carcinoma (IDC), are considered poor candidates for surveillance.
The objective of this study was to determine the sensitivity and specificity of magnetic resonance imaging (MRI)-assisted biopsy for detecting cribriform PCa and IDC.
In this retrospective cohort study, patients who underwent prostate MRI before biopsy within 6 months of prostatectomy at a single institution (2018-2024) were identified. All patients had grade group 2-3 (GG2-3) PCa on biopsy. The primary outcome was the sensitivity of MRI-assisted biopsy for detecting cribriform PCa and IDC by patient in the prostatectomy specimen.
The authors identified 641 patients who had 1186 tumors that were GG2-3 PCa on biopsy. The median time between MRI and biopsy was 31 days, and the median time between biopsy and surgery was 91 days. Cribriform PCa was identified in 35 patients (5.5%) at the time of biopsy and in 119 patients (18.6%) at surgery. IDC was present in 22 patients (3.4%) at biopsy and in 71 patients (11.1%) at surgery. By patient, the sensitivity for detecting cribriform PCa, IDC, or either was 21.8%, 26.8%, and 29.3%, respectively. The sensitivity by tumor for cribriform PCa, IDC, or either was 20.5%, 27.3%, and 28%, respectively.
The sensitivity of MRI-assisted biopsy for detecting cribriform PCa and IDC in patients with GG2-3 PCa is poor. This work should encourage improvements in detecting variant histologies with optimized biopsy, imaging, and adjunct biomarkers.
Cancer. 2025 Jul 15 [Epub]
Raeven S Grant, Preeti Kakani, Pranav Movva, Timothy J Daskivich, Steven S Raman, Anthony E Sisk, Wayne G Brisbane, Robert E Reiter, Adam B Weiner
Department of Urology, David Geffen School of Medicine, University of California-Los Angeles, Los Angeles, California, USA., Department of Urology, Cedars-Sinai Medical Center, Los Angeles, California, USA., Department of Radiological Sciences, David Geffen School of Medicine, University of California-Los Angeles, Los Angeles, California, USA., Department of Pathology, David Geffen School of Medicine, University of California-Los Angeles, Los Angeles, California, USA.
PubMed http://www.ncbi.nlm.nih.gov/pubmed/40614127