Presence of MRI Suspicious Lesion Predicts Gleason 7 or Greater Prostate Cancer in Biopsy Naïve Patients.

To compare the relative value of MRI in biopsy naïve patients to those with previous negative biopsy. Although MRI targeted biopsy has been studied in several major prostate cancer (PCa) cohorts (biopsy naïve, previous negative biopsy, active surveillance), the relative benefit in these cohorts has not been established.

We retrospectively reviewed biopsy naïve (n=45) and previous negative biopsy (n=55) patients who underwent prostate MRI prior to biopsy at our institution. Patients with a MRI suspicious region (MSR) underwent MRI targeted biopsy as well as a systematic template biopsy, while those without MSR underwent only the template biopsy. All biopsies were performed with the TargetScan (Envisioneering, Pittsburgh, PA) biopsy system. MRI targeting was performed with cognitive guidance.

On multivariate logistic regression, presence of a MSR was the only statistically significant and independent predictor of Gleason ≥ 7 PCa on biopsy for biopsy naïve men (OR 40. 2, p=0. 01). For men with previous negative biopsy, presence of MSR was not a predictor of Gleason ≥ 7 PCa on biopsy (OR 4. 35, p=0. 16), while PSA density > 0. 15 ng/mL(2) was a significant and independent predictor (OR 66. 2, p

Prostate MRI should be considered prior to biopsy in all patients presenting with clinical suspicion for PCa, as presence of a MSR will help guide pre-biopsy counseling and provide an opportunity for MRI targeting during biopsy.

Urology. 2015 Nov 03 [Epub ahead of print]

John K Weaver, Eric H Kim, Joel M Vetter, Kathryn J Fowler, Cary L Siegel, Gerald L Andriole

Division of Urology, Washington University School of Medicine, St. Louis, MO, USA. , Division of Urology, Washington University School of Medicine, St. Louis, MO, USA. , Division of Urology, Washington University School of Medicine, St. Louis, MO, USA. , Department of Radiology, Washington University School of Medicine, St. Louis, MO, USA. , Department of Radiology, Washington University School of Medicine, St. Louis, MO, USA. , Division of Urology, Washington University School of Medicine, St. Louis, MO, USA.

PubMed

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