Predictive Value of Negative 3T Multiparametric Prostate MRI on 12 Core Biopsy Results

OBJECTIVE - To evaluate the cancer detection rates (CDR) for men undergoing 12 core systematic prostate biopsy with negative prebiopsy mpMRI (NegMR).

MATERIALS AND METHODS - Clinical data from consecutive men undergoing prostate biopsy with prebiopsy 3T mpMRI from December 2011 to August 2014 were reviewed from an IRB approved prospective database.

Prebiopsy mpMRI was read by a single radiologist and men with NegMR prior to biopsy were identified for this analysis. Clinical features, CDR, and NPV rates were summarized.

RESULTS - Seventy five men underwent SPB with a NegMRI during the study period. For the entire cohort, men with no prior biopsy, men with prior negative biopsy, and men enrolled in active surveillance protocols, overall CDR was 18. 7%, 13. 8%, 8. 0% and 38. 1%, respectively, and detection of Gleason sum ≥ 7 (GS≥7) cancer was 1. 3%, 0%, 4. 0% and 0%, respectively. The NPV for all cancers was 81. 3%, 86. 2%, 92. 0%, and 61. 9%, and for GS≥7 cancer was 98. 7%, 100%, 96. 0% and 100%, respectively.

CONCLUSIONS - Negative prebiopsy mpMRI confers an overall NPV of 82% on 12 core biopsy for all cancer and 98% for GS≥7. Based upon biopsy indication, these findings assist in prebiopsy risk stratification for detection of high risk disease and may provide guidance in the decision to pursue biopsy. This article is protected by copyright. All rights reserved.

BJU international. 2016 Jan 22 [Epub ahead of print]

James S Wysock, Neil Mendhiratta, Fabio Zattoni, Xiaosong Meng, Marc Bjurlin, William C Huang, Herbert Lepor, Andrew B Rosenkrantz, Samir S Taneja

Department of Urology, NYU Langone Medical Center, 150 East 32nd Street, Suite 200, New York, New York, 10016. , Department of Urology, NYU Langone Medical Center, 150 East 32nd Street, Suite 200, New York, New York, 10016. , Department of Urology, NYU Langone Medical Center, 150 East 32nd Street, Suite 200, New York, New York, 10016. , Department of Urology, NYU Langone Medical Center, 150 East 32nd Street, Suite 200, New York, New York, 10016. , Department of Urology, NYU Langone Medical Center, 150 East 32nd Street, Suite 200, New York, New York, 10016. , Department of Urology, NYU Langone Medical Center, 150 East 32nd Street, Suite 200, New York, New York, 10016. , Department of Urology, NYU Langone Medical Center, 150 East 32nd Street, Suite 200, New York, New York, 10016. , Department of Urology, NYU Langone Medical Center, 150 East 32nd Street, Suite 200, New York, New York, 10016. , Department of Urology, NYU Langone Medical Center, 150 East 32nd Street, Suite 200, New York, New York, 10016.

PubMed