Reproducibility of Multiparametric MRI and Fusion-Guided Prostate Biopsy: Multi-Institutional External Validation by a Propensity Score Matched Cohort.

As the adoption of MRI/US fusion-guided biopsy (FB) expands, the reproducibility of outcomes from expert centers becomes essential. The objective of our study was to validate the comprehensive National Cancer Institute (NCI) experience of multiparametric MRI and FB with an external, independent, matched cohort of patients.

We compared 620 patients enrolled in a prospective trial comparing systematic biopy (SB) to FB at the NCI to 310 patients that underwent a similar procedure at Long Island Jewish Hospital (LIJ). The propensity score, defined as the probability of being treated outside NCI, was calculated using the estimated logistic regression model. Patients from LIJ were matched 1:1 for age, PSA, MRI suspicion score, and prior negative biopsies. Clinically significant (CS) disease was defined as Gleason ≥3+4.

Prior to matching, we found differences between cohorts in age (p<0. 001), MRI suspicion score (p<0. 001), the number of patients with prior negative biopsies (p=0. 01), and both overall CDR (<0. 001) and CDR by FB (p<0. 001). No difference was found in the rates of upgrading by FB (p=0. 28) and upgrading to CS disease (p=0. 95). After matching, a statistically significant difference remained in CDR and CDR by FB. On subgroup analysis, we found a difference in CDR (p<0. 001) and CDR by FB (p=0. 003) in patients with prior negative SB and no difference in CDR (p=0. 39) and CDR by FB (p=0. 51) in biopsy naïve patients.

Improved detection of CS cancer by MRI and FB is reproducible with an experienced multi-disciplinary team consisting of dedicated radiologists and urologists.

The Journal of urology. 2016 Jan 23 [Epub ahead of print]

Ardeshir R Rastinehad, Steven F Abboud, Arvin K George, Thomas Frye, Richard Ho, Raju Chelluri, Michele Fascelli, Joanna Shih, Robert Villani, Eran Ben-Levi, Oksana Yaskiv, Baris Turkbey, Peter L Choyke, Maria J Merino, Bradford J Wood, Peter A Pinto

Department of Urology and Radiology, Icahn School of Medicine at Mount Sinai, New York, NY. , Urologic Oncology Branch, National Cancer Institute, National Institutes of Health, Bethesda, MD. , Urologic Oncology Branch, National Cancer Institute, National Institutes of Health, Bethesda, MD. , Urologic Oncology Branch, National Cancer Institute, National Institutes of Health, Bethesda, MD. , Urologic Oncology Branch, National Cancer Institute, National Institutes of Health, Bethesda, MD. , Urologic Oncology Branch, National Cancer Institute, National Institutes of Health, Bethesda, MD. , Urologic Oncology Branch, National Cancer Institute, National Institutes of Health, Bethesda, MD. , Biometric Research Branch, National Cancer Institute, National Institutes of Health, Bethesda, MD. , Department of Radiology, North Shore LIJ Hofstra School of Medicine, New Hyde Park, NY. , Department of Radiology, North Shore LIJ Hofstra School of Medicine, New Hyde Park, NY. , Department of Pathology, North Shore LIJ Hofstra School of Medicine, New Hyde Park, NY. , Molecular Imaging Program, National Cancer Institute, National Institutes of Health, Bethesda, MD. , Molecular Imaging Program, National Cancer Institute, National Institutes of Health, Bethesda, MD. , Laboratory of Pathology, National Cancer Institute, National Institutes of Health, Bethesda, MD. , Center for Center for Interventional Oncology, National Cancer Institute, National Institutes of Health, Bethesda, MD. , Urologic Oncology Branch, National Cancer Institute, National Institutes of Health, Bethesda, MD.  

PubMed

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