PD13-12 TRACKING MRI INVISIBLE TUMORS AND THEIR PATHOLOGIC OUTCOMES IN PROSTATE CANCER (2020)

You have accessJournal of UrologyProstate Cancer: Epidemiology & Natural History I (PD13)1 Apr 2020PD13-12 TRACKING MRI INVISIBLE TUMORS AND THEIR PATHOLOGIC OUTCOMES IN PROSTATE CANCER Sandeep Gurram*, Amir H. Lebastchi, Michael Ahdoot, Luke P. O' Connor, Alex Z. Wang, Nitin Yerram, Patrick H. Gomella, Heather Chalfin, Siobahn Telfer, Bradford J. Wood, Baris Turkbey, and Peter Pinto Sandeep Gurram*Sandeep Gurram* More articles by this author , Amir H. LebastchiAmir H. Lebastchi More articles by this author , Michael AhdootMichael Ahdoot More articles by this author , Luke P. O' ConnorLuke P. O' Connor More articles by this author , Alex Z. WangAlex Z. Wang More articles by this author , Nitin YerramNitin Yerram More articles by this author , Patrick H. GomellaPatrick H. Gomella More articles by this author , Heather ChalfinHeather Chalfin More articles by this author , Siobahn TelferSiobahn Telfer More articles by this author , Bradford J. WoodBradford J. Wood More articles by this author , Baris TurkbeyBaris Turkbey More articles by this author , and Peter PintoPeter Pinto More articles by this author View All Author Informationhttps://doi.org/10.1097/JU.0000000000000847.012AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookLinked InTwitterEmail Abstract INTRODUCTION AND OBJECTIVE: Magnetic resonance imaging (MRI) invisible tumors are a diagnostic challenge in prostate cancer due to the lack of ability to reliably monitor these lesions radiographically or pathologically. The progression and natural history of these lesions are unknown and their outcomes over time are unclear. METHODS: Men with multiparametric MRI of the prostate and MRI/Transrectal ultrasound (TRUS) fusion guided biopsy were assessed for the presence of MRI invisible tumors (MIT). An MIT is defined as cancer detected only on extended sextant biopsy and not visible on MRI. All men first underwent an MRI/TRUS fusion biopsy with tracked extended sextant biopsy which originally detected the MIT. The original biopsy needle course sampling these MITs were tracked and set as a future targets using the MRI/TRUS fusion platform. Men were followed over time and subsequently underwent a combined MRI/TRUS fusion biopsy, systematic extended sextant biopsy, and a Targeted Tracked biopsy of the MIT (TT-MIT) that was recorded and tracked from the original biopsy. A prospectively collected database tracking these tumors from 2013 to 2019 was subsequently queried. We describe the outcomes of tracking these MITs and compare the ability to monitor them with TT-MIT biopsy as opposed to relying solely on systematic biopsy. RESULTS: 446 MITs were identified, 364 (82%) of which were originally Gleason 6 tumors. The median time between biopsies was 17.2 months. 198 tumors were detected on rebiopsy with TT-MIT compared to 151 tumors on systematic biopsy sampling the same corresponding sextant location. TT-MIT demonstrated a 23.7% increased rate of detecting any grade of cancer (p = 0.0003) and a 28.4% increase in detecting Gleason grade group (GG) ≥2 tumors (p = .01) compared to corresponding systematic biopsy. Of the 152 rebiopsies in which a GG ≥2 tumor was discovered, 23 (15.1%) were found only due to the addition of TT-MIT biopsy and would otherwise have been undetected. When followed longitudinally, GG1 MITs have a 12.5% to upgrade to GG ≥2 after a single rebiopsy and a 28.8% rate of upgrading on subsequent rebiopsy. CONCLUSIONS: The ability to follow MRI invisible tumors demonstrates that these tumors are more effectively tracked using TT-MIT biopsy technique. These MITs evolve over time and 29% of them will upgrade to higher Gleason scores. Tracking these tumors with TT-MIT biopsy increases cancer detection rate compared to systematic biopsy and more accurately samples these MITs, unveiling a more aggressive pathology. Source of Funding: None © 2020 by American Urological Association Education and Research, Inc.FiguresReferencesRelatedDetails Volume 203Issue Supplement 4April 2020Page: e271-e271 Advertisement Copyright & Permissions© 2020 by American Urological Association Education and Research, Inc.MetricsAuthor Information Sandeep Gurram* More articles by this author Amir H. Lebastchi More articles by this author Michael Ahdoot More articles by this author Luke P. O' Connor More articles by this author Alex Z. Wang More articles by this author Nitin Yerram More articles by this author Patrick H. Gomella More articles by this author Heather Chalfin More articles by this author Siobahn Telfer More articles by this author Bradford J. Wood More articles by this author Baris Turkbey More articles by this author Peter Pinto More articles by this author Expand All Advertisement PDF downloadLoading ...