MP53-15 MULTI-INSTITUTIONAL ASSESSMENT OF MULTIPARAMETRIC MRI AND FUSION BIOPSY OF THE PROSTATE IN A BIOPSY-NAÏVE POPULATION (2016)

You have accessJournal of UrologyProstate Cancer: Detection & Screening VII1 Apr 2016MP53-15 MULTI-INSTITUTIONAL ASSESSMENT OF MULTIPARAMETRIC MRI AND FUSION BIOPSY OF THE PROSTATE IN A BIOPSY-NAÏVE POPULATION Arvin George, Meet Kadakia, Minhaj Siddiqui, Soroush Rais-Bahrami, Ardeshir Rastinehad, Srinivas Vourganti, Michele Fascelli, Michael Kongnyuy, Akhil Muthigi, Abhinav Sidana, Amichai Kilchevsky, Thomas Frye, Daniel Su, John Thomas, Vidhush Yarlagadda, Vidhush Yarlagadda, Maria Merino, Peter Choyke, Baris Turkbey, Bradford Wood, and Peter Pinto Arvin GeorgeArvin George More articles by this author , Meet KadakiaMeet Kadakia More articles by this author , Minhaj SiddiquiMinhaj Siddiqui More articles by this author , Soroush Rais-BahramiSoroush Rais-Bahrami More articles by this author , Ardeshir RastinehadArdeshir Rastinehad More articles by this author , Srinivas VourgantiSrinivas Vourganti More articles by this author , Michele FascelliMichele Fascelli More articles by this author , Michael KongnyuyMichael Kongnyuy More articles by this author , Akhil MuthigiAkhil Muthigi More articles by this author , Abhinav SidanaAbhinav Sidana More articles by this author , Amichai KilchevskyAmichai Kilchevsky More articles by this author , Thomas FryeThomas Frye More articles by this author , Daniel SuDaniel Su More articles by this author , John ThomasJohn Thomas More articles by this author , Vidhush YarlagaddaVidhush Yarlagadda More articles by this author , Vidhush YarlagaddaVidhush Yarlagadda More articles by this author , Maria MerinoMaria Merino More articles by this author , Peter ChoykePeter Choyke More articles by this author , Baris TurkbeyBaris Turkbey More articles by this author , Bradford WoodBradford Wood More articles by this author , and Peter PintoPeter Pinto More articles by this author View All Author Informationhttps://doi.org/10.1016/j.juro.2016.02.512AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookTwitterLinked InEmail INTRODUCTION AND OBJECTIVES Multiparametric MRI (mpMRI) and fusion biopsy (FB) have demonstrated proven benefit in patients with a prior negative systematic biopsy (SB) or diagnosis of prostate cancer (CaP). Its value in patients with no prior history of prostate biopsy is less defined. We aim to evaluate mpMRI and FB in a biopsy naive population. METHODS A multi-institutional review was performed on patients with no prior biopsy history who underwent mpMRI followed by FB and SB in the same session. Imaging protocol and image interpretation with the previously validated NIH suspicion scoring system was standardized across institutions. MpMRI and pathology was reviewed by respective institutional genitourinary radiologists and pathologists. CaP risk groupings by Gleason Score (GS) were defined as low (GS 6, low volume GS 3+4=7), intermediate (high volume GS 3+4=7), and high (GS≥4+3). Univariate analysis was performed to compare performance of FB versus SB. RESULTS A total of 395 biopsy naive men were identified from 4 participating institutions. Mean age and PSA were 62.3 years (±8.4) and 7.0ng/ml (±5.8), respectively. Patient characteristics, GS and risk classification distribution for FB and SB are presented in Table 1. Overall cancer detection rate (CDR) was 65.0%. In biopsy naive men, FB detected a greater absolute number of high risk CaP than SB (22.3% vs 20.3%). Additionally, FB detected 18% fewer cases of GS 6 CaP (15.7% vs 19.2%, p=0.1). The CDR for FB alone was 57.2% with only 4 intermediate risk and 1 high risk patient not identified. The addition of SB to FB resulted in the diagnosis of 26 additional cases of low risk disease for each case of high risk CaP detected. The CDR of SB alone was 59.2%, however, 1 intermediate and 4 high risk CaP were missed. The addition of FB to SB alone resulted in only 4.5 additional cases of low risk CaP for each high risk CaP detected. CONCLUSIONS In men with no prior biopsy history, mpMRI and fusion biopsy detects a greater proportion of high risk disease while decreasing the detection of low risk CaP. As urologists explore ways to apply this technology in their practice, additional studies with greater power will be required to validate the potential benefit of mpMRI and FB in the biopsy naive population. © 2016FiguresReferencesRelatedDetails Volume 195Issue 4SApril 2016Page: e703 Advertisement Copyright & Permissions© 2016MetricsAuthor Information Arvin George More articles by this author Meet Kadakia More articles by this author Minhaj Siddiqui More articles by this author Soroush Rais-Bahrami More articles by this author Ardeshir Rastinehad More articles by this author Srinivas Vourganti More articles by this author Michele Fascelli More articles by this author Michael Kongnyuy More articles by this author Akhil Muthigi More articles by this author Abhinav Sidana More articles by this author Amichai Kilchevsky More articles by this author Thomas Frye More articles by this author Daniel Su More articles by this author John Thomas More articles by this author Vidhush Yarlagadda More articles by this author Vidhush Yarlagadda More articles by this author Maria Merino More articles by this author Peter Choyke More articles by this author Baris Turkbey More articles by this author Bradford Wood More articles by this author Peter Pinto More articles by this author Expand All Advertisement Advertisement PDF downloadLoading ...