MP48-04 HOW RELIABLE IS A NEGATIVE MRI/TRUS FUSION BIOPSY? THE NEGATIVE PREDICTIVE VALUE OF TARGETED BIOPSY FOR PROSTATE CANCER (2015)

You have accessJournal of UrologyProstate Cancer: Detection and Screening I1 Apr 2015MP48-04 HOW RELIABLE IS A NEGATIVE MRI/TRUS FUSION BIOPSY? THE NEGATIVE PREDICTIVE VALUE OF TARGETED BIOPSY FOR PROSTATE CANCER Rachael Sussman, Michele Fascelli, Thomas Frye, Arvin George, Steven Abboud, Raju Chelluri, Richard Ho, Anna Brown, Sandeep Sankineni, Maria Merino, Ismail Turkbey, Peter Choyke, Bradford Wood, and Peter Pinto Rachael SussmanRachael Sussman More articles by this author , Michele FascelliMichele Fascelli More articles by this author , Thomas FryeThomas Frye More articles by this author , Arvin GeorgeArvin George More articles by this author , Steven AbboudSteven Abboud More articles by this author , Raju ChelluriRaju Chelluri More articles by this author , Richard HoRichard Ho More articles by this author , Anna BrownAnna Brown More articles by this author , Sandeep SankineniSandeep Sankineni More articles by this author , Maria MerinoMaria Merino More articles by this author , Ismail TurkbeyIsmail Turkbey More articles by this author , Peter ChoykePeter Choyke 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.2015.02.1678AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookTwitterLinked InEmail INTRODUCTION AND OBJECTIVES Multiparametric magnetic resonance imaging (mpMRI) has been shown to improve clinically significant prostate cancer (CaP) detection. Targeted biopsy using MRI/transrectal ultrasonography (TRUS) fusion is emerging as a novel diagnostic tool. The negative predictive value (NPV) of an MRI/TRUS fusion targeted biopsy of a suspicious lesion on mpMRI was determined. METHODS 30 of 181 men who underwent radical prostatectomy from 2008-2014 were retrospectively identified and had at least one lesion on mpMRI that was negative for cancer on MRI/TRUS fusion biopsy. Whole mount pathology specimens, considered the gold standard for CaP detection, were aligned with MRI to assess true histopathology of all identified target lesions. Lesions negative for CaP on biopsy and not identified as cancer on pathology were considered true negatives (TN). Lesions biopsied negative but later found to possess foci of CaP on whole mount were considered false negatives (FN). Calculations of NPV were then made per biopsy year, per MRI suspicion score, and per lesion size on MRI. RESULTS 48 lesions of a total 81 identified on mpMRI were reported negative for CaP in the 30 patients who underwent MRI/TRUS fusion biopsy. Of these, 37 lesions were found to be truly negative on histopathology, while 11 lesions had foci on CaP on the whole mount pathologic specimen. Overall NPV was 77% (37/48). NPV calculations were made per biopsy year, per MRI suspicion score, and per lesion size on MRI (Table 1). The NPV increased over time, and was as high as 85.7% in the most recent years. CONCLUSIONS This series demonstrated a NPV of 77% for targeted MRI/TRUS fusion biopsy of lesions seen on mpMRI. The increasing NPV trend noted over time may have further applications to assess the learning curve for this diagnostic method. Not surprisingly, NPV is higher for low and moderately suspicious lesions than for highly suspicious lesions. This data may help urologists interpret the clinical significance and implications of a negative fusion biopsy. Year NPV True Negative Lesions False Negative Lesions Total Negative Lesions 2008-2009 76.9 10 3 13 2010-2011 64.3 9 5 14 2012-2014 85.7 18 3 21 Total 77.1 37 11 48 MRI Suspicion Score NPV True Negative Lesions False Negative Lesions Total Negative Lesions Low 75.0 15 5 20 Moderate 80.8 21 5 26 High 50.0 1 1 2 Size on MRI (cm) NPV True Negative Lesions False Negative Lesions Total Negative Lesions ≤ 0.5 70.0 7 3 10 > 0.5 & < 1.0 78.6 11 3 14 ≥ 1.0 & < 1.5 84.6 11 2 13 ≥ 1.5 72.7 8 3 11 © 2015 by American Urological Association Education and Research, Inc.FiguresReferencesRelatedDetails Volume 193Issue 4SApril 2015Page: e595 Advertisement Copyright & Permissions© 2015 by American Urological Association Education and Research, Inc.MetricsAuthor Information Rachael Sussman More articles by this author Michele Fascelli More articles by this author Thomas Frye More articles by this author Arvin George More articles by this author Steven Abboud More articles by this author Raju Chelluri More articles by this author Richard Ho More articles by this author Anna Brown More articles by this author Sandeep Sankineni More articles by this author Maria Merino More articles by this author Ismail Turkbey More articles by this author Peter Choyke 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 ...