302 DOES D'AMICO RISK STRATIFICATION CORRELATE WITH DEGREE OF SUSPICION OF PROSTATE CANCER ON MULTI-PARAMETRIC MAGNETIC RESONANCE IMAGING (MRI)? (2010)

You have accessJournal of UrologyProstate Cancer: Staging II1 Apr 2010302 DOES D'AMICO RISK STRATIFICATION CORRELATE WITH DEGREE OF SUSPICION OF PROSTATE CANCER ON MULTI-PARAMETRIC MAGNETIC RESONANCE IMAGING (MRI)? Ardeshir R. Rastinehad, Angelo A. Baccala, Paul H. Chung, Sheng Xu, Jochen Kruecker, Stacey P. Gates, Julia K. Locklin, Baris I. Turkbey, Joanna H. Shih, W. Marston Linehan, Gennady Bratslavsky, Neil D. Glossop, Peter L. Choyke, Bradford J. Wood, and Peter A. Pinto Ardeshir R. RastinehadArdeshir R. Rastinehad Washington, DC More articles by this author , Angelo A. BaccalaAngelo A. Baccala Bethesda, MD More articles by this author , Paul H. ChungPaul H. Chung Bethesda, MD More articles by this author , Sheng XuSheng Xu Briarcliff Manor, NY More articles by this author , Jochen KrueckerJochen Kruecker Briarcliff Manor, NY More articles by this author , Stacey P. GatesStacey P. Gates Frederick, MD More articles by this author , Julia K. LocklinJulia K. Locklin Bethesda, MD More articles by this author , Baris I. TurkbeyBaris I. Turkbey Bethesda, MD More articles by this author , Joanna H. ShihJoanna H. Shih Bethesda, MD More articles by this author , W. Marston LinehanW. Marston Linehan Bethesda, MD More articles by this author , Gennady BratslavskyGennady Bratslavsky Bethesda, MD More articles by this author , Neil D. GlossopNeil D. Glossop Toronto, ON More articles by this author , Peter L. ChoykePeter L. Choyke Bethesda, MD More articles by this author , Bradford J. WoodBradford J. Wood Bethesda, MD More articles by this author , and Peter A. PintoPeter A. Pinto Bethesda, MD More articles by this author View All Author Informationhttps://doi.org/10.1016/j.juro.2010.02.365AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookTwitterLinked InEmail INTRODUCTION AND OBJECTIVES Recent publications have investigated the correlation of MRI and the index of suspicion of prostate cancer. We sought to determine if there is a correlation between using our platform which consists of multi-parametric MR imaging and US fusion guided biopsies with the D'Amico risk stratification? METHODS Patients and lesions were stratified by D'Amico Risk stratification taking into account Gleason score and PSA at time of Biopsy. 101 patients underwent a multi-parametric MR imaging of the prostate which consisted of a T2, dynamic contrast enhanced (DCE), diffusion weighted images (DWI), and proton spectroscopy images in patients with suspicion or diagnosis of prostate cancer. All lesions were then identified and graded by number of modalities positive: low (<2), mod (3) and high (4) suspicion by a single radiologist. An electromagnetic field (EM) generator (Northern Digital Inc., Canada) was placed above the pelvis which allows for real-time tracking of a custom made biopsy probe with an embedded miniature electromagnetic tracking sensor (Traxtal Inc., A Philips Healthcare Company, Canada) incorporated into the needle guide (Civco Inc, IA). A 2D prostate sweep is performed manually to render a 3D ultrasound image that is then registered and fused to the pre-operative prostate MR images and assigned targets for biopsy. The protocol included a standard 12 core biopsy combined with MRI/US fusion biopsy of the suspicious MR targeted lesions utilizing EM tracking. RESULTS 90.1% (91/101) were clinical T1c with a mean age was 62.7 + 8.3 years with a median PSA 5.8, and 56/101 (55.4%) patients were positive for cancer on a protocol biopsy. Two Chi-squared analysis resulted in a statistical significant correlation between the MR suspicion and D'Amico Risk stratification for patients and MR lesions positive for cancer(p<0.05), (Table 1). CONCLUSIONS The multi-parametric MR assessment of patients with positive lesion for prostate cancer resulted in a statistically significant correlation with the D'Amico risk stratification. This data may give insight into which patients may be eligible active surveillance, with interval imaging assessment of the lesion, obviating the need for multiple biopsies and the associated morbidity while following these patients long term. © 2010 by American Urological Association Education and Research, Inc.FiguresReferencesRelatedDetails Volume 183Issue 4SApril 2010Page: e120 Advertisement Copyright & Permissions© 2010 by American Urological Association Education and Research, Inc.MetricsAuthor Information Ardeshir R. Rastinehad Washington, DC More articles by this author Angelo A. Baccala Bethesda, MD More articles by this author Paul H. Chung Bethesda, MD More articles by this author Sheng Xu Briarcliff Manor, NY More articles by this author Jochen Kruecker Briarcliff Manor, NY More articles by this author Stacey P. Gates Frederick, MD More articles by this author Julia K. Locklin Bethesda, MD More articles by this author Baris I. Turkbey Bethesda, MD More articles by this author Joanna H. Shih Bethesda, MD More articles by this author W. Marston Linehan Bethesda, MD More articles by this author Gennady Bratslavsky Bethesda, MD More articles by this author Neil D. Glossop Toronto, ON More articles by this author Peter L. Choyke Bethesda, MD More articles by this author Bradford J. Wood Bethesda, MD More articles by this author Peter A. Pinto Bethesda, MD More articles by this author Expand All Advertisement Advertisement PDF downloadLoading ...