MP77-01 NATURAL HISTORY OF PROSTATIC LESIONS ON SERIAL MULTIPARAMETRIC MRI. (2015)

You have accessJournal of UrologyProstate Cancer: Detection and Screening VI1 Apr 2015MP77-01 NATURAL HISTORY OF PROSTATIC LESIONS ON SERIAL MULTIPARAMETRIC MRI. Samrad Ghavimi, Richard Savdie, Hamidreza Abdi, Silvia Chang, Alison Harris, Lindsay Machan, Martin Gleave, Alan So, Larry Goldenberg, and Peter Black Samrad GhavimiSamrad Ghavimi More articles by this author , Richard SavdieRichard Savdie More articles by this author , Hamidreza AbdiHamidreza Abdi More articles by this author , Silvia ChangSilvia Chang More articles by this author , Alison HarrisAlison Harris More articles by this author , Lindsay MachanLindsay Machan More articles by this author , Martin GleaveMartin Gleave More articles by this author , Alan SoAlan So More articles by this author , Larry GoldenbergLarry Goldenberg More articles by this author , and Peter BlackPeter Black More articles by this author View All Author Informationhttps://doi.org/10.1016/j.juro.2015.02.541AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookTwitterLinked InEmail INTRODUCTION AND OBJECTIVES The natural history of prostatic lesions identified on multiparametric MRI (mpMRI) is unknown. We aimed to describe changes observed over time on serial mpMRI, and to determine especially how these influenced management of men on active surveillance (AS). METHODS Between January 2008 and October 2014, 754 men underwent mpMRI, of whom 65 had ≥2 studies. Imaging findings and corresponding clinico-pathologic parameters were compared and related to the discontinuation of AS. RESULTS Serial mpMRIs were performed for AS monitoring in 42 men and for suspicion of prostate cancer in 23 men. Collectively, there were 93 lesions on 1st mpMRI and 143 on 2nd mpMRI for analysis. The median time between scans was 19.7 months (IQR 13.5-29.5). New lesions were seen in 34 of 65 (52.3%) patients. The Median (IQR) number of lesions seen per patient increased from 1 (1-2) to 2 (1-3). Lesion size increased in 29.4% (mean 3.0 mm/yr) and decreased in 18.5% (mean -2.1mm/yr ). The ADC value decreased in 47.9 % of lesions (>300 unit decrease in 15%) between scans and increased in a further 25 %. Three of 47 (6%) lesions moved from ADC>600 to ADC <600. Forty-nine (53%) lesions were scored PIRADS 3 on first MRI, of which 5 (10%) converted to PIRADS 4. There were 21 de novo PIRADS 4/5 lesions identified in 15 patients (23%). Overall, 10 (24.3%) men on AS chose to undergo definitive therapy following an increase in suspicion of cancer on their MRI. Eight of the 10 men were confirmed to have pathological progression on biopsy. Four of these developed a new PIRADS 4 lesion, and 2 had conversion of PIRADS 3 to PIRADS 4. Two additional patients had an increase in lesion size between scans. CONCLUSIONS In general, serial mpMRI demonstrates small changes in lesion appearance over time. However, new lesions are common, and changes in lesion characteristics between MRIs significantly influenced the management of men on AS. © 2015 by American Urological Association Education and Research, Inc.FiguresReferencesRelatedDetails Volume 193Issue 4SApril 2015Page: e992 Advertisement Copyright & Permissions© 2015 by American Urological Association Education and Research, Inc.MetricsAuthor Information Samrad Ghavimi More articles by this author Richard Savdie More articles by this author Hamidreza Abdi More articles by this author Silvia Chang More articles by this author Alison Harris More articles by this author Lindsay Machan More articles by this author Martin Gleave More articles by this author Alan So More articles by this author Larry Goldenberg More articles by this author Peter Black More articles by this author Expand All Advertisement Advertisement PDF downloadLoading ...