MP30-07 ADDED PERFORMANCE OF SYSTEMATIC BIOPSY TO 3T MULTIPARAMETRIC MRI DERIVED MR/US FUSION BIOPSY FOR THE DETECTION AND GRADING OF PROSTATE CANCER (2021)

You have accessJournal of UrologyProstate Cancer: Detection & Screening III (MP30)1 Sep 2021MP30-07 ADDED PERFORMANCE OF SYSTEMATIC BIOPSY TO 3T MULTIPARAMETRIC MRI DERIVED MR/US FUSION BIOPSY FOR THE DETECTION AND GRADING OF PROSTATE CANCER Sohrab Afshari Mirak, Kyunghyun Sung, Ely Felker, Anthony Sisk, Robert Reiter, and Steven Raman Sohrab Afshari MirakSohrab Afshari Mirak More articles by this author , Kyunghyun SungKyunghyun Sung More articles by this author , Ely FelkerEly Felker More articles by this author , Anthony SiskAnthony Sisk More articles by this author , Robert ReiterRobert Reiter More articles by this author , and Steven RamanSteven Raman More articles by this author View All Author Informationhttps://doi.org/10.1097/JU.0000000000002027.07AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookLinked InTwitterEmail Abstract INTRODUCTION AND OBJECTIVE: Systematic 12-core transrectal ultrasound-guided biopsy (TRUS) is the gold standard for the detection of Prostate Cancer (PCa) lesions, which might result in over diagnosis of clinically insignificant PCa or under diagnosis of clinically significant PCa. MR/US fusion biopsy provides an opportunity for more accurate detection of PCa. In this study, we investigated the performance of 3 Tesla multiparametric MRI (3TmpMRI) with subsequent MR/US fusion prostate biopsy with subcohort analysis of Targeted Biopsy (MRgFBx) & Systematic Biopsy (SB) for the detection & grading of PCa with Whole Mount Histopathology (WMHP) reference. METHODS: This IRB approved, HIPAA compliant observational study included 309 men, who underwent 3TmpMRI with subsequent MRgFBx & SB prior to radical prostatectomy. The per-patient performance of MRgFBx with & without SB for the detection & grading (ISUP groups) of PCa was evaluated & correlated to final WMHP. RESULTS: Mean total & positive cores were 11.4 & 2.9 for SB & 5.4 & 3.3 for MRgFBx, respectively. The per-patient detection rates (DR) for SB & MRgFBx were 86.4% (267/309) & 95.5% (295/309), respectively. MRgFBx ISUP grading was concordant with WMHP in 47.9% (148/309) patients, discordant with upgrading in 27.8% (86/309) & downgrading in 20.1% (62/309) of patients. Among upgraded cases, 69.8% (60/86), 25.6% (22/86) & 4.6% (4/86) cases were upgraded by 1,2 & 3 ISUP groups, respectively. In 12% (37/309) of cases, upgrading was from PCa ISUP group 1 to ISUP group>1. SB increased the DR of PCa & csPCA of MRgFbx by 4.5% (14/309) & 3.6% (11/309.) In cases with lower prediction of grading by MRgFBx, SB increased the ISUP group of the MRgFBx in 9.4% (29/309), among which 5.5%(17/309), 2.6%(8/309) & 1.3%(4/309) were upgraded to the same grading group as WMHP, lower than the group of WMHP & falsely to higher group than WMHP, respectively. In 72.4% (21/29), the upgrading SB cores were ipsilateral to the target in MRgFbx. True upgrading by SB from ISUP group 1 to group >1 was 5.2% (16/309). CONCLUSIONS: MRgFBx has high performance for detection & grading of PCa & csPCa. SB has minimal added value to MRgFBx for improving the detection & grading. Source of Funding: This work was supported by funds from the Integrated Diagnostics Program, Department of Radiological Sciences & Department of Pathology and Laboratory Medicine, David Geffen School of Medicine at UCLA © 2021 by American Urological Association Education and Research, Inc.FiguresReferencesRelatedDetails Volume 206Issue Supplement 3September 2021Page: e501-e502 Advertisement Copyright & Permissions© 2021 by American Urological Association Education and Research, Inc.MetricsAuthor Information Sohrab Afshari Mirak More articles by this author Kyunghyun Sung More articles by this author Ely Felker More articles by this author Anthony Sisk More articles by this author Robert Reiter More articles by this author Steven Raman More articles by this author Expand All Advertisement Loading ...