MP46-07 PROSTATE CANCER DETECTION IN BIOPSY-NAÏVE MEN: A PROSPECTIVE, COMPARATIVE, ONGOING CLINICAL TRIAL OF MULTIPARAMETRIC MRI- AND CONTRAST ENHANCED ULTRASOUND-TARGETED BIOPSY VERSUS SYSTEMATIC BIOPSY

Field: Medicine (Health Sciences)

You have accessJournal of UrologyProstate Cancer: Detection & Screening IV1 Apr 2018MP46-07 PROSTATE CANCER DETECTION IN BIOPSY-NAÏVE MEN: A PROSPECTIVE, COMPARATIVE, ONGOING CLINICAL TRIAL OF MULTIPARAMETRIC MRI- AND CONTRAST ENHANCED ULTRASOUND-TARGETED BIOPSY VERSUS SYSTEMATIC BIOPSY Christophe Mannaerts, Olivia Lodeizen, Arnoud Postema, Ruud Van Sloun, Rogier Wildeboer, Massimo Mischi, Dilara Savci-Heijink, Marc Engelbrecht, Theo De Reijke, and Hessel Wijkstra Christophe MannaertsChristophe Mannaerts More articles by this author , Olivia LodeizenOlivia Lodeizen More articles by this author , Arnoud PostemaArnoud Postema More articles by this author , Ruud Van SlounRuud Van Sloun More articles by this author , Rogier WildeboerRogier Wildeboer More articles by this author , Massimo MischiMassimo Mischi More articles by this author , Dilara Savci-HeijinkDilara Savci-Heijink More articles by this author , Marc EngelbrechtMarc Engelbrecht More articles by this author , Theo De ReijkeTheo De Reijke More articles by this author , and Hessel WijkstraHessel Wijkstra More articles by this author View All Author Informationhttps://doi.org/10.1016/j.juro.2018.02.1466AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookTwitterLinked InEmail INTRODUCTION AND OBJECTIVES Substituting transrectal ultrasound (TRUS) guided systematic biopsies (SBx) with multiparametric MRI (mpMRI) targeted biopsy (TBx) remains controversial in the biopsy-naive setting. Contrast-enhanced ultrasound (CEUS) with quantitative parametric imaging has shown promising results for the detection of prostate cancer (PCa). In this trial, we will determine the individual and complementary value of mpMRI and CEUS for PCa detection by comparing PCa and clinically significant (csPCa) detection for mpMRI/TRUS-fusion TBx and CEUS TBx with routine SBx in biopsy-naive men. METHODS This institutional review board-approved, prospective trial (ClinicalTrials.gov: NCT02831920) will include 299 biopsy-naive men. Prebiopsy mpMRI consists of T2-weighted, diffusion-weighted and dynamic contrast-enhanced imaging while CEUS imaging consists of 4 prostate-plane recordings using an US contrast agent and quantification software. The mpMRI and CEUS will be evaluated in a blinded fashion by an uro-radiologist and a CEUS expert using likelihood of PCa based on PIRADSv2 and a 1 to 5 Likert Scale, respectively. A TRUS-guided 12-core SBx protocol is performed by an operator blinded for imaging. A second operator, using an MRI/TRUS fusion device will take TBx from mpMRI and CEUS lesions. PCa and csPCa (definition 1: Gleason score (GS) ≥3+4=7 / definition 2: GS ≥4+3=7) detection rates will be compared between the regimens. RESULTS In this ongoing trial in progress, 97 patients signed informed consent. Ninety patients were eligible for preliminary analysis with median PSA (IQR) of 6.4 ng/mL (4.7-8.2) and clinical T-stage (cT2c vs. T1c) of 38% vs. 62%. A total of 50 (56%) men had PCa; of these, 39 (78%) were diagnosed with GS ≥7 PCa and 11 (22%) with GS 6 PCa. For definition 1: mpMRI TBx (N=32) yielded GS ≥3+4=7 PCa in 26 (29%) men and 0 GS 6 PCa while CEUS TBx (N=54) yielded GS ≥3+4=7 PCa in 24 (27%) men and 2 (2%) GS 6 PCa. SBx yielded GS ≥3+4=7 PCa in 36 (40%) men and 13 (14%) GS 6 PCa. For definition 2: mpMRI TBx and CEUS TBx yielded GS ≥4+3=7 PCa in 17 (19%) and 13 (14%) men compared to 11 (12%) in SBx, respectively. CONCLUSIONS This trial is the first to combine mpMRI imaging with advanced CEUS imaging using quantification software for PCa detection. Preliminary results demonstrate that mpMRI and CEUS TBx enable detection of high GS PCa and avoidance of biopsy in men without PCa or low-grade PCa. However, both imaging modalities do not guarantee complete certainty of GS 3+4=7 PCa detection as compared to SBx. © 2018FiguresReferencesRelatedDetails Volume 199Issue 4SApril 2018Page: e608 Advertisement Copyright & Permissions© 2018MetricsAuthor Information Christophe Mannaerts More articles by this author Olivia Lodeizen More articles by this author Arnoud Postema More articles by this author Ruud Van Sloun More articles by this author Rogier Wildeboer More articles by this author Massimo Mischi More articles by this author Dilara Savci-Heijink More articles by this author Marc Engelbrecht More articles by this author Theo De Reijke More articles by this author Hessel Wijkstra More articles by this author Expand All Advertisement Advertisement PDF downloadLoading ...