Identifying Risk Factors for MRI-Invisible Prostate Cancer in Patients Undergoing Transperineal Saturation Biopsy
| Autor: | Mercedes Ruiz Hernández, Enrique Sanz Mayayo, Agustín Fraile Poblador, Silvia García Barreras, Francisco Javier Burgos Revilla, Rafael Rodríguez-Patrón Rodríguez, Marina Mata Alcaraz, Alberto Medina, Guillermo Fernández Conejo |
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| Rok vydání: | 2021 |
| Předmět: |
medicine.medical_specialty
Univariate analysis Multivariate analysis medicine.diagnostic_test Research and Reports in Urology business.industry Urology Magnetic resonance imaging Retrospective cohort study clinically significant prostate cancer medicine.disease negative MRI prostate cancer Prostate cancer medicine.anatomical_structure saturation biopsy Prostate Biopsy medicine multi-parametric magnetic resonance imaging Radiology Risk factor business Original Research |
| Zdroj: | Research and Reports in Urology |
| ISSN: | 2253-2447 |
| Popis: | Alberto Artiles Medina, Rafael RodrÃguez-Patrón RodrÃguez, Mercedes Ruiz Hernández, Marina Mata Alcaraz, Silvia GarcÃa Barreras, Guillermo Fernández Conejo, AgustÃn Fraile Poblador, Enrique Sanz Mayayo, Francisco Javier Burgos Revilla Department of Urology, Hospital Universitario Ramón y Cajal, University of Alcalá, Madrid, SpainCorrespondence: Alberto Artiles MedinaDepartment of Urology, Hospital Universitario Ramón y Cajal, M-607, km. 9, 100, Madrid, 28034, SpainTel +91.336.87.60Fax +91.336.87.59Email alberc.artiles@gmail.comPurpose: Prostatic multi-parametric magnetic resonance imaging (mpMRI) has markedly improved the assessment of men with suspected prostate cancer (PCa). Nevertheless, as mpMRI exhibits a high negative predictive value, a negative MRI may represent a diagnostic dilemma. The aim of this study was to evaluate the incidence of positive transperineal saturation biopsy in men who have negative mpMRI and to analyse the factors associated with positive biopsy in this scenario.Patients and Methods: A retrospective study of men with normal mpMRI and suspicion of PCa who underwent saturation biopsy (⥠20 cores) was carried out. A total of 580 patients underwent transperineal MRI/transrectal ultrasound fusion targeted biopsies or saturation prostate biopsies from January 2017 to September 2020. Of them, 73 had a pre-biopsy negative mpMRI (with Prostate Imaging â Reporting and Data System, PI-RADS, ⤠2) and were included in this study. Demographics, clinical characteristics, data regarding biopsy results and potential predictive factors of positive saturation biopsy were collected. Univariate and multivariate logistic regression analyses were used to identify independent risk factors for MRI-invisible PCa.Results: The detection rate of PCa with saturation biopsy in patients with negative MRI was 34/73 (46.58%). Out of 34 MRI-invisible prostate cancers detected, 12 (35.29%) were clinically significant PCa (csPCa) forms. Regarding factors of positive biopsy, in univariate analysis, the use of 5-alpha reductase inhibitors and free:total prostate-specific antigen (PSA) ratio were associated with the result of the saturation biopsy. In multivariate analysis, only an unfavourable free:total PSA ratio remained a risk factor (OR 11.03, CI95% 1.93â 63.15, p=0.01). Furthermore, multivariate logistic analysis demonstrated that prostate volume > 50mL significantly predicts the absence of csPCa on saturation biopsy (OR 0.11, 95% CI 0.01â 0.94, p=0.04).Conclusion: A free:total PSA ratio < 20% is a risk factor for MRI-invisible PCa. Saturation biopsy could be considered in patients with suspected PCa, despite having a negative MRI.Keywords: clinically significant prostate cancer, multi-parametric magnetic resonance imaging, negative MRI, prostate cancer, saturation biopsy |
| Databáze: | OpenAIRE |
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