The effect of multiplicity of PI-RADS 3 lesions on cancer detection rate of confirmatory targeted biopsy in patients diagnosed with prostate cancer and managed with active surveillance
| Autor: | Shaheen Alanee, Mustafa Deebajah, Milan Pantelic, Sean R. Williamson, Grace Yaguchi, Nilesh S. Gupta, Mani Menon, James O. Peabody, Ali Dabaja, Hoang J. Tang, Jacob Keeley |
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| Rok vydání: | 2019 |
| Předmět: |
Image-Guided Biopsy
Male medicine.medical_specialty Prostate biopsy Urology 030232 urology & nephrology Lesion 03 medical and health sciences Prostate cancer 0302 clinical medicine Interquartile range Prostate Biopsy medicine Humans Prospective Studies Multiparametric Magnetic Resonance Imaging Watchful Waiting Aged medicine.diagnostic_test business.industry Prostatic Neoplasms Middle Aged medicine.disease PI-RADS Prostate-specific antigen medicine.anatomical_structure Oncology 030220 oncology & carcinogenesis Radiology medicine.symptom business |
| Zdroj: | Urologic oncology. 38(6) |
| ISSN: | 1873-2496 |
| Popis: | Background and Objective To determine the effect of multiplicity of prostate imaging reporting and data system assessment category 3 (PI-RADS 3) lesions on cancer detection rate (CDR) of confirmatory targeted biopsy of such lesion in patients diagnosed with prostate cancer and managed with active surveillance. Methods This study was conducted at a single academic institution. There were 91 men with ≥ 1 PI-RADS 3 lesion detected through magnetic resonance imaging (MRI) after systematic prostate biopsy in the course of management of patients diagnosed with prostate cancer with active surveillance. We compared the CDRs based on targeted biopsy of PI-RADS 3 lesions that occurred (1) as solitary lesions, (2) as 1 of multiple PI-RADS 3 only lesions, or (3) with ≥ 1 higher grade lesion. Results Median age was 65.0 years (interquartile range 59.5–70.0), median prostate specific antigen was 5.95 ng/ml (interquartile range 4.30–8.83), and median prostate specific antigen density was 0.161 ng/ml2 (0.071–0.194). Forty-three men had solitary PI-RADS 3 lesions, 22 had multiple PI-RADS 3 only lesions, and 26 had multiple lesions with ≥ 1 higher grade lesion. The overall CDR (Gleason score ≥ 3 + 3) based on confirmatory MRI targeted biopsy in a given PI-RADS 3 lesion in each group was 23%, 45%, and 54%, respectively (P = 0.0274). The CDRs for clinically significant disease (Gleason score ≥ 3 + 4) were 16%, 32%, and 35%, respectively (P = 0.1701). Conclusions Coexisting lesions increase the CDR of confirmatory MRI targeted biopsy of PI-RADS 3 lesions in patients managed with active surveillance. Risk stratification algorithms for PI-RADS 3 lesion to guide biopsy and management decisions may consider including multiplicity of lesions. |
| Databáze: | OpenAIRE |
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