How to optimize follow-up in patients with a suspicious multiparametric MRI and a subsequent negative targeted prostate biopsy. Results from a large, single-institution series

Barletta, Francesco; Stabile, Armando; Mazzone, Elio; Brembilla, Giorgio; Sorce, Gabriele; Pellegrino, Francesco; Scuderi, Simone; Cannoletta, Donato; Cirulli, Giuseppe; Cucchiara, Vito; Gandaglia, Giorgio; Cobelli, Francesco De; Montorsi, Francesco; Briganti, Alberto

doi:10.1016/j.urolonc.2021.09.015

Cited by 15 publications

(11 citation statements)

References 13 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“… 28 Similarly, Barletta et al emphasized the high positive predictive value of follow-up mp-MRI and its strong association with the presence of cs-PCa. 29 These studies showed that radiological follow-up could be effective in the diagnostic management of PI-RADS 4–5 cases.…”

Section: Discussionmentioning

confidence: 99%

Long-term follow-up results of multiparametric prostate MRI and the prognostic value of PI-RADS: a single-center retrospective cohort study

Önder,

Ayva,

Yaraşır

et al. 2024

dir

View full text Add to dashboard Cite

PURPOSE We aim to examine the long-term outcomes of patients who underwent multiparametric prostate magnetic resonance imaging (mp-MRI) for suspected prostate cancer (PCa), specifically based on their initial Prostate Imaging Reporting and Data System (PI-RADS) categories and various clinical factors. Our secondary aim is to evaluate the prognostic value of the PI-RADS through the National Comprehensive Cancer Network (NCCN) risk group distribution. METHODS This research was conducted as a single-center retrospective cohort study in a tertiary care hospital. A total of 1,359 cases having at least one histopathological examination after the initial mp-MRI and/or adequate clinical/radiological follow-up data were included in the clinically significant PCa (cs-PCa) diagnosis-free survival analysis. Initial mp-MRI dates were accepted as the start of follow-up for the time-to-event analysis. The event was defined as cs-PCa diagnosis (International Society of Urological Pathology ≥2). Patients who were not diagnosed with cs-PCa during follow-up were censored according to predefined literature-based criteria at the end of the maximum follow-up duration with no reasonable suspicion of PCa and no biopsy indication. The impact of various factors on survival was assessed using a log-rank test and multivariable Cox regression. Subsequently, 394 cases diagnosed with PCa during follow-up were evaluated, based on initial PI-RADS categories and NCCN risk groups. RESULTS Three main risk factors for cs-PCa diagnosis during follow-up were an initial PI-RADS 5 category, initial PI-RADS 4 category, and high MRI-defined PSA density (mPSAD), with average hazard ratios of 29.52, 14.46, and 3.12, respectively. The PI-RADS 3 category, advanced age group, and biopsy-naïve status were identified as additional risk factors (hazard ratios: 2.03, 1.54–1.98, and 1.79, respectively). In the PI-RADS 1–2 cohort, 1, 3, and 5-year cs-PCa diagnosis-free survival rates were 99.1%, 96.5%, and 93.8%, respectively. For the PI-RADS 3 cohort, 1, 3, and 5-year cs-PCa diagnosis-free survival rates were 94.9%, 90.9%, and 89.1%, respectively. For the PI-RADS 4 cohort, 1, 3, and 5-year cs-PCa diagnosis-free survival rates were 56.6%, 55.1%, and 55.1%, respectively. These rates were found to all be 24.2% in the PI-RADS 5 cohort. Considering the 394 cases diagnosed with PCa during follow-up, PI-RADS ≥4 cases were more likely to harbor unfavorable PCa compared to PI-RADS ≤3 cases ( P < 0.001). In the PI-RADS 3 subgroup analysis, a low mPSAD (<0.15 ng/mL 2 ) was found to be a protective prognostic factor against unfavorable PCa ( P = 0.005). CONCLUSION The PI-RADS category has a significant impact on patient management and provides important diagnostic and prognostic information. Higher initial PI-RADS categories are associated with decreased follow-up losses, a shorter time to PCa ...

show abstract

Section: Discussionmentioning

confidence: 99%

Long-term follow-up results of multiparametric prostate MRI and the prognostic value of PI-RADS: a single-center retrospective cohort study

Önder,

Ayva,

Yaraşır

et al. 2024

dir

View full text Add to dashboard Cite

show abstract

“…Other studies also displayed a substantial number of negative biopsies in case of suspicious mpMRI in up to 18–37% of cases [2] , [4] , [6] . Although follow-up for these patients is not yet standardized, a recent study found that 4.9% of patients were diagnosed with csPCa in the follow-up [16] . Our cohort is currently in follow-up and will be analyzed for any csPCa development in the future.…”

Section: Discussionmentioning

confidence: 99%

Magnetic Resonance Imaging–targeted Prostate Biopsy Compared with Systematic Prostate Biopsy in Biopsy-naïve Patients with Suspected Prostate Cancer

Alkema

Hoogeveen²,

Cauberg³

et al. 2022

European Urology Open Science

View full text Add to dashboard Cite

“…The mpMRI images were scored and reported using the PI‐RADS version 2 16 . All patients underwent both TBx and SBx at our center according to the technique previously described 17–19 . TBx was performed using a software‐registration fusion approach and was immediately followed by additional random SBx using a sextant biopsy scheme during the same session, in accordance with the currently available guidelines 11 .…”

Section: Methodsmentioning

confidence: 99%

“…16 All patients underwent both TBx and SBx at our center according to the technique previously described. [17][18][19] TBx was performed using a softwareregistration fusion approach and was immediately followed by additional random SBx using a sextant biopsy scheme during the same session, in accordance with the currently available guidelines. 11 Biopsies were performed by experienced urologists using an 18-gauge needle and a biopsy gun providing a specimen size of 18−22 mm.…”

Section: Mpmri and Biopsy Techniquementioning

confidence: 99%

Does previous prostate surgery affect multiparametric magnetic resonance imaging accuracy in detecting clinically significant prostate cancer? Results from a single institution series

et al. 2022

Self Cite

View full text Add to dashboard Cite

Background: Multiparametric MRI (mpMRI) has demonstrated high diagnostic accuracy for clinically significant PCa (csPCa). However, the accuracy of this test in men that received a previous prostatic surgery is still controversial. We aimed at assessing the effect of previous prostatic surgery on the detection of csPCa in a tertiary referral center. Method:We relied on a cohort of 311 men with a positive mpMRI (prostate imagingreporting and data system [PI-RADS] ≥ 3) who underwent a targeted (TBx) plus concomitant systematic random biopsy (SBx) at a single tertiary referral center between 2017 and 2020. The study outcome was to compare the detection of csPCa (Gleason score ≥ 3 + 4) between the two groups (no previous prostate surgery [Group 1] vs. previous prostate surgery [Group 2]). Multivariable logistic regression analysis (MVA) was used to assess the relationship between previous prostate surgery and the detection of csPCa at TBx, after taking into account potential clinical confounders.Results: Overall, 24 (8%) patients received a previous prostate surgery before undergoing mpMRI. Median prostate-specific antigen density was 0.15 versus 0.08 ng/ml/cc, in Group 1 versus 2, respectively. The most frequent finding at mpMRI was in Group 1 versus 2, PI-RADS 4 (55%) versus PI-RADS 3 and 4 (42% each). The majority of patients were biopsy naïve in both Groups 1 (66%) and 2 (71%). The overall detection of csPCa in Group 1 versus 2 was 83% versus 75%, respectively. Differently, the detection of csPCa at TBx in Groups 1 versus 2 was 76% versus 71%, respectively. At MVA, previous prostate surgery (odds ratio: 0.65; p = 0.02) was significantly associated with lower csPCa detection at TBx, after accounting for potential confounders.

show abstract

How to optimize follow-up in patients with a suspicious multiparametric MRI and a subsequent negative targeted prostate biopsy. Results from a large, single-institution series

Cited by 15 publications

References 13 publications

Long-term follow-up results of multiparametric prostate MRI and the prognostic value of PI-RADS: a single-center retrospective cohort study

Long-term follow-up results of multiparametric prostate MRI and the prognostic value of PI-RADS: a single-center retrospective cohort study

Magnetic Resonance Imaging–targeted Prostate Biopsy Compared with Systematic Prostate Biopsy in Biopsy-naïve Patients with Suspected Prostate Cancer

Does previous prostate surgery affect multiparametric magnetic resonance imaging accuracy in detecting clinically significant prostate cancer? Results from a single institution series

Contact Info

Product

Resources

About