644 Validation of The Prostate Imaging Reporting and Data System (PIRADS) Tool for Prostate Cancer Detection in A Contemporary British Cohort

Abstract

Abstract Introduction The European Association of Urology (EAU) recommends multiparametric MRI (mpMRI) prior to prostate biopsy for investigation of prostate cancer (CaP). Specifically, the mpMRI should be reported using the Prostate Imaging Reporting and Data System (PIRADS) tool. Our study aims to externally validate the PIRADS tool over a multi-centre district general hospital. Method Retrospective review was performed on 104 consecutive patients who underwent mpMRI and subsequent cognitive transrectal ultrasound biopsy of prostate (CTRUSB) over an 18-month period. Collected mpMRI data was correlated with Gleason grading obtained through CTRUSB histology. Results On histology findings, a total of 64.4% patients (n = 67) were found to have prostate cancer with a mean PSA density (PSAD) of 0.48. Extremes of the PIRADS scoring tool showed a clear correlation. PIRADS 2 correlated to a 0% prostate cancer detection rate (PSAD 0.16), whereas PIRADS 5 correlated to 93.1% detection rate (PSAD 0.49). However, for PIRADS 3 and 4, prostate cancer detection rates were 49.8% (PSAD 0.25) and 50.9% (PSAD 0.18) respectively. Conclusions Our study substantiates the association of lesions scored as PIRADS 5 with prostate cancer detection. CTRUSB in PIRADS 2 lesions can be safely avoided. For PIRADS 3 and 4 lesions, PSAD should be considered before performing a biopsy.