MP05-17 SELECTING PROSTATE BIOPSY METHOD BASED ON PI-RADS SCORE: A SECONDARY ANALYSIS OF THE TRIO STUDY

Abstract

You have accessJournal of UrologyProstate Cancer: Detection & Screening I (MP05)1 Sep 2021MP05-17 SELECTING PROSTATE BIOPSY METHOD BASED ON PI-RADS SCORE: A SECONDARY ANALYSIS OF THE TRIO STUDY Michael Ahdoot, Lori Long, Andrew Wilbur, Patrick Gomella, Michael Daneshvar, Cheyenne Williams, Nabila Khondakar, Sandeep Gurram, Sherif Mehralivand, Nitin Yerram, and Peter Pinto Michael AhdootMichael Ahdoot More articles by this author , Lori LongLori Long More articles by this author , Andrew WilburAndrew Wilbur More articles by this author , Patrick GomellaPatrick Gomella More articles by this author , Michael DaneshvarMichael Daneshvar More articles by this author , Cheyenne WilliamsCheyenne Williams More articles by this author , Nabila KhondakarNabila Khondakar More articles by this author , Sandeep GurramSandeep Gurram More articles by this author , Sherif MehralivandSherif Mehralivand More articles by this author , Nitin YerramNitin Yerram More articles by this author , and Peter PintoPeter Pinto More articles by this author View All Author Informationhttps://doi.org/10.1097/JU.0000000000001972.17AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookLinked InTwitterEmail Abstract INTRODUCTION AND OBJECTIVE: While MRI-targeted biopsy has been shown to result in improved prostate cancer detection relative to systematic biopsy, the combination of both methods increases clinically significant cancer detection relative to either biopsy method alone. However, combined biopsy subjects patients to an increased number of biopsy cores, and increased clinically insignificant cancer detection. We sought to determine if pre-biopsy prostate MRI can identify men into groups who could forgo combined biopsy without substantial risk of missing clinically significant cancer. METHODS: Men with MRI-visible prostate lesions underwent combined MRI-targeted plus systematic prostate biopsies. The primary outcomes were grade group(GG)≥2 and GG≥3 cancer detection rates by MRI-targeted and systematic biopsy, stratified by the radiologists’ MRI risk stratifications(PI-RADS groups). (ClinicalTrials.gov, NCT00102544) RESULTS: Among PI-RADS 5 men, nearly all clinically significant cancers were detected by MRI-targeted biopsy, as adding systematic biopsy resulting in only 2.5% more GG≥2 cancer detection. Among PI-RADS 3-4 men, however, the addition of systematic biopsy resulted in substantially more clinically significant cancer than MRI-targeted biopsy alone (7.5% and 8%, respectively). Conversely, MRI-targeted biopsy added little to clinically significant cancer detection among men with PI-RADS 2 lesions (2%) relative to systematic biopsy(7.8%). CONCLUSIONS: While combined biopsies increase the clinically significant cancer detection among men with MRI-visible prostate lesions, this benefit was largely restricted to men with PI-RADS 3-4 lesions. Using a strategy of MRI-targeted biopsy only for PIRADS 5 men and combined biopsy only for PI-RADS 3-4 men would avoiding excess biopsies in PIRADS 5 men while resulting in a low risk of missing clinically significant prostate cancers (1%). Source of Funding: NIH intramural funding © 2021 by American Urological Association Education and Research, Inc.FiguresReferencesRelatedDetails Volume 206Issue Supplement 3September 2021Page: e85-e85 Advertisement Copyright & Permissions© 2021 by American Urological Association Education and Research, Inc.MetricsAuthor Information Michael Ahdoot More articles by this author Lori Long More articles by this author Andrew Wilbur More articles by this author Patrick Gomella More articles by this author Michael Daneshvar More articles by this author Cheyenne Williams More articles by this author Nabila Khondakar More articles by this author Sandeep Gurram More articles by this author Sherif Mehralivand More articles by this author Nitin Yerram More articles by this author Peter Pinto More articles by this author Expand All Advertisement Loading ...