MP10-05 UTILITY OF MRI AND TARGETED BIOPSY TO DIAGNOSE LOCAL CANCER RECURRENCE AFTER PROSTATECTOMY

Abstract

You have accessJournal of UrologySurgical Technology & Simulation: Instrumentation & Technology I (MP10)1 Sep 2021MP10-05 UTILITY OF MRI AND TARGETED BIOPSY TO DIAGNOSE LOCAL CANCER RECURRENCE AFTER PROSTATECTOMY Cheyenne Williams, Michael Daneshvar, Nabila Khondakar, Jeunice Owens-Walton, Luke P. OConnor, Nitin Yerram, Patrick T. Gomella, Michael Ahdoot, Bradley R. Webster, Peter Choyke, Baris Turkbey, Maria Merino, Bradford Wood, and Peter Pinto Cheyenne WilliamsCheyenne Williams More articles by this author , Michael DaneshvarMichael Daneshvar More articles by this author , Nabila KhondakarNabila Khondakar More articles by this author , Jeunice Owens-WaltonJeunice Owens-Walton More articles by this author , Luke P. OConnorLuke P. OConnor More articles by this author , Nitin YerramNitin Yerram More articles by this author , Patrick T. GomellaPatrick T. Gomella More articles by this author , Michael AhdootMichael Ahdoot More articles by this author , Bradley R. WebsterBradley R. Webster More articles by this author , Peter ChoykePeter Choyke More articles by this author , Baris TurkbeyBaris Turkbey More articles by this author , Maria MerinoMaria Merino More articles by this author , Bradford WoodBradford Wood More articles by this author , and Peter PintoPeter Pinto More articles by this author View All Author Informationhttps://doi.org/10.1097/JU.0000000000001983.05AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookLinked InTwitterEmail Abstract INTRODUCTION AND OBJECTIVE: Following radical prostatectomy (RP), biochemical recurrence (BCR) may be attributed to either metastasis, local cancer recurrence, or retained benign prostatic gland tissue. With increased utilization of prostate MRI, similar cross-sectional imaging in this setting can occasionally identify a suspicious lesion at the surgical site. We sought to explore the utility of urologist performed MRI Fusion-guided biopsy (Fbx) for diagnosing benign versus malignant retained prostate tissue in the prostatectomy bed and if imaging characteristics were predictive of local cancer recurrence. METHODS: Patients with BCR after RP with MRI visible lesion in the prostate bed between February 2015 and December 2020 were identified. Cancer detection via MRI-guided fusion biopsy using the UroNav platform was evaluated, and multivariable regression identified patient variables associated with confirmed local recurrence including RP Gleason Grade group (GG). Covariates evaluated included margin involvement, extraprostatic extension, PSA at BCR, and prostate bed lesion size on MRI. RESULTS: Ultimately, 23 patients with BCR and positive MRI underwent Fbx of the prostate bed at our institution Median age, PSA at BCR, and time to BCR were 67.8 years, 0.51 ng/mL, and 2.3 years. 6/23 (26%) patients had positive RP margins, and 9/23 (39.1%) had extraprostatic extension. Median prostate bed lesion size was 1.3 cm (IQR 0.25-1.95). 16/23 (69.5%) biopsies contained prostate adenocarcinoma, 4/23 (17.4%) biopsies contained benign prostate glands, and 3/23 (13.0%) biopsies contained fibromuscular tissue. Median cores per patient was 4 (IQR 2.5-5.5), and among patients with positive biopsies, median number of positive cores was 2.5 (0.5-4.75). In patients with benign biopsies, none had further evidence of metastasis at median follow-up of 13.5 months after Fbx and 182 months after RP. Meanwhile, 3/16 (18.8%) patients with positive Fbx had later metastasis. On multivariable regression, prostate bed lesion size (cm) was independently associated with diagnosing local recurrence on Fbx (OR =2.48, 95% CI:1.31- 4.69, p=0.016). CONCLUSIONS: This series demonstrates MRI fusion biopsy is a feasible familiar approach for urologists to evaluate for local recurrence in patients with BCR and imaging identifiable lesions at the prostate resection site, and prostate bed lesion size on post-RP imaging is predictive of local cancer recurrence. Source of Funding: The National Institute of Health (NIH) Medical Research Scholars Program, Foundation for the NIH, NIH Intramural Research Program © 2021 by American Urological Association Education and Research, Inc.FiguresReferencesRelatedDetails Volume 206Issue Supplement 3September 2021Page: e170-e170 Advertisement Copyright & Permissions© 2021 by American Urological Association Education and Research, Inc.MetricsAuthor Information Cheyenne Williams More articles by this author Michael Daneshvar More articles by this author Nabila Khondakar More articles by this author Jeunice Owens-Walton More articles by this author Luke P. OConnor More articles by this author Nitin Yerram More articles by this author Patrick T. Gomella More articles by this author Michael Ahdoot More articles by this author Bradley R. Webster More articles by this author Peter Choyke More articles by this author Baris Turkbey More articles by this author Maria Merino More articles by this author Bradford Wood More articles by this author Peter Pinto More articles by this author Expand All Advertisement Loading ...