MP18-01 IDENTIFICATION OF PROSTATE SPECIFIC ANTIGEN AND PROSTATE SPECIFIC ANTIGEN DENSITY THRESHOLDS AT WHICH FUSION-GUIDED BIOPSY OUTPERFORMS SYSTEMATIC BIOPSY

Abstract

You have accessJournal of UrologyImaging/Radiology: Uroradiology III1 Apr 2017MP18-01 IDENTIFICATION OF PROSTATE SPECIFIC ANTIGEN AND PROSTATE SPECIFIC ANTIGEN DENSITY THRESHOLDS AT WHICH FUSION-GUIDED BIOPSY OUTPERFORMS SYSTEMATIC BIOPSY Sherif Mehralivand, Sandra Bednarova, Francesca Mertan, Sonia Gaur, Maria Merino, Bradford Wood, Peter Pinto, Peter Choyke, and Baris Turkbey Sherif MehralivandSherif Mehralivand More articles by this author , Sandra BednarovaSandra Bednarova More articles by this author , Francesca MertanFrancesca Mertan More articles by this author , Sonia GaurSonia Gaur More articles by this author , Maria MerinoMaria Merino More articles by this author , Bradford WoodBradford Wood More articles by this author , Peter PintoPeter Pinto More articles by this author , Peter ChoykePeter Choyke More articles by this author , and Baris TurkbeyBaris Turkbey More articles by this author View All Author Informationhttps://doi.org/10.1016/j.juro.2017.02.611AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookTwitterLinked InEmail INTRODUCTION AND OBJECTIVES Transrectal ultrasound/magnetic resonance imaging fusion-guided biopsy (FB) of the prostate improves detection of clinically significant prostate cancer (CS PCa) compared to standard 12-core systematic biopsy (SB). However, it is still unclear which patient population benefits from FB rather than SB alone. Our goal was to determine prostate specific antigen (PSA) and PSA density (PSAD) thresholds at which FB outperforms SB. METHODS 1226 patients underwent prostate multiparametric MRI (mpMRI) including T2 weighted, diffusion weighted, apparent diffusion coefficient maps, high b value (1500-2000s/mm2) and dynamic contrast enhancement sequences from May 2015 to August 2016. Lesions were assigned suspicion scores according to the Prostate Imaging-Reporting and Data System version 2 (PI-RADSv2). PI-RADSv2 lesions scored ≥ 3 were routinely biopsied. 362/1226 patients underwent FB and SB in the same session. The highest Gleason scores detected by FB and SB were determined on a patient level. Patients who were upgraded to CS PCa (≥Gleason score of 3+4) by FB over SB and vice versa were identified. By calculating cumulative PSA and PSAD curves, exact thresholds for PSA and PSAD were determined at which FB upgraded more patients to CS PCa compared to SB. RESULTS 167/362 patients were diagnosed with CS PCa. 55 patients were upgraded by FB, 35 were upgraded by SB, and both modalities diagnosed CS PCa in 77 patients. Thresholds of 6.15ng/ml for PSA and 0.14 for PSAD were determined (Figure 1). CONCLUSIONS Patients with a PSA ≥ 6.15ng/ml or a PSAD ≥ 0.14 appear to benefit more from mpMRI and subsequent FB if suspicious lesions are detected on mpMRI than patients with values below these thresholds. © 2017FiguresReferencesRelatedDetails Volume 197Issue 4SApril 2017Page: e219 Advertisement Copyright & Permissions© 2017MetricsAuthor Information Sherif Mehralivand More articles by this author Sandra Bednarova More articles by this author Francesca Mertan More articles by this author Sonia Gaur 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 Peter Choyke More articles by this author Baris Turkbey More articles by this author Expand All Advertisement Advertisement PDF downloadLoading ...