MP20-09 MRI-BASED RISK ASSESSMENT FOR POSTOPERATIVE BIOCHEMICAL RECURRENCE USING THE PROSTATE IMAGING REPORTING AND DATA SYSTEM (PI-RADS) SCORES AND CAPSULAR CONTACT LENGTH

Abstract

You have accessJournal of UrologyImaging/Radiology: Uroradiology II1 Apr 2018MP20-09 MRI-BASED RISK ASSESSMENT FOR POSTOPERATIVE BIOCHEMICAL RECURRENCE USING THE PROSTATE IMAGING REPORTING AND DATA SYSTEM (PI-RADS) SCORES AND CAPSULAR CONTACT LENGTH Yoh Matsuoka, Junichiro Ishioka, Hiroshi Tanaka, Tomo Kimura, Yuma Waseda, Sho Uehara, Yosuke Yasuda, Toshiki Kijima, Soichiro Yoshida, Minato Yokoyama, Kazutaka Saito, Kazunori Kihara, and Yasuhisa Fujii Yoh MatsuokaYoh Matsuoka More articles by this author , Junichiro IshiokaJunichiro Ishioka More articles by this author , Hiroshi TanakaHiroshi Tanaka More articles by this author , Tomo KimuraTomo Kimura More articles by this author , Yuma WasedaYuma Waseda More articles by this author , Sho UeharaSho Uehara More articles by this author , Yosuke YasudaYosuke Yasuda More articles by this author , Toshiki KijimaToshiki Kijima More articles by this author , Soichiro YoshidaSoichiro Yoshida More articles by this author , Minato YokoyamaMinato Yokoyama More articles by this author , Kazutaka SaitoKazutaka Saito More articles by this author , Kazunori KiharaKazunori Kihara More articles by this author , and Yasuhisa FujiiYasuhisa Fujii More articles by this author View All Author Informationhttps://doi.org/10.1016/j.juro.2018.02.679AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookTwitterLinked InEmail INTRODUCTION AND OBJECTIVES The latest tumor-node-metastasis staging of prostate cancer (PC) does not include MRI for clinical T categorization. However, PI-RADS version 2 might be useful for prognostic prediction as well as capsular contact length (CL) on MRI (AUA2013, 2016) because the PI-RADS scale for the likelihood of clinically significant PC is based on signal intensity, size, and invasive behavior. We aim to develop an MRI-based simple risk stratification of biochemical recurrence (BCR) after radical prostatectomy (RP). METHODS We enrolled 312 clinically localized PC patients who had undergone multiparametric MRI and RP without prior treatment. Index lesions were assessed by MRI for PI-RADS scores, size, location, extraprostatic involvement, and CL. BCR was defined as PSA >0.2 ng/ml. MRI findings were examined for associations with BCR by Cox regression analyses. BCR-free survival was estimated using the Kaplan-Meier method and compared by log-rank test. The predictive ability of models was evaluated. RESULTS A total of 85 men (27%) had pathological extraprostatic extension and 69 men (22%) experienced BCR at a median follow-up of 56 months. On MRI, 24/38/109/141 men (8/12/35/45%) were assigned to PI-RADS scores ≤2/3/4/5. Index lesions were located in anterior/posterior/both halves of the prostate in 116/139/37 men (37/45/12%). Median diameter and CL of index tumors were 13mm and 11mm, respectively, and 174 men (56%) met PI-RADS criteria for extraprostatic involvement. BCR-free survival was stratified according to PI-RADS scores overall (p <0.001), but no difference was found between scores 3 and 4 (p = 0.80). Multivariate analyses showed that PI-RADS score 5 (hazard ratio [HR] 9.5, p = 0.002), score 3-4 (HR 4.7, p = 0.05), and CL >15mm (HR 2.0, p = 0.02) were independent predictors of BCR. Patients were divided into three groups as follows: PI-RADS score ≤2 (n = 24); score 3-4 with CL ≤15mm (n = 131); and score 3-4 with CL >15mm or score 5 (n = 157); these had five-year BCR-free rates of 100%, 83%, and 57%, respectively (p <0.001). The concordance indexes for this model and PI-RADS local staging were 0.69 and 0.61, respectively. CONCLUSIONS The MRI-based assessment model consisting of PI-RADS scores and CL is simple and useful in risk stratification for postoperative BCR. © 2018FiguresReferencesRelatedDetails Volume 199Issue 4SApril 2018Page: e255-e256 Advertisement Copyright & Permissions© 2018MetricsAuthor Information Yoh Matsuoka More articles by this author Junichiro Ishioka More articles by this author Hiroshi Tanaka More articles by this author Tomo Kimura More articles by this author Yuma Waseda More articles by this author Sho Uehara More articles by this author Yosuke Yasuda More articles by this author Toshiki Kijima More articles by this author Soichiro Yoshida More articles by this author Minato Yokoyama More articles by this author Kazutaka Saito More articles by this author Kazunori Kihara More articles by this author Yasuhisa Fujii More articles by this author Expand All Advertisement Advertisement PDF downloadLoading ...