MP21-18 PROSTATE CANCER DETECTION BETWEEN PERIPHERAL ZONE AND TRANSITIONAL ZONE TARGETED BIOPSIES: PRELIMINARY RESULTS FROM A PROSPECTIVE COHORT OF MEN UNDERGOING MRI-US FUSION BIOPSY

Abstract

You have accessJournal of UrologyProstate Cancer: Detection & Screening III1 Apr 2016MP21-18 PROSTATE CANCER DETECTION BETWEEN PERIPHERAL ZONE AND TRANSITIONAL ZONE TARGETED BIOPSIES: PRELIMINARY RESULTS FROM A PROSPECTIVE COHORT OF MEN UNDERGOING MRI-US FUSION BIOPSY Bruno Nahar, Nachiketh Soodana Prakash, Raymond Balise, Tara Abboud, Nicola Pavan, Samarpit Rai, Felipe Munera, Vasanti Jhaveri, Rosa Castillo, Murugesan Manoharan, Bruce Kava, Ramgopal Satyanarayana, Mark Gonzalgo, Chad Ritch, Dipen Parekh, and Sanoj Punnen Bruno NaharBruno Nahar More articles by this author , Nachiketh Soodana PrakashNachiketh Soodana Prakash More articles by this author , Raymond BaliseRaymond Balise More articles by this author , Tara AbboudTara Abboud More articles by this author , Nicola PavanNicola Pavan More articles by this author , Samarpit RaiSamarpit Rai More articles by this author , Felipe MuneraFelipe Munera More articles by this author , Vasanti JhaveriVasanti Jhaveri More articles by this author , Rosa CastilloRosa Castillo More articles by this author , Murugesan ManoharanMurugesan Manoharan More articles by this author , Bruce KavaBruce Kava More articles by this author , Ramgopal SatyanarayanaRamgopal Satyanarayana More articles by this author , Mark GonzalgoMark Gonzalgo More articles by this author , Chad RitchChad Ritch More articles by this author , Dipen ParekhDipen Parekh More articles by this author , and Sanoj PunnenSanoj Punnen More articles by this author View All Author Informationhttps://doi.org/10.1016/j.juro.2016.02.652AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookTwitterLinked InEmail INTRODUCTION AND OBJECTIVES Multiparametric MRI has emerged as a popular imaging modality to localize prostate cancer. Nevertheless, interpretation of MRI is subjective, with concerns for false positives, particularly in the transitional zone (TZ), where hyperplastic changes that are common to this region may be confused for suspicion of cancer. We analyzed a prospective cohort of men undergoing MRI-US fusion biopsy and compared cancer detection rate between lesions seen in the peripheral zone (PZ) and the TZ. METHODS 185 men with elevated PSA or positive digital rectal exam underwent MRI-US fusion biopsy with average of 2 cores taken per target for the detection of prostate cancer between October 2015 and October 2015. Each targeted lesion in the PZ and TZ was previously classified by radiologists according to the MRI PI-RADS score and grouped according to their level of suspicion as probably benign (1-2), indeterminate (3) or probably malignant (4-5). Histopathology from targeted cores were categorized as no cancer, non-significant cancer (Gleason 6) and significant cancer (Gleason ≥ 7). We compared the cancer detection rates between lesions in PZ and TZ lesions, based on PI-RADS score. RESULTS We identified 195 lesions in the PZ and 123 lesions in the TZ. Among lesions found in the TZ, 54% were reported as probably malignant, compared to 46% of lesions seen in the PZ. Cancer was diagnosed in 25% of the lesions in the PZ, compared to only in 9.7% in the TZ (p<0.007). With respect to significant cancer, there was a higher detection rate in the PZ (15% vs 6% p<0.01) compared to TZ. Furthermore, lesions in the PZ with a PI-RADS score > 4 were associated with a three-fold increase in the odds of detecting cancer compared to lesions with PI-RADS < 4 (OR 3.53; CI 95% 1.7-7.31, p<0.007), whereas in the TZ there was no increased risk of cancer with higher PI-RADS scores CONCLUSIONS There is an increased likelihood of false positives when reporting the presence and aggressiveness of cancer in the TZ versus the PZ. This may lead to unnecessary biopsies in men undergoing MRI of the prostate. © 2016FiguresReferencesRelatedDetails Volume 195Issue 4SApril 2016Page: e252 Advertisement Copyright & Permissions© 2016MetricsAuthor Information Bruno Nahar More articles by this author Nachiketh Soodana Prakash More articles by this author Raymond Balise More articles by this author Tara Abboud More articles by this author Nicola Pavan More articles by this author Samarpit Rai More articles by this author Felipe Munera More articles by this author Vasanti Jhaveri More articles by this author Rosa Castillo More articles by this author Murugesan Manoharan More articles by this author Bruce Kava More articles by this author Ramgopal Satyanarayana More articles by this author Mark Gonzalgo More articles by this author Chad Ritch More articles by this author Dipen Parekh More articles by this author Sanoj Punnen More articles by this author Expand All Advertisement Advertisement PDF downloadLoading ...