MP22-13 PROSTATE LESION GROWTH VELOCITY ON CONSECUTIVE MRIS PREDICTS GRADE PROGRESSION

Abstract

You have accessJournal of UrologyImaging/Radiology: Uroradiology II (MP22)1 Sep 2021MP22-13 PROSTATE LESION GROWTH VELOCITY ON CONSECUTIVE MRIS PREDICTS GRADE PROGRESSION Cheyenne Williams, Nitin Yerram, Michael Daneshvar, Luke P. OConnor, Jillian Egan, Patrick T. Gomella, Jeunice Owens-Walton, Nabila Khondakar, Michael Ahdoot, Maria Merino, Bradford Wood, Peter Choyke, Baris Turkbey, and Peter Pinto Cheyenne WilliamsCheyenne Williams More articles by this author , Nitin YerramNitin Yerram More articles by this author , Michael DaneshvarMichael Daneshvar More articles by this author , Luke P. OConnorLuke P. OConnor More articles by this author , Jillian EganJillian Egan More articles by this author , Patrick T. GomellaPatrick T. Gomella More articles by this author , Jeunice Owens-WaltonJeunice Owens-Walton More articles by this author , Nabila KhondakarNabila Khondakar More articles by this author , Michael AhdootMichael Ahdoot More articles by this author , Maria MerinoMaria Merino More articles by this author , Bradford WoodBradford Wood More articles by this author , Peter ChoykePeter Choyke More articles by this author , Baris TurkbeyBaris Turkbey More articles by this author , and Peter PintoPeter Pinto More articles by this author View All Author Informationhttps://doi.org/10.1097/JU.0000000000002013.13AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookLinked InTwitterEmail Abstract INTRODUCTION AND OBJECTIVE: Multiparametric MRI (mpMRI) has demonstrated utility in diagnosing prostate cancer and selecting patients for active surveillance (AS). Additionally, among patients on AS, imaging changes over the course of surveillance may indicate pathological progression suggestive for a switch to active treatment. We explored the value of mpMRI for measuring index lesion growth velocity and changes in PI-RADS over the whole length of AS and assessed their value for predicting grade progression. METHODS: Patients with ≥2 surveillance MRIs and combined MRI-targeted and systematic biopsy were identified from a prospectively maintained AS database. Patients eligible for AS had Gleason grade group (GG) 1 or GG2 disease. Patients were included if they had consistent index lesions, defined by largest diameter, and measured across every surveillance MRI. Linear regression modeled the change in index lesion size over surveillance period in mm/year. Cox proportional hazard analysis modeled predictors of grade progression on active surveillance, and Kaplan-Meier curves compared progression risk among patients with no growth, 0-1mm/year growth and >1mm/year growth. RESULTS: Ultimately, 369 patients were included in the analysis. Median follow-up was 28 months, and patients received on average 3.1(±0.03) MRIs. Average index lesion growth rate was 0.40 (±0.05) mm/year. Grade progression was independently predicted by PSA density (OR: 1.52, CI: 1.16-1.99, p=0.003), having GG2 disease at AS enrollment (OR: 2.39, CI: 1.45-3.96, p <0.001), and index lesion growth (mm/year) (OR: 1.50, CI:1.17-1.93, p=0.001). Increase in PI-RADS was not independently predictive of progression (p>0.05); however, receiver operator curve analysis showed growth velocity+change in PI-RADS had good predictive value for progression (AUC=0.70). Median time to progression was 157 months for patients with no growth, 93 months for patients with 0-1 mm/year growth, and 49 months for patients with >1mm/year growth (log-ranked p <0.001) (Figure 1). CONCLUSIONS: Active surveillance MRI can reliably track prostate lesion growth over the course of surveillance, and growth velocity is independently associated risk of grade progression. Future use of lesion growth rate thresholds may be used to stratify patients who should switch from active surveillance to active treatment. 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: e396-e396 Advertisement Copyright & Permissions© 2021 by American Urological Association Education and Research, Inc.MetricsAuthor Information Cheyenne Williams More articles by this author Nitin Yerram More articles by this author Michael Daneshvar More articles by this author Luke P. OConnor More articles by this author Jillian Egan More articles by this author Patrick T. Gomella More articles by this author Jeunice Owens-Walton More articles by this author Nabila Khondakar More articles by this author Michael Ahdoot More articles by this author Maria Merino More articles by this author Bradford Wood More articles by this author Peter Choyke More articles by this author Baris Turkbey More articles by this author Peter Pinto More articles by this author Expand All Advertisement Loading ...