MP22-08 NEGATIVE PREDICTIVE VALUE OF PROSTATE MRI IN REAL WORLD PRACTICE: RESULTS FROM A STATEWIDE SURGICAL COLLABORATIVE

Abstract

You have accessJournal of UrologyImaging/Radiology: Uroradiology II (MP22)1 Sep 2021MP22-08 NEGATIVE PREDICTIVE VALUE OF PROSTATE MRI IN REAL WORLD PRACTICE: RESULTS FROM A STATEWIDE SURGICAL COLLABORATIVE John Michael DiBianco, Ji Qi, Anna Johnson, Stephanie Ferrante, Ali Dabaja, Karla Witzke, Alice Semerjian, Arvin K. George, and for the Michigan Urological Surgery Improvement Collaborative John Michael DiBiancoJohn Michael DiBianco More articles by this author , Ji QiJi Qi More articles by this author , Anna JohnsonAnna Johnson More articles by this author , Stephanie FerranteStephanie Ferrante More articles by this author , Ali DabajaAli Dabaja More articles by this author , Karla WitzkeKarla Witzke More articles by this author , Alice SemerjianAlice Semerjian More articles by this author , Arvin K. GeorgeArvin K. George More articles by this author , and for the Michigan Urological Surgery Improvement Collaborative More articles by this author View All Author Informationhttps://doi.org/10.1097/JU.0000000000002013.08AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookLinked InTwitterEmail Abstract INTRODUCTION AND OBJECTIVE: Prostate MRI may help reduce unnecessary biopsies given the reported negative predictive value (NPV) for the presence of clinically significant prostate cancer (PCa). However, wide variation in the quality of MRI acquisition and interpretation exists. We aimed to determine the NPV of prostate MRI across diverse practices in the Michigan Urological Surgery Improvement Collaborative (MUSIC). METHODS: The MUSIC clinical registry was used to identify biopsy naïve patients who underwent biopsy with negative MRI between 4/2018-11/2020 and patients with a negative MRI in the setting of active surveillance (AS) between 7/2016-11/2020. Negative MRI was defined as absence of PI-RADS 3-5 lesions. Clinically significant PCa was defined as ≥Grade Group (GG) 2. Patients were stratified by prostate specific antigen (PSA), PSA density and digital rectal exam (DRE) findings. RESULTS: A total of 433 negative MRI and biopsies were identified across 21 practices. There were 169 (39%) performed in the biopsy naïve setting, and 264 (61%) performed during AS. Median age was 65 years (IQR 60–70), median PSA was 5.5 (IQR 4–8), 10.9% had positive DRE and 25.6% had a positive family history for PCa. The figure demonstrates the proportion of patients with negative prostate MRI by biopsy results. The NPV of prostate MRI for ≥GG2 PCa in biopsy-naïve patients was 81.7%. The NPV of prostate MRI for ≥GG2 PCa in men considering or enrolled on AS was 76.9%. The combined NPV for both cohorts was 78.6%. In biopsy naïve patients, PSA density was associated with ≥GG2 PCa (p<0.05). In AS patients, PSA and PSA density were significantly associated with biopsy resulting in ≥GG2 PCa (p<0.05 for each). CONCLUSIONS: Across diverse urologic practices in the community, the NPV of prostate MRI is consistent with published level 1 evidence at expert centers. The NPV for ≥GG2 PCa determined by PIRADS score performs similarly in different clinical settings. Source of Funding: Funding from Blue Cross Blue Shield of Michigan © 2021 by American Urological Association Education and Research, Inc.FiguresReferencesRelatedDetails Volume 206Issue Supplement 3September 2021Page: e393-e394 Advertisement Copyright & Permissions© 2021 by American Urological Association Education and Research, Inc.MetricsAuthor Information John Michael DiBianco More articles by this author Ji Qi More articles by this author Anna Johnson More articles by this author Stephanie Ferrante More articles by this author Ali Dabaja More articles by this author Karla Witzke More articles by this author Alice Semerjian More articles by this author Arvin K. George More articles by this author for the Michigan Urological Surgery Improvement Collaborative More articles by this author Expand All Advertisement Loading ...