MP26-18 BIPARAMETRIC VS. MULTI-PARAMETRIC MRI FOR THE DETECTION OF CLINICALLY SIGNIFICANT PROSTATE CANCER IN BIOPSY NAÏVE MEN. A PROSPECTIVE, SINGLE CENTRE, NON-INFERIORITY RANDOMIZED TRIAL

Abstract

You have accessJournal of UrologyProstate Cancer: Detection & Screening II (MP26)1 Sep 2021MP26-18 BIPARAMETRIC VS. MULTI-PARAMETRIC MRI FOR THE DETECTION OF CLINICALLY SIGNIFICANT PROSTATE CANCER IN BIOPSY NAÏVE MEN. A PROSPECTIVE, SINGLE CENTRE, NON-INFERIORITY RANDOMIZED TRIAL Matteo Manfredi, Enrico Checcucci, Daniele Amparore, Sabrina Titti De Cillis, Gabriele Volpi, Angela Pecoraro, Federico Piramide, Alberto Piana, Michele Sica, Stefano Granato, Juliette Mézière, Davide Zamengo, Giovanni Cattaneo, Stefano De Luca, Cristian Fiori, and Francesco Porpiglia Matteo ManfrediMatteo Manfredi More articles by this author , Enrico CheccucciEnrico Checcucci More articles by this author , Daniele AmparoreDaniele Amparore More articles by this author , Sabrina Titti De CillisSabrina Titti De Cillis More articles by this author , Gabriele VolpiGabriele Volpi More articles by this author , Angela PecoraroAngela Pecoraro More articles by this author , Federico PiramideFederico Piramide More articles by this author , Alberto PianaAlberto Piana More articles by this author , Michele SicaMichele Sica More articles by this author , Stefano GranatoStefano Granato More articles by this author , Juliette MézièreJuliette Mézière More articles by this author , Davide ZamengoDavide Zamengo More articles by this author , Giovanni CattaneoGiovanni Cattaneo More articles by this author , Stefano De LucaStefano De Luca More articles by this author , Cristian FioriCristian Fiori More articles by this author , and Francesco PorpigliaFrancesco Porpiglia More articles by this author View All Author Informationhttps://doi.org/10.1097/JU.0000000000002023.18AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookLinked InTwitterEmail Abstract INTRODUCTION AND OBJECTIVE: European and American urological guidelines of 2020 recommend to perform multiparametric (mp) MRI in men with suspicion of prostate cancer (PCa), before the execution of prostate biopsy. The new guidelines will furtherly increase the requests of MRI exams, but the restricted accessibility of scanners and costs’ increase might determine an important pressure on healthcare systems. A single plane biparametric MRI (fast-MRI) could decrease exam execution time and costs, hereby augmenting test availability, considering that fast-MRI maintains a high detection rate of clinically significant PCa (CsPCa). METHODS: In this study, biopsy-naïve men with PSA <15 ng/ml and non-suspicious digital rectal examination were randomly submitted to either fast-MRI (axial T2w and DWI, arm A) or mp-MRI (arm B), in a 2:1 ratio. If the results of fast-MRI were ambiguous, men in arm A underwent mp-MRI. The reference standard was systematic core biopsy and/or fusion biopsy on MRI suspicious lesions. CsPCa was defined as Grade Group ≥3 or a maximum cancer core length involvement ≥6 mm. RESULTS: 311 men were enrolled in our study from January 2018 to March 2020: 213 underwent fast-MRI and 98 mp-MRI using a 1.5 Tesla scanner. 26 men with ambiguous fast-MRI underwent mp-MRI. CsPCa was diagnosed in 56 patients in arm A and 29 patients in arm B. Sensitivity and negative predictive values (NPV) of mp-MRI and of the fast-MRI workout were 100% (95%CI 88–100%) versus 87.5% (76-95%), (p=0.96) and 100% (94-100) versus 95% (90-97%) (p=0.97), respectively. Compared to fast-MRI both mp-MRI and PSA density with a cut-off of 0.12 ng/ml detected 9 additional CsPCa. CONCLUSIONS: In biopsy-naïve men, fast-MRI followed by mp-MRI or PSA density evaluation in case of ambiguous findings has sensitivity and NPV similar to mp-MRI. In future, fast-MRI protocols might represent a solution in order to reduce costs and exam acquisition time of mp-MRI in selected biopsy-naïve men. The proposed diagnostic workflow should be tested in a multicentre, multi-observer setting. Source of Funding: None © 2021 by American Urological Association Education and Research, Inc.FiguresReferencesRelatedDetails Volume 206Issue Supplement 3September 2021Page: e470-e470 Advertisement Copyright & Permissions© 2021 by American Urological Association Education and Research, Inc.MetricsAuthor Information Matteo Manfredi More articles by this author Enrico Checcucci More articles by this author Daniele Amparore More articles by this author Sabrina Titti De Cillis More articles by this author Gabriele Volpi More articles by this author Angela Pecoraro More articles by this author Federico Piramide More articles by this author Alberto Piana More articles by this author Michele Sica More articles by this author Stefano Granato More articles by this author Juliette Mézière More articles by this author Davide Zamengo More articles by this author Giovanni Cattaneo More articles by this author Stefano De Luca More articles by this author Cristian Fiori More articles by this author Francesco Porpiglia More articles by this author Expand All Advertisement Loading ...