MP33-18 ASSOCIATION OF PATIENT AND IMAGING-RELATED FACTORS WITH FALSE NEGATIVE FUSION BIOPSIES OF PI-RADS 4 AND 5 LESIONS ON MRI

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You have accessJournal of UrologyCME1 May 2022MP33-18 ASSOCIATION OF PATIENT AND IMAGING-RELATED FACTORS WITH FALSE NEGATIVE FUSION BIOPSIES OF PI-RADS 4 AND 5 LESIONS ON MRI Miyad Movassaghi, Firas Ahmed, Hanisha Patel, Lyndon Luk, Elias Hyams, Sven Wenske, and Hiram Shaish Miyad MovassaghiMiyad Movassaghi More articles by this author , Firas AhmedFiras Ahmed More articles by this author , Hanisha PatelHanisha Patel More articles by this author , Lyndon LukLyndon Luk More articles by this author , Elias HyamsElias Hyams More articles by this author , Sven WenskeSven Wenske More articles by this author , and Hiram ShaishHiram Shaish More articles by this author View All Author Informationhttps://doi.org/10.1097/JU.0000000000002587.18AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookLinked InTwitterEmail Abstract INTRODUCTION AND OBJECTIVE: In patients who end up having a negative MRI/TRUS-fusion biopsy (TBx) with positive systematic biopsies in the sextant core corresponding with the targeted area or adjacent sextant cores notable for clinically significant prostate cancer (csPCa), identifying the source of error to rule out missed disease is critical. The goal of this study was to investigate whether specific imaging and patient-related factors, including discrepant US and MRI prostate segmentation volumes, are associated with a false negative (FN) TBx of PI-RADS 4/5 lesions. METHODS: This was a retrospective study of patients with PI-RADS 4 or 5 peripheral zone (PZ) lesions on MRIs performed between 11/2015-12/2020 and subsequent TBx. Biopsied lesions were separated into true positive (TP), false positive (FP) and false negative (FN) using a combination of systematic and fusion biopsy and grade group 2 or higher as the reference standard. FP cases were excluded. FN TBx was defined as negative targeted fusion cores with adjacent positive systematic cores. The impact of patient and imaging-specific factors on the probability of a FN fusion biopsy were tested using logistic regression. RESULTS: 530 consecutive patients with 685 PI-RADS 4 or 5 PZ lesions on MRI and subsequent TBx were retrospectively collected. 361 lesions in 304 patients (median age 69 years, IQR 63-75, median PSA 6.5 ng/ml, IQR 4.7-9.3), including 67 (19%) FN and 294 TP (81%) were included. There was a significant inverse association between lesion size and probability of FN biopsy (odds ratio (OR): 0.90, 95% CI: 0.85 - 0.95, p-value: <0.0001). Similarly, PSA level was inversely associated with a FN biopsy (OR: 0.86, 95%CI: 0.77 - 0.93, p-value: 0.0003). The probability of a FN TBx was not associated with use of an enema prep before MRI, size of prostate gland, discrepancy between US and MRI segmented prostate volume or the operator (p-value >0.05). CONCLUSIONS: Among men undergoing TBx, lower PSA values and smaller PI-RADS 4/5 lesions are associated with FN fusion biopsies. Discrepant US and MRI prostate segmentation volumes derived as part of fusion biopsy were not associated with a FN biopsy. Our data support a biopsy strategy for select men, especially those with smaller PI-RADS 4/5 lesions, that includes a concomitant SBx at the time of TBx. Source of Funding: None © 2022 by American Urological Association Education and Research, Inc.FiguresReferencesRelatedDetails Volume 207Issue Supplement 5May 2022Page: e576 Advertisement Copyright & Permissions© 2022 by American Urological Association Education and Research, Inc.MetricsAuthor Information Miyad Movassaghi More articles by this author Firas Ahmed More articles by this author Hanisha Patel More articles by this author Lyndon Luk More articles by this author Elias Hyams More articles by this author Sven Wenske More articles by this author Hiram Shaish More articles by this author Expand All Advertisement PDF DownloadLoading ...