MP33-20 UTILITY OF ADDITIONAL TARGETED AND SYSTEMIC BIOPSIES IN THE PRESENCE OF AN INDEX PI-RADS 5 LESION

Abstract

You have accessJournal of UrologyCME1 May 2022MP33-20 UTILITY OF ADDITIONAL TARGETED AND SYSTEMIC BIOPSIES IN THE PRESENCE OF AN INDEX PI-RADS 5 LESION Ahmad Alzubaidi, Michael Maidaa, Mohammad Said, Grant Owens, Max Yudovich, R. Scott Grant, Thomas F. Stringer, Chad Tracy, and Jay D. Raman Ahmad AlzubaidiAhmad Alzubaidi More articles by this author , Michael MaidaaMichael Maidaa More articles by this author , Mohammad SaidMohammad Said More articles by this author , Grant OwensGrant Owens More articles by this author , Max YudovichMax Yudovich More articles by this author , R. Scott GrantR. Scott Grant More articles by this author , Thomas F. StringerThomas F. Stringer More articles by this author , Chad TracyChad Tracy More articles by this author , and Jay D. RamanJay D. Raman More articles by this author View All Author Informationhttps://doi.org/10.1097/JU.0000000000002587.20AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookLinked InTwitterEmail Abstract INTRODUCTION AND OBJECTIVE: Prostatic mpMRI targeted biopsy is increasingly utilized for the diagnosis of prostate cancer (CaP). Traditionally, systematic biopsy (SB) and targeted biopsies are performed for all index and non-index lesions. The diagnostic yield of additional biopsies is not clearly defined. We evaluate the utility of additional biopsies of non-index and SB in patients with a PI-RADS 5 index lesion to detect clinically significant cancer (CSC). METHODS: Records of 1029 patients undergoing transrectal mpMRI targeted biopsy across 4 medical centers were reviewed. Those with a PI-RADS 5 index lesion were included. Pathology obtained from the index PI-RADS 5 lesion was then compared to SB pathology, and that of the other PI-RADS lesions to evaluate for pathologic upgrade from benign or clinically insignificant cancer (CIC) to clinically significant cancer (CSC) (Grade Group≥2). RESULTS: We identified 326 Index PI-RADS 5 lesions in patients. 191 (59%) targeted PI-RADS 5 biopsies had CSC, while 135 (41%) noted CIC or benign pathology. Figure summarizes pathologic findings in these respective subgroups. Of the 191 CSC lesions, SB further upgraded 40 patients (21%). Of the 135 CIC or benign lesions, SB upgraded 22 (16%) to CSC. 119 patients had ≥2 lesions; biopsy of non-index lesions showed an upgrade in only 15 (13%) patients, while 104 patients (87%) showed no change or downgraded Grade group. CONCLUSIONS: When performing MRI targeted biopsy of an index PI-RADS 5 lesion, additional biopsies of non-index lesions offers minimal additional clinical value and could potentially be omitted. However, SB potentially identifies significant malignancies whereby 37% upgraded to CSC or higher Grade group Source of Funding: None © 2022 by American Urological Association Education and Research, Inc.FiguresReferencesRelatedDetails Volume 207Issue Supplement 5May 2022Page: e577 Advertisement Copyright & Permissions© 2022 by American Urological Association Education and Research, Inc.MetricsAuthor Information Ahmad Alzubaidi More articles by this author Michael Maidaa More articles by this author Mohammad Said More articles by this author Grant Owens More articles by this author Max Yudovich More articles by this author R. Scott Grant More articles by this author Thomas F. Stringer More articles by this author Chad Tracy More articles by this author Jay D. Raman More articles by this author Expand All Advertisement PDF DownloadLoading ...