MP44-03 PI-RADS 5 LESIONS WITHIN THE TRANSITION ZONE ARE ASSOCIATED WITH DECREASED DETECTION OF CLINICALLY SIGNIFICANT PROSTATE CANCER VERSUS PERIPHERAL ZONE LESIONS IN PATIENTS UNDERGOING MRI FUSION PROSTATE BIOPSY

Abstract

You have accessJournal of UrologyCME1 Apr 2023MP44-03 PI-RADS 5 LESIONS WITHIN THE TRANSITION ZONE ARE ASSOCIATED WITH DECREASED DETECTION OF CLINICALLY SIGNIFICANT PROSTATE CANCER VERSUS PERIPHERAL ZONE LESIONS IN PATIENTS UNDERGOING MRI FUSION PROSTATE BIOPSY Andrew Wood, Prajit Khooblall, Tarik Benidir, Jennifer Bullen, Ruben Olivares, Zeyad Schwen, Samuel Haywood, Eric Klein, Ryan Ward, Andrei Purysko, and Christopher Weigh Andrew WoodAndrew Wood More articles by this author , Prajit KhooblallPrajit Khooblall More articles by this author , Tarik BenidirTarik Benidir More articles by this author , Jennifer BullenJennifer Bullen More articles by this author , Ruben OlivaresRuben Olivares More articles by this author , Zeyad SchwenZeyad Schwen More articles by this author , Samuel HaywoodSamuel Haywood More articles by this author , Eric KleinEric Klein More articles by this author , Ryan WardRyan Ward More articles by this author , Andrei PuryskoAndrei Purysko More articles by this author , and Christopher WeighChristopher Weigh More articles by this author View All Author Informationhttps://doi.org/10.1097/JU.0000000000003290.03AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookLinked InTwitterEmail Abstract INTRODUCTION AND OBJECTIVE: MRI-fusion targeted prostate biopsy (MRI-TBx) of Prostate Imaging Reporting and Data System (PI-RADS) lesions in both the peripheral zone (PZ) and transition zone (TZ) has become an integral part of prostate cancer (PCa) diagnosis. However, interpretation of the TZ remains challenging due to a markedly heterogeneous background and benign processes mimicking PCa. Our objective was to examine whether TZ, compared to PZ location, impacted odds of detecting clinically significant PCa (csPCa), defined as International Society of Urological Pathology (ISUP) grade group ≥2. METHODS: We performed a retrospective review of all patients who underwent MRI-TBx at a tertiary care center. Lesion level review was performed to compare MRI-TBx in lesions located in the TZ vs. PZ. The primary outcome of interest was detection of csPCa, however, detection of ISUP grade group 1 PCa (GG1 PCa) was also examined. Multivariable (MV) logistic regression analyses were performed to assess for predictors of csPCa detection. RESULTS: 1464 lesions from 1087 patients were included in the analysis. 31.3% of lesions were located in the TZ. Overall, TZ lesions were significantly less likely to harbor csPCa as compared with those in the PZ (26.9% vs 34.3%, p=0.017). When stratified by PI-RADS score, only PI-RADS 5 lesions demonstrated a significant difference in detection of csPCa between TZ and PZ lesions (40.1% vs. 66.8%, p<0.001). Additionally, PI-RADS 5 lesions in the TZ were significantly more likely to harbor GG1 PCa (39.4% vs. 20.3%, p<0.001). On MV analysis, TZ location remained an independent predictor of csPCa within PI-RADS 5 lesions (OR=0.35, p<0.001). CONCLUSIONS: PI-RADS 5 lesions in the TZ have 65% lower odds of harboring csPCa and are more likely to harbor GG1 PCa than those in the PZ. This has important implications for both risk stratification and consideration of further workup in patients with negative or low-grade pathology on MRI-TBx of PI-RADS 5 lesions. Source of Funding: None © 2023 by American Urological Association Education and Research, Inc.FiguresReferencesRelatedDetails Volume 209Issue Supplement 4April 2023Page: e611 Advertisement Copyright & Permissions© 2023 by American Urological Association Education and Research, Inc.MetricsAuthor Information Andrew Wood More articles by this author Prajit Khooblall More articles by this author Tarik Benidir More articles by this author Jennifer Bullen More articles by this author Ruben Olivares More articles by this author Zeyad Schwen More articles by this author Samuel Haywood More articles by this author Eric Klein More articles by this author Ryan Ward More articles by this author Andrei Purysko More articles by this author Christopher Weigh More articles by this author Expand All Advertisement PDF downloadLoading ...