MP55-10 LOWER RATES OF CLINICALLY-SIGNIFICANT PROSTATE CANCER ARE PRESENT IN PI-RADS 4 AND 5 LESIONS IN THE TRANSITIONAL ZONE THAN PERIPHERAL ZONE

Abstract

You have accessJournal of UrologyCME1 Apr 2023MP55-10 LOWER RATES OF CLINICALLY-SIGNIFICANT PROSTATE CANCER ARE PRESENT IN PI-RADS 4 AND 5 LESIONS IN THE TRANSITIONAL ZONE THAN PERIPHERAL ZONE Jessica Shannon, Sabrina L. Noyes, Andrew Moriarity, Grand Rapids, Mi, Ji Qi, Bruce Lyu, Brian R Lane, and For the Michigan Urological Surgery Improvement Collaborative Jessica ShannonJessica Shannon More articles by this author , Sabrina L. NoyesSabrina L. Noyes More articles by this author , Andrew MoriarityAndrew Moriarity More articles by this author , Grand RapidsGrand Rapids More articles by this author , Mi Mi More articles by this author , Ji QiJi Qi More articles by this author , Bruce LyuBruce Lyu More articles by this author , Brian R LaneBrian R Lane More articles by this author , and For the Michigan Urological Surgery Improvement CollaborativeFor the Michigan Urological Surgery Improvement Collaborative More articles by this author View All Author Informationhttps://doi.org/10.1097/JU.0000000000003308.10AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookLinked InTwitterEmail Abstract INTRODUCTION AND OBJECTIVE: There is limited data comparing prostate cancer (PC) detection rates in lesions identified within the peripheral zone (PZ) and transitional zone (TZ) on prostate MRI (pMRI). We compared the diagnostic performance of PIRADSv2 for detecting clinically significant (CS) PC in the PZ and TZ. METHODS: Data were queried from the Michigan Urological Surgery Improvement Collaborative (MUSIC) and Spectrum Health EMR to identify patients undergoing MRI assessed using PIRADS v2 by Advanced Radiology Services physicians between June 2016 and September 2022. All patients identified as having one or more PIRADS 4 or 5 lesions were included if they underwent targeted biopsy within 12 months of the MRI. The primary outcome was CSPC defined as GG2 or greater in biopsy of the targeted lesion. RESULTS: A total of 322 lesions in 224 patients were identified, with mean age 67 years, mean PSA 7.1 ng/ml, and mean prostate volume 63.4 cm3. Overall detection of PC was 75.2%, CSPC was 47.2%, and predominant pattern 4-5 (GG3-GG5) was 47.2%. 131 lesions were in the TZ and 191 in the PZ. CSPC was detected in 41.2% of TZ lesions and 51.3% of PZ lesions (p=0.075). CSPC detection was significantly higher for PI-RADS 4 lesions in the PZ compared to TZ (44.7% vs. 29.4%, p=0.034) and trended towards significance in PI-RADS 5 lesions (70.0% vs. 54.0%, p=0.0823). For GG3-GG5 PC, there was also a significant difference seen with PI-RADS 4 (8.8% vs. 20.6%, p=0.033) and a trend with PI-RADS 5 lesions (12.7% vs. 24.0%, p=0.117). CONCLUSIONS: Overall detection of PC was consistent with prior literature for PI-RADS 4 and 5 lesions. Lesions in the TZ were more likely to be benign or low-grade PC. This is important information for clinicians managing patients with TZ lesions and may suggest re-consideration of the precise features leading to PI-RADS assignments in the TZ in subsequent revisions. Source of Funding: The corresponding author would like to thank the Betz Family Endowment for Cancer Research for their continued support. Funding was provided in part by the Spectrum Health Foundation. Funding was provided in part by the Value Partnerships program at Blue Cross Blue Shield of Michigan. © 2023 by American Urological Association Education and Research, Inc.FiguresReferencesRelatedDetails Volume 209Issue Supplement 4April 2023Page: e767 Advertisement Copyright & Permissions© 2023 by American Urological Association Education and Research, Inc.MetricsAuthor Information Jessica Shannon More articles by this author Sabrina L. Noyes More articles by this author Andrew Moriarity More articles by this author Grand Rapids More articles by this author Mi More articles by this author Ji Qi More articles by this author Bruce Lyu More articles by this author Brian R Lane More articles by this author For the Michigan Urological Surgery Improvement Collaborative More articles by this author Expand All Advertisement PDF downloadLoading ...