MP62-16 PROSTATE CANCER RADIOLOGICAL ESTIMATION OF CHANGE IN SEQUENTIAL EVALUATION (PRECISE) SCORING TO PREDICT CLINICAL OUTCOMES IN ACTIVE SURVEILLANCE OF PROSTATE CANCER

Abstract

You have accessJournal of UrologyProstate Cancer: Localized: Active Surveillance II (MP62)1 Sep 2021MP62-16 PROSTATE CANCER RADIOLOGICAL ESTIMATION OF CHANGE IN SEQUENTIAL EVALUATION (PRECISE) SCORING TO PREDICT CLINICAL OUTCOMES IN ACTIVE SURVEILLANCE OF PROSTATE CANCER Yasin Bhanji, Mufaddal Mamawala, Patricia Landis, Demetrios Simopoulos, Katarzyna Macura, and Christian Pavlovich Yasin BhanjiYasin Bhanji More articles by this author , Mufaddal MamawalaMufaddal Mamawala More articles by this author , Patricia LandisPatricia Landis More articles by this author , Demetrios SimopoulosDemetrios Simopoulos More articles by this author , Katarzyna MacuraKatarzyna Macura More articles by this author , and Christian PavlovichChristian Pavlovich More articles by this author View All Author Informationhttps://doi.org/10.1097/JU.0000000000002102.16AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookLinked InTwitterEmail Abstract INTRODUCTION AND OBJECTIVE: The use of serial magnetic resonance imaging (MRI) to detect tumor progression during prostate cancer (PCa) active surveillance (AS) is not well-studied. The PRECISE score standardizes reporting of interval MRI changes in AS patients. We report findings from our AS cohort for men with lesion(s) reviewed and prospectively PRECISE scored. METHODS: We evaluated 255 men (309 lesions) with grade group 1 (GG1) PCa who underwent MRI from 2019 - 2020 and received both PRECISE and PI-RADS v2.0 scores (Prostate Imaging-Reporting and Data System). Grade reclassification (GR) to GG≥2 PCa was assessed in lesions targeted at biopsy (n=103). We also assessed rates of GR on a per-patient basis (n=255) utilizing the highest PI-RADS and PRECISE and subsequent biopsy results (+/- MRI targeting). RESULTS: 37 lesions were scored as PRECISE 1 or 2, 205 as PRECISE 3, and 67 as PRECISE 4 or 5. Median time on AS was 50 months (IQR: 30–91). The proportion of PRECISE 4-5 lesions increased as time between MRIs increased from <24 months to > 36 months, (14% to 34%, respectively, p<0.002). On a per-lesion basis there was no difference in rates of GR based on PRECISE score (Table). On a per-patient basis there was significant heterogeneity in the rate of GR in men with PRECISE 3 MRIs (n=89) based on PI-RADS score (Figure). On univariable analysis, PRECISE score was not associated with GR (PRECISE 4-5 vs. PRECISE 3, OR=1.89 [95% CI: 0.91–3.91]; p = 0.13). PI-RADS score remained significantly associated with GR after adjusting for PSA density and NCCN risk status (PI-RADS 4-5 vs. PI-RADS≤3, OR=2.71 [95% CI: 1.28–5.72], p=0.01). CONCLUSIONS: In men with favorable GG1 disease, a higher PRECISE score does not necessarily confer a higher risk of GR. The risk of GR is higher for men with persistent PI-RADS 4-5 lesions (PRECISE 3) compared to men with new PI-RADS 4-5 lesions (PRECISE 4-5). This suggests suboptimal initial targeting and the persistence of an aggressive tumor more accurately targeted on subsequent biopsy. Source of Funding: None © 2021 by American Urological Association Education and Research, Inc.FiguresReferencesRelatedDetails Volume 206Issue Supplement 3September 2021Page: e1098-e1099 Advertisement Copyright & Permissions© 2021 by American Urological Association Education and Research, Inc.MetricsAuthor Information Yasin Bhanji More articles by this author Mufaddal Mamawala More articles by this author Patricia Landis More articles by this author Demetrios Simopoulos More articles by this author Katarzyna Macura More articles by this author Christian Pavlovich More articles by this author Expand All Advertisement Loading ...