MP70-03 CLINICAL PERFORMANCE OF MULTI PARAMETRIC MAGNETIC RESONANCE IMAGING IN THE FOLLOW-UP OF PARTIAL GLAND ABLATION FOR PROSTATE CANCER

Abstract

You have accessJournal of UrologyProstate Cancer: Localized: Ablative Therapy I1 Apr 2017MP70-03 CLINICAL PERFORMANCE OF MULTI PARAMETRIC MAGNETIC RESONANCE IMAGING IN THE FOLLOW-UP OF PARTIAL GLAND ABLATION FOR PROSTATE CANCER Arjun Sivaraman, Melissa Assel, Andreas Hoetker, Govindarajan Srimathveeravalli, Behfar Ehdaie, Oguz Akin, and Jonathan Coleman Arjun SivaramanArjun Sivaraman More articles by this author , Melissa AsselMelissa Assel More articles by this author , Andreas HoetkerAndreas Hoetker More articles by this author , Govindarajan SrimathveeravalliGovindarajan Srimathveeravalli More articles by this author , Behfar EhdaieBehfar Ehdaie More articles by this author , Oguz AkinOguz Akin More articles by this author , and Jonathan ColemanJonathan Coleman More articles by this author View All Author Informationhttps://doi.org/10.1016/j.juro.2017.02.2279AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookTwitterLinked InEmail INTRODUCTION AND OBJECTIVES Multi parametric Magnetic Resonance Imaging (mp-MRI) is the most common imaging modality used for detecting residual cancer following Partial Gland Ablation (PGA) for Prostate Cancer. The aim of this study was to assess the diagnostic accuracy of mp-MRI to detect residual cancer in the ablated area following PGA and to assess whether a biopsy of the ablated area may be avoided based on MRI. METHODS Prospectively maintained institutional database was queried to identify 65 patients with primary PGA from May 2010 to February 2016 and had a postoperative MRI and a control biopsy within 18 months after the procedure. All the MRIs were reviewed by a single radiologist blinded to the biopsy results and visible abnormalities in the ablated area were scored based on a 5-point Likert scale and PIRADS V2. Univariate generalized estimating equation regression with an exchangeable correlation structure to account for within patient correlation was used to test the association between a high MRI score (Likert or PIRADS score =3) and any- (Gleason =6) and high-grade (Gleason =7) disease detected on biopsy of the ablated area. RESULTS After exclusions, we identified 38 post-PGA MRI and biopsy pairs with 6 patients having 2 MRI/biopsy combinations. Any-grade disease was detected on 15 biopsies (39%; 95% CI 24%, 57%) and high-grade on 2 biopsies (5.3%; 95% CI 0.6%, 18%). Patient with MRI lesion of Likert and PIRADS score =3 in the ablated area were 8 (21%) and 7 (18%) respectively. Both the 2 instances of high-grade disease detected on biopsy occurred among the 8 MRIs with a Likert score =3 (25%; 95% CI 3.2%, 65%) and 7 MRIs with a PIRADS score =3. No high-grade disease was detected among participants with a Likert or PIRADS score <3, the upper bound of a 97.5% exact confidence interval was 11.6% and 11.2% based on Likert score (n=30) and PIRADS Score (n=31) respectively. One patient had a PIRADS score of 5 and had a Gleason 6 disease detected on biopsy. We did not find sufficient evidence to suggest an association between a PIRADS score and any-grade disease (p = 0.6) nor between Likert score and any-grade disease (p = 0.9), the association was not estimable as we had no participants with high-grade disease with an MRI score less than 3. CONCLUSIONS This preliminary study was unable to identify an association between MRI scores and presence of prostate cancer in the treated area following PGA therapy. Men with MRI scores of <3 should not be precluded from biopsy given that it is plausible that the rate of high-grade disease is meaningfully high. © 2017FiguresReferencesRelatedDetails Volume 197Issue 4SApril 2017Page: e935 Advertisement Copyright & Permissions© 2017MetricsAuthor Information Arjun Sivaraman More articles by this author Melissa Assel More articles by this author Andreas Hoetker More articles by this author Govindarajan Srimathveeravalli More articles by this author Behfar Ehdaie More articles by this author Oguz Akin More articles by this author Jonathan Coleman More articles by this author Expand All Advertisement Advertisement PDF downloadLoading ...