MP79-10 THE ROLE OF PROSTATE CANCER ANTIGEN 3 TEST AND MULTI-PARAMETRIC PROSTATIC MAGNETIC RESONANCE IMAGING FOR DIAGNOSIS OF PROSTATE CANCER IN PATIENT WITH MULTIPLE PRIOR NEGATIVE BIOPSIES

Abstract

You have accessJournal of UrologyProstate Cancer: Markers II1 Apr 2014MP79-10 THE ROLE OF PROSTATE CANCER ANTIGEN 3 TEST AND MULTI-PARAMETRIC PROSTATIC MAGNETIC RESONANCE IMAGING FOR DIAGNOSIS OF PROSTATE CANCER IN PATIENT WITH MULTIPLE PRIOR NEGATIVE BIOPSIES Thamir Alkasab, Girish Kulkarni, Alexander Zlotta, Antonio Finelli, Rob Hamilton, and Neil Fleshner Thamir AlkasabThamir Alkasab More articles by this author , Girish KulkarniGirish Kulkarni More articles by this author , Alexander ZlottaAlexander Zlotta More articles by this author , Antonio FinelliAntonio Finelli More articles by this author , Rob HamiltonRob Hamilton More articles by this author , and Neil FleshnerNeil Fleshner More articles by this author View All Author Informationhttps://doi.org/10.1016/j.juro.2014.02.2513AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookTwitterLinked InEmail INTRODUCTION AND OBJECTIVES For clinicians, identifying new biomarkers and imaging modalities can better detect prostate cancer and eventually reduce the number of unnecessary biopsies. It has been suggested that the most relevant practice in which the prostate cancer antigen 3 (PCA-3) test could be used for patients with a previous negative prostate biopsy and abnormal elevated PSA levels. Multi-parametric MRI is not currently the first approach for diagnosing prostate cancer, it is useful for directing targeted biopsies, especially in patients with high PSA levels and a multiple previous negative biopsies. We aimed to evaluate the role of prostatic MRI and PCA-3 as additional diagnostic tools for improving the accuracy of the prostate biopsies patients with increased PSA levels and more than two previous negative biopsies. METHODS This is a retrospective study on patients with more that two previous negative prostate biopsies and elevated PSA levels from Jan 2012 to Aug 2013. In total, 260 cases submitted to PCA-3 test were analyzed. Only 21 patients underwent PCA-3, prostatic MRI and more than 2 previous negative prostate biopsy within 6 months. RESULTS In patients with more than two negative biopsy, a histological diagnosis of prostate cancer of subsequent biopsy was found in 21 patients of 50 cases (42%). The sensitivity and specificity of MRI were 71.4% and 57.1% respectively (positive predictive value of 45.5%, negative predictive value of 80%). For PCA-3, the sensitivity and specificity were 61% and 67%, respectively (positive predictive value of 58.5%, negative predictive value of 73%. When comparing both test together, 40% had both PCA-3 and MRI positive and MRI alone missed 63% and PCA-3 alone missed 69%. CONCLUSIONS In patients with a previous negative biopsy and persistently elevated PSA levels, our results highlight the limitation of these novel diagnostic aids among this challenging group of patients © 2014FiguresReferencesRelatedDetails Volume 191Issue 4SApril 2014Page: e933 Advertisement Copyright & Permissions© 2014MetricsAuthor Information Thamir Alkasab More articles by this author Girish Kulkarni More articles by this author Alexander Zlotta More articles by this author Antonio Finelli More articles by this author Rob Hamilton More articles by this author Neil Fleshner More articles by this author Expand All Advertisement Advertisement PDF downloadLoading ...