PD32-05 GRADE CONCORDANCE OF TARGETED MRI-ULTRASOUND FUSION TARGETED PROSTATE BIOPSY RESULTS WITH FINAL PATHOLOGY FOLLOWING RADICAL PROSTATECTOMY

Abstract

You have accessJournal of UrologyProstate Cancer: Staging II1 Apr 2015PD32-05 GRADE CONCORDANCE OF TARGETED MRI-ULTRASOUND FUSION TARGETED PROSTATE BIOPSY RESULTS WITH FINAL PATHOLOGY FOLLOWING RADICAL PROSTATECTOMY Michael Fenstermaker, Neil Mendhiratta, Xiaosong Meng, Fang-Ming Deng, Ming Zhou, Andrew B. Rosenkrantz, Richard Huang, Susan Marshall, James S. Wysock, Marc Bjurlin, William C. Huang, Herbert Lepor, and Samir S. Taneja Michael FenstermakerMichael Fenstermaker More articles by this author , Neil MendhirattaNeil Mendhiratta More articles by this author , Xiaosong MengXiaosong Meng More articles by this author , Fang-Ming DengFang-Ming Deng More articles by this author , Ming ZhouMing Zhou More articles by this author , Andrew B. RosenkrantzAndrew B. Rosenkrantz More articles by this author , Richard HuangRichard Huang More articles by this author , Susan MarshallSusan Marshall More articles by this author , James S. WysockJames S. Wysock More articles by this author , Marc BjurlinMarc Bjurlin More articles by this author , William C. HuangWilliam C. Huang More articles by this author , Herbert LeporHerbert Lepor More articles by this author , and Samir S. TanejaSamir S. Taneja More articles by this author View All Author Informationhttps://doi.org/10.1016/j.juro.2015.02.2116AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookTwitterLinked InEmail INTRODUCTION AND OBJECTIVES Targeted MRI-Ultrasound fusion biopsy (MRF-TB) has been shown to have a higher discrimination for clinically significant cancer than systematic biopsy (SB). Yet, there is limited data comparing MRF-TB results with final whole-gland pathology. In this study, we analyzed the concordance between grade on MRF-TB and SB and final surgical pathology following radical prostatectomy (RP). METHODS Between 6/12 and 8/14, all 824 men presenting to our institution for prostate biopsy underwent pre-biopsy mpMRI followed by MRF-TB. Outcomes were recorded in an IRB-approved database. Of those, 80 men underwent RP following MRF-TB and SB. The highest Gleason score detected via SB, MRF-TB, as well as the maximum of both SB and MRF-TB were extracted. Gleason scores and their concordance with final surgical pathology following RP were analyzed. RESULTS Of the 80 men who underwent RP, final surgical pathology demonstrated Gleason 6 disease in 14 (17.5%) cases, Gleason 7 in 58 (72.5%), and Gleason 8-10 in 8 (10.0%). When compared to final surgical pathology, the Gleason score was upgraded from SB pathology in 54 (56.3%) cases, from MRF-TB pathology in 21 (26.3%) cases, and from combined MRF-TB and SB findings in 12 (15.0%) cases. Gleason downgrading occurred in 8 (10%) cases for SB, 12 (15%) for MRF-TB, and 16 (20%) for combined MRF-TB and SB. The primary Gleason pattern on biopsy was concordant with the surgical primary pattern in 51 (63.8%) cases for SB, 57 (71.3%) cases for MRF-TB, and 67 (83.8%) cases for the maximum Gleason score of MRF-TB and SB. Among men with Gleason 7 disease on biopsy, upgrading from 3+4 occurred in 8 (25.8%) cases from MRF-TB, 3 (15.8%) from SB, and 10 (27%) from SB+MRF-TB. Upgrading from 4+3 occurred in 3 (35.0%) from MRF-TB, 1 (14.3%) from SB, and 4 (23.5%) from SB+MRF-TB. CONCLUSIONS MRF-TB demonstrates better concordance with final surgical pathology than SB alone. Although a combined approach of MRF-TB and SB has the lowest rates of upgrading upon final pathology, this may be the result of poor lesion targeting with MRF-TB in select cases. © 2015 by American Urological Association Education and Research, Inc.FiguresReferencesRelatedDetails Volume 193Issue 4SApril 2015Page: e706 Advertisement Copyright & Permissions© 2015 by American Urological Association Education and Research, Inc.MetricsAuthor Information Michael Fenstermaker More articles by this author Neil Mendhiratta More articles by this author Xiaosong Meng More articles by this author Fang-Ming Deng More articles by this author Ming Zhou More articles by this author Andrew B. Rosenkrantz More articles by this author Richard Huang More articles by this author Susan Marshall More articles by this author James S. Wysock More articles by this author Marc Bjurlin More articles by this author William C. Huang More articles by this author Herbert Lepor More articles by this author Samir S. Taneja More articles by this author Expand All Advertisement Advertisement PDF DownloadLoading ...