PD38-12 NATURAL HISTORY OF SMALL INDEX LESIONS ON MULTIPARAMETRIC MRI: IMPLICATIONS FOR ACTIVE SURVEILLANCE

Abstract

You have accessJournal of UrologyCME1 Apr 2023PD38-12 NATURAL HISTORY OF SMALL INDEX LESIONS ON MULTIPARAMETRIC MRI: IMPLICATIONS FOR ACTIVE SURVEILLANCE Anjali Pillai, Zoe Blake, Daniel R. Nemirovsky, Jacob J. Enders, Neil Mendhiratta, Alexander P. Kenigsberg, Michael B. Rothberg, Jibriel Noun, Daniel Nethala, Sandeep Gurram, Bradford J. Wood, Baris Turkbey, and Peter A. Pinto Anjali PillaiAnjali Pillai More articles by this author , Zoe BlakeZoe Blake More articles by this author , Daniel R. NemirovskyDaniel R. Nemirovsky More articles by this author , Jacob J. EndersJacob J. Enders More articles by this author , Neil MendhirattaNeil Mendhiratta More articles by this author , Alexander P. KenigsbergAlexander P. Kenigsberg More articles by this author , Michael B. RothbergMichael B. Rothberg More articles by this author , Jibriel NounJibriel Noun More articles by this author , Daniel NethalaDaniel Nethala More articles by this author , Sandeep GurramSandeep Gurram More articles by this author , Bradford J. WoodBradford J. Wood More articles by this author , Baris TurkbeyBaris Turkbey More articles by this author , and Peter A. PintoPeter A. Pinto More articles by this author View All Author Informationhttps://doi.org/10.1097/JU.0000000000003336.12AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookLinked InTwitterEmail Abstract INTRODUCTION AND OBJECTIVE: Multiparametric magnetic resonance imaging (mpMRI) has demonstrated utility as an adjunct to active surveillance (AS). However, the optimal time interval between sequential MRIs is not standardized. This aims to analyze index lesion growth rates to potentially inform modern AS imaging practice. METHODS: A prospectively maintained database of patients on AS at our institution was queried for patients with ≥2 mpMRIs with no index lesion or index lesions ≤7 mm, as well as a subset of patients with no index lesion or index lesions ≤5 mm. Both cohorts were limited to patients with paired MRI-targeted biopsy showing benign or Gleason grade group (GG) 1 disease. For MRIs preceding PI-RADS scoring, an internal Likert suspicion scoring system was converted into PI-RADS scores. Imaging intervals were calculated between serial mpMRIs and growth rate was calculated with two-tailed t-tests to assess differences between initial and most recent lesion sizes measured on mpMRI. RESULTS: Between 2003-2021, patients on AS with ≥2 mpMRIs with small index lesions measuring ≤7 mm (n=123) or <5 mm (n=65) were identified (Table 1). Lesions in both the ≤7 mm (p=.015) and ≤5 mm (p=.003) cohorts demonstrated a significant change between first and last mpMRI. For the ≤7 mm cohort, average overall growth rate was 0.44±2.4 mm/year over a mean imaging interval of 1.27±0.09 years. For the ≤5 mm cohort, the average overall growth rate was 0.70±3.05 mm/year over a mean imaging interval of 1.31±0.13 years. There were 11 lesions that grew over 5 mm in the first year after initial mpMRI, however, univariate analysis of age, PSA, PI-RADS, and GG did not identify these variables as significant predictors of growth. The majority of lesions (84.6%) grew <1 mm/year (Figure 1). CONCLUSIONS: Small MRI lesions in patients on AS demonstrate minimal growth between follow up mpMRIs. This may indicate that these lesions can be followed longer surveillance intervals. Further studies are needed to prospectively identify the small subset of lesions that demonstrate more rapid growth. Source of Funding: N/A © 2023 by American Urological Association Education and Research, Inc.FiguresReferencesRelatedDetails Volume 209Issue Supplement 4April 2023Page: e998 Advertisement Copyright & Permissions© 2023 by American Urological Association Education and Research, Inc.MetricsAuthor Information Anjali Pillai More articles by this author Zoe Blake More articles by this author Daniel R. Nemirovsky More articles by this author Jacob J. Enders More articles by this author Neil Mendhiratta More articles by this author Alexander P. Kenigsberg More articles by this author Michael B. Rothberg More articles by this author Jibriel Noun More articles by this author Daniel Nethala More articles by this author Sandeep Gurram More articles by this author Bradford J. Wood More articles by this author Baris Turkbey More articles by this author Peter A. Pinto More articles by this author Expand All Advertisement PDF downloadLoading ...