PD43-06 A MULTIVARIATE LOGISTIC REGRESSION INVESTIGATING WHICH FACTORS INFLUENCE DETECTION OF CLINICALLY SIGNIFICANT CANCER BY MRI-TARGETED PROSTATE BIOPSY

Abstract

You have accessJournal of UrologyProstate Cancer: Detection & Screening VI1 Apr 2017PD43-06 A MULTIVARIATE LOGISTIC REGRESSION INVESTIGATING WHICH FACTORS INFLUENCE DETECTION OF CLINICALLY SIGNIFICANT CANCER BY MRI-TARGETED PROSTATE BIOPSY Veeru Kasivisvanathan, Osayuki Nehikhare, Sara Renshaw, Susan Charman, Jan van der Meulen, Shonit Punwani, Alistair Grey, Henrietta Mair, Esmee van der Saar, Ross Warner, Hashim Ahmed, Mark Emberton, and Caroline Moore Veeru KasivisvanathanVeeru Kasivisvanathan More articles by this author , Osayuki NehikhareOsayuki Nehikhare More articles by this author , Sara RenshawSara Renshaw More articles by this author , Susan CharmanSusan Charman More articles by this author , Jan van der MeulenJan van der Meulen More articles by this author , Shonit PunwaniShonit Punwani More articles by this author , Alistair GreyAlistair Grey More articles by this author , Henrietta MairHenrietta Mair More articles by this author , Esmee van der SaarEsmee van der Saar More articles by this author , Ross WarnerRoss Warner More articles by this author , Hashim AhmedHashim Ahmed More articles by this author , Mark EmbertonMark Emberton More articles by this author , and Caroline MooreCaroline Moore More articles by this author View All Author Informationhttps://doi.org/10.1016/j.juro.2017.02.1911AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookTwitterLinked InEmail INTRODUCTION AND OBJECTIVES MRI-targeted prostate biopsy (MRI-TB) is a promising diagnostic test option for the detection of clinically significant prostate cancer. There is limited data on what the key radiological, surgical and patient factors are that influence detection of clinically significant cancer by MRI-TB. Knowledge of these factors will help optimise the conduct of this diagnostic strategy. METHODS 604 men with clinical suspicion of prostate cancer underwent multiparametric MRI (scored on a 1-5 Likert scale) followed by cognitively registered transperineal MRI-TB at a single centre in a 30-month period. Multi-parametric MRI included T2-weighted, diffusion-weighted and dynamic-contrast enhanced sequences reported by an expert uro-radiologist. Factors influencing detection of clinically significant cancer by MRI-TB were investigated with a multivariate logistic regression using STATA. Multiple imputation was carried out to account for missing data. RESULTS In the 604 men, mean age was 65 and median was PSA 7.1. Significant cancer was detected in 390 men (65%). The multivariate analysis adjusting for key confounders showed that factors significantly associated with clinically significant cancer detection included MRI-Likert score (p<0.0001), MRI coil strength (p=0.0013), prior biopsy status (biopsy naive, previous negative biopsy, previous positive biopsy, p=0.0016) and PSA (p=0.0135). Factors not associated with detection of significant cancer included anaesthetic (general versus local,p=0.1274), abnormal digital rectal examination (p=0.0918), surgeon (p=0.1724) and location of tumour (anterior vs posterior, p=0.5825; basal vs apical, p=0.9204). CONCLUSIONS Key factors that influence the odds of detection of clinically significant cancer have been identified. This study validates the MRI-Likert score as one of the strongest predictors of clinically significant cancer detection. It highlights the importance of presenting PSA and MRI coil strength. Notably, this data also highlights that digital rectal exam finding is not very reliable, consistent with previous studies. Of particular importance, this data supports the feasibility of a local anaesthetic-only approach for transperineal targeted biopsy which has major healthcare delivery and health resource use benefits. © 2017FiguresReferencesRelatedDetails Volume 197Issue 4SApril 2017Page: e819-e820 Advertisement Copyright & Permissions© 2017MetricsAuthor Information Veeru Kasivisvanathan More articles by this author Osayuki Nehikhare More articles by this author Sara Renshaw More articles by this author Susan Charman More articles by this author Jan van der Meulen More articles by this author Shonit Punwani More articles by this author Alistair Grey More articles by this author Henrietta Mair More articles by this author Esmee van der Saar More articles by this author Ross Warner More articles by this author Hashim Ahmed More articles by this author Mark Emberton More articles by this author Caroline Moore More articles by this author Expand All Advertisement Advertisement PDF downloadLoading ...