Using MRI/ultrasound fusion biopsy to detect clinically significant prostate cancer in the African American population.

Abstract

57 Background: African-American (AA) men are at greater risk for prostate cancer (CaP) and experience increased prostate cancer-specific mortality. We aimed to determine racial disparities in CaP incidence, pathology, and anatomy identified on MRI/US fusion biopsy. Methods: Patients who underwent MP-MRI with targeted MRI/US fusion biopsy at our institution between May 2007 and June 2013 were reviewed. AA patients undergoing fusion biopsy were matched by age and PSA with a Caucasian cohort at a 1:2 ratio. MRI and pathologic parameters including lesion location, number of lesions, and Gleason score. Bivariate comparisons were made with the Student’s t-test and Χ2 analysis. Results: 822 patients had MRI/US fusion biopsy. 127 AA men were paired with a matched cohort of 254 Caucasians. Mean age was 60.2 and 61.4 years and mean PSA was 11.6 and 10.7ng/ml in AAs and Caucasians, respectively. We identified significantly more AA with CaP (49.6% vs 37.4%, p=0.03; Table). AAs also had higher grade disease (Gleason 7-10) versus white men (20.5% vs. 11.8%, p=0.04). Additionally, the diagnostic yield for the AA cohort was significantly higher per sampled lesion (37.5% vs 24.5%, p<0.01), despite no significant differences in % core involvement of the highest risk lesion between the groups. While there was no significant difference in presence of anterior lesions between the groups (15.7% vs 12.9%, p=NS), anterior lesions equally represented the highest risk lesions in both cohorts. Conclusions: MRI/US Fusion-guided biopsy demonstrates increased diagonostic yield/incidence of CaP and higher risk disease in the AA population in an age and PSA matched cohort of Caucasian patients. [Table: see text]