You have accessJournal of UrologyCME1 May 2022PD17-05 CHARACTERISTICS AND OUTCOMES OF PATIENTS WITH PIRADS 5 LESIONS AND NEGATIVE BIOPSIES Eric Li, Mohammad Siddiqui, Jonathan Aguiar, Brandon Ansbro, Parth Shah, Moataz Soliman, Jordan Rich, Jasmine Lin, Johan Alfaro Carballo, Mary Kate Keeter, Quan Mai, Edward Schaeffer, and Ashley Ross Eric LiEric Li More articles by this author , Mohammad SiddiquiMohammad Siddiqui More articles by this author , Jonathan AguiarJonathan Aguiar More articles by this author , Brandon AnsbroBrandon Ansbro More articles by this author , Parth ShahParth Shah More articles by this author , Moataz SolimanMoataz Soliman More articles by this author , Jordan RichJordan Rich More articles by this author , Jasmine LinJasmine Lin More articles by this author , Johan Alfaro CarballoJohan Alfaro Carballo More articles by this author , Mary Kate KeeterMary Kate Keeter More articles by this author , Quan MaiQuan Mai More articles by this author , Edward SchaefferEdward Schaeffer More articles by this author , and Ashley RossAshley Ross More articles by this author View All Author Informationhttps://doi.org/10.1097/JU.0000000000002555.05AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookLinked InTwitterEmail Abstract INTRODUCTION AND OBJECTIVE: Best evidence supports use of mpMRI prior to initial diagnosis of prostate cancer. PIRADS 5 lesions typically have a 80-90% concordance with diagnosis of clinically significant disease. Here we investigate the characteristics and outcomes of patients with PIRADS 5 lesions and subsequent negative biopsies. METHODS: We queried our institutional database for men without an established diagnosis of prostate cancer for whom MRI targeted biopsy was performed after demonstration of a PIRADS 5 lesion from March 2018-present. T test, chi-squared test, and logistic regression were performed. RESULTS: 2,206 men underwent MRI for suspicion of prostate cancer, with PIRADS 5 lesions detected in 268 patients. 257 of these men underwent prostate biopsy (13 with transperineal biopsy) with a positivity rate of 93.8%. Men with PIRADS 5 lesions and negative biopsies (n=16) were more likely to be African American (25% vs 13.3%, p<0.001), younger (61.4 vs 66.3, p=0.03), have larger prostates (80.3 g vs 48.4 g, p<0.001), and have lower prostate health index (PHI, 44.3 vs. 78.2, p=0.04). There was no significant difference in anterior lesions, prostate inflammation, PSA, or PSA density. Of men with negative prostate biopsies, 1 patient was subsequently diagnosed with prostate cancer, and 2 patients had bladder outlet procedures with negative pathology. 2 patients with negative biopsies previously received BCG for non-muscle invasive bladder cancer and were subsequently found to have inflammation on prostate biopsy. CONCLUSIONS: Men with PIRADS 5 lesions and negative prostate biopsies tend to be African American, younger, have larger prostates, and have lower PHI compared to patients with positive prostate biopsies. Additional investigation is needed to determine lesion location is a risk factor for undersampling that may benefit from transperineal prostate biopsy, as well as the role of inflammation in determining how to follow these patients. Source of Funding: None © 2022 by American Urological Association Education and Research, Inc.FiguresReferencesRelatedDetails Volume 207Issue Supplement 5May 2022Page: e337 Advertisement Copyright & Permissions© 2022 by American Urological Association Education and Research, Inc.MetricsAuthor Information Eric Li More articles by this author Mohammad Siddiqui More articles by this author Jonathan Aguiar More articles by this author Brandon Ansbro More articles by this author Parth Shah More articles by this author Moataz Soliman More articles by this author Jordan Rich More articles by this author Jasmine Lin More articles by this author Johan Alfaro Carballo More articles by this author Mary Kate Keeter More articles by this author Quan Mai More articles by this author Edward Schaeffer More articles by this author Ashley Ross More articles by this author Expand All Advertisement PDF DownloadLoading ...