TY - JOUR
T1 - Multiple Regions of Interest on Multiparametric Magnetic Resonance Imaging are Not Associated with Increased Detection of Clinically Significant Prostate Cancer on Fusion Biopsy
AU - Patel, Neal
AU - Halpern, Joshua Alexander
AU - Kasabwala, Khushabu
AU - Cricco-Lizza, Eliza
AU - Herman, Michael
AU - Margolis, Daniel
AU - Xu, Chris
AU - Robinson, Brian D.
AU - Wang, Yi
AU - McClure, Timothy
AU - Hu, Jim C.
N1 - Publisher Copyright:
© 2018 American Urological Association Education and Research, Inc.
PY - 2018/9
Y1 - 2018/9
N2 - Purpose: We sought to determine the association between multiple regions of interest on prebiopsy magnetic resonance imaging and the detection of clinically significant prostate cancer in men undergoing magnetic resonance imaging-ultrasound fusion biopsy. Materials and Methods: We performed a retrospective, single institution analysis of men who underwent fusion biopsy. Men with prior positive biopsies, magnetic resonance imaging performed elsewhere and/or magnetic resonance imaging prior to release of the PI-RADS ™ (Prostate Imaging Reporting and Data System) version 2 were excluded from study, resulting in 381 participants. Modeled independent variables included patient age, number of regions of interest with a PI-RADS categorization of 3 or greater, body mass index, prostate specific antigen, prostate volume and PI-RADS categorization. Multivariable logistic regression was performed to determine factors associated with finding clinically significant prostate cancer (Gleason 7 or greater) on biopsy. Results: Median age was 67.2 years (IQR (61.6–73.0) and median prostate specific antigen was 6.6 ng/ml (5.0–10.0). Adjusted analysis demonstrated that age (OR 1.10, 95% CI 1.06–1.15, p ≤0.001), body mass index (OR 1.08, 95% CI 1.01–1.16, p = 0.038) and prostate specific antigen (OR 1.06, 95% CI 1.01–1.10, p = 0.015) were associated with detection of clinically significant prostate cancer. PI-RADS categories 4 (OR 4.62, 95% CI 2.23–9.33) and 5 (OR 6.75, 95% CI 2.72–16.71, each p <0.001) were associated with greater odds of clinically significant prostate cancer. Multiple regions of interest were not associated with the detection of clinically significant prostate cancer (OR 1.05, 95% CI 0.60–1.84, p = 0.857). Conclusions: Multiple regions of interest do not portend a greater likelihood of finding clinically significant prostate cancer. Physicians should recognize that multiple regions of interest should not influence the decision to perform fusion biopsy. Our findings may ease patient anxiety concerning these findings.
AB - Purpose: We sought to determine the association between multiple regions of interest on prebiopsy magnetic resonance imaging and the detection of clinically significant prostate cancer in men undergoing magnetic resonance imaging-ultrasound fusion biopsy. Materials and Methods: We performed a retrospective, single institution analysis of men who underwent fusion biopsy. Men with prior positive biopsies, magnetic resonance imaging performed elsewhere and/or magnetic resonance imaging prior to release of the PI-RADS ™ (Prostate Imaging Reporting and Data System) version 2 were excluded from study, resulting in 381 participants. Modeled independent variables included patient age, number of regions of interest with a PI-RADS categorization of 3 or greater, body mass index, prostate specific antigen, prostate volume and PI-RADS categorization. Multivariable logistic regression was performed to determine factors associated with finding clinically significant prostate cancer (Gleason 7 or greater) on biopsy. Results: Median age was 67.2 years (IQR (61.6–73.0) and median prostate specific antigen was 6.6 ng/ml (5.0–10.0). Adjusted analysis demonstrated that age (OR 1.10, 95% CI 1.06–1.15, p ≤0.001), body mass index (OR 1.08, 95% CI 1.01–1.16, p = 0.038) and prostate specific antigen (OR 1.06, 95% CI 1.01–1.10, p = 0.015) were associated with detection of clinically significant prostate cancer. PI-RADS categories 4 (OR 4.62, 95% CI 2.23–9.33) and 5 (OR 6.75, 95% CI 2.72–16.71, each p <0.001) were associated with greater odds of clinically significant prostate cancer. Multiple regions of interest were not associated with the detection of clinically significant prostate cancer (OR 1.05, 95% CI 0.60–1.84, p = 0.857). Conclusions: Multiple regions of interest do not portend a greater likelihood of finding clinically significant prostate cancer. Physicians should recognize that multiple regions of interest should not influence the decision to perform fusion biopsy. Our findings may ease patient anxiety concerning these findings.
KW - biopsy
KW - diagnostic imaging
KW - magnetic resonance imaging
KW - prostatic neoplasms
KW - standard of care
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U2 - 10.1016/j.juro.2018.03.002
DO - 10.1016/j.juro.2018.03.002
M3 - Article
C2 - 29518433
AN - SCOPUS:85050112791
SN - 0022-5347
VL - 200
SP - 559
EP - 563
JO - Journal of Urology
JF - Journal of Urology
IS - 3
ER -