Multiparametric MRI avoids prostate biopsy in over 50% of patients

  • Venderink W & al.
  • BJU Int
  • 25 Jun 2019

  • curated by Deepa Koli
  • Univadis Clinical Summaries
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Takeaway

  • Multiparametric MRI (mpMRI) avoids biopsy in over 50% of patients with suspected prostate cancer; 94.1% of these individuals were free of cancer diagnosis 6 years later.

Why this matters

  • This study underscores the importance of mpMRI in the diagnostic workup in clinical setting.
  • Limited data are available on follow-up in patients with negative mpMRI scans.

Study design

  • Study of 4259 patients (median age was 65 years) with clinical suspicion for prostate cancer who received first prostate mpMRI between 2012 and 2017.
  • Funding: None disclosed.

Key results

  • 53.6% of patients had negative mpMRI (Prostate Imaging Reporting And Data System [PI‐RADS] ≤2 lesions).
  • In patients with negative mpMRI, cancer diagnosis‐free survival was 99.6% after 3 years and 94.1% at 6 years.
  • In patients with PI-RADS 3, 4, and 5, immediate biopsy detected clinically significant cancer in 15.8%, 43.2%, and 74.5% of patients, respectively.
  • In 320 patients with PI‐RADS ≤2, 10.6% of follow‐up mpMRI (median, 57 months) were classified as PI-RADS 4/5.
  • In 108 patients with PI-RADS 3 who underwent mpMRI at median of 41 months, 11.1% of mpMRI were classified as PI-RADS 4/5.
  • Age was a predictor for clinically significant cancer during follow‐up (P<.05>

Limitations

  • Retrospective design.