- Annual surveillance multiparametric MRI (mpMRI) precludes biopsy for 3 years in 71% of patients with low-grade prostate cancer undergoing active surveillance.
- Because mpMRI misses a small number of significant high-grade tumors, these authors do not recommend skipping biopsies for >3 years.
Why this matters
- Clinicians should discuss with patients the risks and benefits of replacing annual biopsy.
- An interim analysis of the Magnetic Resonance Imaging in Active Surveillance (MRIAS) trial.
- 100 patients with cT2 or lower histologically proven prostate cancer were eligible for active surveillance.
- Patients received annual mpMRI.
- Abnormal findings on mpMRI and PSA triggered surveillance biopsy.
- Funding: None.
- The mpMRI was negative (Prostate Imaging Reporting and Data System 1/2/3) in 87 patients at baseline.
- The median follow-up was 36 months.
- The detection of clinically significant prostate cancer (csPCa) was significantly lower in 71 patients with a negative vs 29 patients with a positive surveillance mpMRI (11.3% vs 44.8%; P<.001>
- With surveillance mpMRI for detection of csPCa:
- Sensitivity, 61%.
- Specificity, 80%.
- Positive predictive value, 45%.
- Negative predictive value, 89%.
- Significant predictors of csPCa:
- Positive surveillance MRI (aOR, 5.73; P=.002).
- PSA density >0.2 ng/mL (OR, 4.44; P=.042).
- No comparator group.