Factors predicting prostate cancer upgrading on magnetic resonance imaging–targeted biopsy in an active surveillance population

Lai, Win Shun; Gordetsky, Jennifer B.; Thomas, John V.; Nix, Jeffrey; Rais‐Bahrami, Soroush

doi:10.1002/cncr.30548

Cited by 67 publications

(43 citation statements)

References 21 publications

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“…Stamatakis et al [28] found that among a cohort of men who met the Johns Hopkins AS criteria at diagnosis and subsequently underwent mpMRI, the MRI suspicion score (defined as low, medium or high) was a significant predictor for finding significant disease (≤50% tumour in any core, GG ≥ 2) on confirmatory biopsy. Similarly, other groups have found MRI-suspicion scores from PI-RADS to be a significant predictor of upgrading to GG ≥ 2 on confirmatory [11,29], as well as follow-up biopsies [30].…”

Section: Discussionmentioning

confidence: 62%

Utility of multiparametric magnetic resonance imaging in the risk stratification of men with Grade Group 1 prostate cancer on active surveillance

et al. 2020

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ObjectiveTo assess if the adoption of multiparametric magnetic resonance imaging (mpMRI) in active surveillance (AS) has improved the identification of occult higher-grade prostate cancer (PCa). Patients and MethodsWe retrospectively identified men from the Johns Hopkins AS registry enrolled since 2013 (year of mpMRI adoption) with Grade Group (GG) 1 PCa and who underwent a single mpMRI. Men in this group were dichotomised by the presence (n = 207) or absence (negative mpMRI, n = 225) of one or more lesions with a Prostate Imaging-Reporting and Data System (PI-RADS) score of ≥ 3. Both groups were compared to a third cohort of men with GG1 PCa enrolled in AS prior to 2013 (pre-mpMRI era, n = 669). The risk of upgrading to GG ≥ 2 PCa on follow-up biopsies (performed with or without MRI targeting) was evaluated among the groups using survival analysis. ResultsMen in both mpMRI groups underwent a median (interquartile range [IQR]) of 2 (2-3) biopsies separated by a median (IQR) interval of 13 (12-16) months, whereas men in the pre-MRI era underwent a median (IQR) of 3 (2-5) biopsies, separated by a median (IQR) interval of 12 (12-14) months. The 2-and 4-year upgrade-free survival rates were 93% and 83%, 74% and 59%; and, 87% and 76% for the negative mpMRI, PI-RADS ≥ 3, and pre-mpMRI-era groups, respectively (P < 0.001). On multivariable analysis, both mpMRI groups had significantly different risk of upgrading compared to pre-mpMRI-era group (negative mpMRI group: hazard ratio [HR] 0.61, 95% confidence interval [CI] 0.39-0.95, P = 0.03; PI-RADS ≥ 3 group: HR 1.96, 95% CI 1.36-2.82, P < 0.001). ConclusionsmpMRI improves the risk stratification of men on AS and should be used to aid enrolment and monitoring decisions.

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Section: Discussionmentioning

confidence: 62%

Utility of multiparametric magnetic resonance imaging in the risk stratification of men with Grade Group 1 prostate cancer on active surveillance

et al. 2020

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“…Additionally, it has been reported that the combination of findings in mpMRI and clinical parameter like PSA density [38] and the use of nomograms based on these parameter might help to predict tumour upgrading to clinically significant PCa in a non-invasive approach to confirm AS [7,29,39]. However, this approach has to be investigated continuously especially with regard to further diagnostic and predictive biomarkers.…”

Section: Discussionmentioning

confidence: 99%

Evaluation of Magnetic Resonance Imaging/Ultrasound-Fusion Biopsy in Patients with Low-Risk Prostate Cancer Under Active Surveillance Undergoing Surveillance Biopsy

Borkowetz¹,

Renner²,

Platzek³

et al. 2018

Urol Int

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Introduction: Targeted biopsy of tumour-suspicious lesions detected in multiparametric magnetic resonance imaging (mpMRI) plays an increasing role in the active surveillance (AS) of patients with low-risk prostate cancer (PCa). The aim of this study was to compare MRI/ultrasound-fusion biopsy (fusPbx) with systematic biopsy (sysPbx) in patients undergoing biopsy for AS. Methods: Patients undergoing mpMRI and transperineal fusPbx combined with transrectal sysPbx (comPbx) as surveillance biopsy were investigated. The detection of Gleason score upgrading and reclassification according to Prostate Cancer Research International Active Surveillance criteria were evaluated. Results: Eighty-three patients were enrolled. PCa upgrading was detected in 39% by fusPbx and in 37% by sysPbx (p = 1.0). The percentage of patients who were reclassified in fusPbx and sysPbx (p = 0.45) were 64 and 59% respectively. ComPbx detected more frequently tumour upgrading than fusPbx (71 vs. 64%, p = 0.016) and sysPbx (71 vs. 59%, p < 0.001) and more patients had to be reclassified after comPbx than after fusPbx or sysPbx alone. Conclusions: The combination of fusPbx and sysPbx outperforms both modalities alone with regard to the detection of upgrading and reclassification in patients under AS. Because a high missing rate of significant PCa still exists in both biopsy modalities, a combination of fusPbx and sysPbx should be recommended in these patients.

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“…[9][10][11] Another nomogram was recently developed for use in patients who are naive to prostate biopsy. [9][10][11] Another nomogram was recently developed for use in patients who are naive to prostate biopsy.…”

Section: Introductionmentioning

confidence: 99%

“…Several mpMRI-based nomograms have been previously developed for use in PCa patients on active surveillance. [9][10][11] Another nomogram was recently developed for use in patients who are naive to prostate biopsy. 12 Currently, validated nomograms for use in the prior negative biopsy population, particularly those that incorporate PI-RADS version 2, are much needed.…”

Section: Introductionmentioning

confidence: 99%

Multi‐institutional nomogram predicting benign prostate pathology on magnetic resonance/ultrasound fusion biopsy in men with a prior negative 12‐core systematic biopsy

Truong

Wang

Gordetsky

et al. 2017

Cancer

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False-positive mpMRI examinations may occur in up to 46.3% of patients with a prior negative biopsy. Thus, a multi-institutional nomogram has been developed and validated for predicting benign pathology after FB in patients with a prior negative biopsy, and this may help to reduce the number of unnecessary biopsies in the setting of abnormal mpMRI findings. Cancer 2018;124:278-85. © 2017 American Cancer Society.

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Factors predicting prostate cancer upgrading on magnetic resonance imaging–targeted biopsy in an active surveillance population

Cited by 67 publications

References 21 publications

Utility of multiparametric magnetic resonance imaging in the risk stratification of men with Grade Group 1 prostate cancer on active surveillance

Utility of multiparametric magnetic resonance imaging in the risk stratification of men with Grade Group 1 prostate cancer on active surveillance

Evaluation of Magnetic Resonance Imaging/Ultrasound-Fusion Biopsy in Patients with Low-Risk Prostate Cancer Under Active Surveillance Undergoing Surveillance Biopsy

Multi‐institutional nomogram predicting benign prostate pathology on magnetic resonance/ultrasound fusion biopsy in men with a prior negative 12‐core systematic biopsy

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