Mp36-17 defining Biochemical Recurrence in Prostate Cancer With Hybrid Psma Pet Mri

Abstract

CSPC was defined as either Gleason grade group 2 or greater, or grade group 1 with more than 1/3 of total cores positive. Univariate Chi square, logistic regression and receiver operating characteristic (ROC) curve analyses were performed to evaluate the association between PSAD values and CSPC. RESULTS: For all mp-MRI in our patient cohort PPV was 54%, NPV 85%, Sn 95% and Sp 27%. Of the 1857 men with PI-RADS scores of 1 or 2 on mp-MRI, 200 men were followed by our practice and had undergone subsequent biopsy. Average age was 67 years, average PSA 7.3 ng/mL, average prostate size 71 mL, and average PSAD .13. Overall cancer detection rate on biopsy was 22.5% (45 patients) and for CSPC 8% (16 patients). On logistic regression analysis, PSAD was found to be a statistically significant predictor of CSPC (p[<.001), with the area under the ROC being .68 (Fig 1). Using a cutoff of 0.1 NPV is 96%, PPV 11%, Sn 75% and Sp 51%. Using a cutoff of 0.2 NPV is 94%, PPV 22.2%, Sn 37%, and Sp 88% and 36% PPV for any cancer on biopsy. CONCLUSIONS: Similar to prior reports, a negative MRI will miss <10% of CSPC. PSAD appears to have statistically significant prognostic value for patients with a negative MRI. Based on our data cohort, patients with negative mp-MRI and a PSAD score above 0.2 still have a 22% risk of CSPC and 36% of any cancer. Our results strongly confirm the utility of PSAD to stratify which patients with a negative prostate mp-MRI should undergo a prostate biopsy.