Risk of Clinically Significant Prostate Cancer Associated With Prostate Imaging Reporting and Data System Category 3 (Equivocal) Lesions Identified on Multiparametric Prostate MRI

Sheridan, Alison; Nath, Sameer K.; Syed, Jamil; Aneja, Sanjay; Sprenkle, Preston; Weinreb, Jeffrey C.; Spektor, Michael

doi:10.2214/ajr.17.18516

Cited by 60 publications

(43 citation statements)

References 20 publications

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“…Diverse diagnostic and monitoring strategies have been investigated previously; these have involved adding clinical parameters or subcharacteristics of target lesions to mpMRI results. [17][18][19][20] We here confirmed the value of PSAD as a csPCa predictor in PI-RADS 3 patients. Washino et al showed that the PI-RADS version 2 score and PSAD were independent risk factors for PCa and csPCa.…”

Section: Discussionsupporting

confidence: 82%

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Is it worth carrying out ultrasound–magnetic resonance imaging fusion targeted biopsy on Prostate Imaging Reporting and Data System score 3 prostate lesions?

Kim

Park

et al. 2020

Int J of Urology

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Abbreviations & Acronyms csPCa = clinically significant prostate cancer DCE = dynamic contrastenhanced DWI = diffusion-weighted imaging GS = Gleason score insignPCa = clinically insignificant prostate cancer mpMRI = multiparametric magnetic resonance imaging MRFB = ultrasoundmagnetic resonance imaging fusion targeted biopsy MRI = magnetic resonance imaging PCa = prostate cancer PI-RADS = Prostate Imaging Reporting and Data System PSA = prostate-specific antigen PSAD = prostate-specific antigen density ROC = receiver operating characteristic TRUSGB = transrectal ultrasound guided systemic biopsy

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Section: Discussionsupporting

confidence: 82%

Section: Discussionsupporting

confidence: 80%

Is it worth carrying out ultrasound–magnetic resonance imaging fusion targeted biopsy on Prostate Imaging Reporting and Data System score 3 prostate lesions?

Kim

Park

et al. 2020

Int J of Urology

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“…In our study, the overall and clinically significant CDR in all the patients with PI‐RADS 3 lesions was 25.3% and 22.2%, respectively. In contrast, the overall and significant CDR in the study by Sheridan et al was 27% and 17.1%, respectively 13 . They used a combined biopsy method (targeted + standard) in their study.…”

Section: Discussionmentioning

confidence: 81%

“…Based on these findings, we suggest using those parameters which are useful for characterization of PI‐RADS 3 lesions for making more accurate decisions. The only study employing clinical parameters for the evaluation of PI‐RADS 3 lesions was conducted by Sheridan et al in 2017, who evaluated a total of 111 PI‐RADS 3 lesions and defined several risk factors for PCa, such as age, prostate volume, and abnormal DRE 13 . Based on the total number of these risk factors, the authors revealed that the CDR ranged between 4% and 67%.…”

Section: Discussionmentioning

confidence: 99%

Clinical factors for predicting malignancy in patients with PSA < 10 ng/mL and PI‐RADS 3 lesions

Sönmez

Tombul

Demirtaş

et al. 2020

Asia-Pac J Clncl Oncology

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Aim: To determine clinical risk factors in patients with PI-RADS 3 lesions and prostate-specific antigen (PSA) < 10 ng/mL. Methods: In this prospective study, all patients underwent multiparametric magnetic resonance imaging. Following the 2-5 core fusion-targeted biopsy, standard 12-core prostate biopsy was performed in each patient (combined biopsy). The cutoff values were calculated with receiver-operating characteristic analysis. First, univariate logistic regression analysis was used to evaluate the relationship between total eight parameters and prostate cancer. Subsequently, multiple logistic regression analysis was performed to the parameters associated with prostate cancer. Results: Two hundred and eighty-eight patients were included in the study. Some clinical parameters are determined to be significant in univariate and multiple logistic regression analyses, including PSA, free/total PSA ratio, PSA density (PSA/total prostate volume), positive family history of PCa, and PI-RADS 3 lesion diameter. Patients were classified between 0 and 5 according to the number of risk factors. While the risk of cancer was 7.1% in patients with one or less risk factors, the PCA rate was 45.2% among patients with all risk factors. Conclusion: In patients with PI-RADS 3 lesion and PSA < 10 ng/mL, histopathological results of biopsy can be estimated with higher accuracy using some clinical parameters.

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“…Sathianathen, et al15 argued that repeat biopsy of PI-RADS 3 lesions could be avoided in men who have undergone a negative TRUS biopsy because of the low rate of prostate cancer detection. Sheridan, et al16 also reported a lower detection rate for PI-RADS 3 lesions. They reported that, of 111 PI-RADS category 3 lesions, 81 (73.0%) were benign, 11 (9.9%) were not clinically significant, and 19 (17.1%) were clinically significant.…”

Section: Discussionmentioning

confidence: 96%

Effectiveness of Bi-Parametric MR/US Fusion Biopsy for Detecting Clinically Significant Prostate Cancer in Prostate Biopsy Naïve Men

2019

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PurposeTo explore the effect of bi-parametric MRI-ultrasound (MR/US) fusion prostate biopsy on the detection of overall cancer and significant prostate cancer (sPCa).Materials and MethodsWe examined 140 patients with suspected prostate cancer lesions on MRI from August 2016 to March 2018. All patients had undergone 3T pre-biopsy bi-parametric (T2 weighted and diffusion-weighted) prostate MRI (bpMRI), and their MRI images were evaluated with Prostate Imaging Reporting and Data System (PI-RADS) version 2.0. MR/US fusion targeted prostate biopsy was performed for lesions with a PI-RADS score ≥3 before systemic biopsy. The results of targeted and systemic biopsy were evaluated in regards to detection rate according to PI-RADS score.ResultsOf the patients (mean age=67.2 years, mean prostate-specific antigen level=8.1 ng/mL), 66 (47.1%) and 37 (26.4%) patients were diagnosed with cancer and significant prostate cancer, respectively. The rate of positive targeted biopsy increased with higher PI-RADS score (3: 40.4%, 4: 56.7%, 5: 90.0%). The proportion of significant prostate cancer among positive target lesions was 65.3% (32/49).ConclusionbpMRI is a feasible tool with which to identify sPCa. MR/US fusion biopsy, rather than systemic biopsy, can help identify sPCa. We recommend using supplemental tools to increase prostate cancer detection in patients with PI-RADS 3 lesions.

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Risk of Clinically Significant Prostate Cancer Associated With Prostate Imaging Reporting and Data System Category 3 (Equivocal) Lesions Identified on Multiparametric Prostate MRI

Abstract: Incorporating clinical parameters into risk stratification algorithms may improve the ability to detect clinically significant disease among PI-RADS category 3 lesions and may aid in the decision to perform biopsy.

Cited by 60 publications

References 20 publications

Is it worth carrying out ultrasound–magnetic resonance imaging fusion targeted biopsy on Prostate Imaging Reporting and Data System score 3 prostate lesions?

Is it worth carrying out ultrasound–magnetic resonance imaging fusion targeted biopsy on Prostate Imaging Reporting and Data System score 3 prostate lesions?

Clinical factors for predicting malignancy in patients with PSA < 10 ng/mL and PI‐RADS 3 lesions

Effectiveness of Bi-Parametric MR/US Fusion Biopsy for Detecting Clinically Significant Prostate Cancer in Prostate Biopsy Naïve Men

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