The effect of 5 alpha-reductase inhibitor therapy on prostate cancer detection in the era of multi-parametric magnetic resonance imaging

Kim, Jung Kwon; Lee, Hak Jong; Hwang, Sung Il; Choe, Gheeyoung; Kim, Hak Ju; Hong, Sung Kyu

doi:10.1038/s41598-019-54464-9

Cited by 7 publications

(11 citation statements)

References 22 publications

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“…Kim et al [ 20 ] first evaluated the effect of 5ARI treatment on prostate cancer and clinically significant prostate cancer detection in patients undergoing MRI-TRUS fusion biopsy. They concluded that 5-ARI use had no significant association with prostate cancer detection, and exposure to 5-ARI may not impair mpMRI performance.…”

Section: Discussionmentioning

confidence: 99%

5-alpha reductase inhibitors and MRI prostates: actively reducing prostate sizes and ambiguity

Wang

Ong

et al. 2023

BMC Urol

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Background Magnetic resonance imaging (MRI) scans are increasingly first-line investigations for suspected prostate cancer, and essential in the decision for biopsy. 5-alpha reductase inhibitor (5-ARI) use has been shown to reduce prostate size and prostate cancer risk. However, insufficient data exists on how 5-ARI use affects MRI findings and yield of biopsy. This study explores the differences in imaging and prostate cancer diagnoses between patients receiving and not receiving 5-ARI therapy. Methods From 2015 to 2020, we collected retrospective data of consecutive patients undergoing prostate biopsy at one centre. We included patients who were biopsy-naïve, had prior negative biopsies, or on active surveillance for low-grade prostate cancer. Clinical and pathological data was collected, including 5-ARI use, Prostate Imaging Reporting and Data System (PIRADS) classification and biopsy results. Results 351 men underwent saturation biopsy with or without targeted biopsies. 54 (15.3%) had a history of 5-ARI use. On mpMRI, there was no significant difference between the 5ARI and non-5-ARI groups in PIRADS distribution, number of lesions, and lesion location. Significantly fewer cancers were detected in the 5-ARI group (46.3% vs. 68.0%; p < 0.01). There were no significant differences in PIRADS distribution in 5-ARI patients with positive and negative biopsy. Conclusion Our study found significant differences in biochemical, imaging and biopsy characteristics between 5-ARI and non-5-ARI groups. While both groups had similar PIRADS distribution, 5-ARI patients had a lower rate of positive biopsies across all PIRADS categories, which may suggest that the use of 5ARI may confound MRI findings. Further studies on how 5-ARI therapy affects the imaging characteristics of prostate cancer should be performed.

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Section: Discussionmentioning

confidence: 99%

5-alpha reductase inhibitors and MRI prostates: actively reducing prostate sizes and ambiguity

Wang

Ong

et al. 2023

BMC Urol

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“…To the best of our knowledge, previous research assessing the influence of 5-ARI treatment on prostate MRI performance for detecting csPCa is limited to a single retrospective study. 11 In this previous study, no difference was observed in the detection of csPCa with MRI and MRI-guided biopsies between patients treated with 5-ARIs (36.2%) and those not treated with 5-ARIs (28.8%; p[0.074); this finding held true even in a subgroup of patients who were treated with 5-ARIs for !3 years. 11 Additionally, among patients who underwent subsequent radical prostatectomy, no significant differences were seen between the groups in terms of Gleason score or Gleason score upgrading.…”

Section: Discussionmentioning

confidence: 74%

“…6e11 Preliminary data suggest that 5-ARIs may affect the conspicuity of PCa on MRI, 6e10 but exposure to these agents has not been found to affect the performance of MRI in clinical practice. 11 In this retrospective matched cohort study, we aimed to evaluate the influence of 5-ARIs on the performance of MRI for csPCa detection. We also sought to assess the influence of these agents on quantitative MRI features derived from apparent diffusion coefficient (ADC) maps.…”

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confidence: 99%

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Influence of 5-Alpha Reductase Inhibitors on Prostate Cancer Detection with Magnetic Resonance Imaging: A Matched Cohort Study

et al. 2021

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Purpose:We evaluated the influence of 5-alpha reductase inhibitors (5-ARIs) on the performance of magnetic resonance imaging (MRI) for detection of Gleason grade group (GG) ≥2 prostate cancer, and on apparent diffusion coefficient (ADC) maps.Materials and Methods:This single center, retrospective study included men who had MRI for initial detection or active surveillance of prostate cancer. The study group included 59 men who used for 5-ARIs for ≥12 months, and the control group included 59 men who were matched for both MRI indication and biopsy results. DeLong’s test was used to compare the area under the receiver operating characteristic curve (AUC) for detection of GG ≥2 cancer between the groups. Wilcoxon rank sum test was used for comparison of lesions apparent diffusion coefficient (ADC) metrics between the groups.Results:MRI accuracy in the study group (AUC=0.778) was not significantly different compared to the control group (AUC=0.821; 95% CI for difference 0.22–0.13; p=0.636). In the control group, all ADC metrics were lower in lesions with GG ≥2 cancer on biopsy than in those with GG 1 cancer or negative results (p=0.001–0.01). In the study group, this difference was significant only when the mean ADC of the lesions was normalized by the ADC of urine (p=0.044).Conclusions:Long-term exposure to 5-ARIs does not seem to impair the detection of significant cancer on MRI but may affect the ability of ADC metrics to discriminate between lesions that harbor significant cancer and those that harbor insignificant cancer or benign tissue.

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“…The detailed protocols were described in our previous reports. 19 All images were reviewed by two high-volume radiologists (H.J.L. and S.I.H.)…”

Section: Methodsmentioning

confidence: 99%

Diagnostic accuracy of F-18-Fluorocholine PET/CT and multiparametric MRI for prostate cancer

Kim

Song

Lee

et al. 2022

Prostate International

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The effect of 5 alpha-reductase inhibitor therapy on prostate cancer detection in the era of multi-parametric magnetic resonance imaging

Cited by 7 publications

References 22 publications

5-alpha reductase inhibitors and MRI prostates: actively reducing prostate sizes and ambiguity

5-alpha reductase inhibitors and MRI prostates: actively reducing prostate sizes and ambiguity

Influence of 5-Alpha Reductase Inhibitors on Prostate Cancer Detection with Magnetic Resonance Imaging: A Matched Cohort Study

Diagnostic accuracy of F-18-Fluorocholine PET/CT and multiparametric MRI for prostate cancer

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