Mp56-07 the value of psa density in pi-rads 3 lesions on multiparametric mri - a strategy to avoid unnecessary prostate biopsies

You have accessJournal of UrologyProstate Cancer: Detection & Screening IV (MP56)1 Apr 2020MP56-07 THE VALUE OF PSA DENSITY IN PI-RADS 3 LESIONS ON MULTIPARAMETRIC MRI - A STRATEGY TO AVOID UNNECESSARY PROSTATE BIOPSIES Magdalena Görtz*, Jan Philipp Radtke, Gencay Hatiboglu, Viktoria Schütz, Georgi Tosev, Maximilian Güttlein, Jonas Leichsenring, Albrecht Stenzinger, David Bonekamp, Heinz-Peter Schlemmer, Markus Hohenfellner, and Joanne Nyaboe Nyarangi-Dix Magdalena Görtz*Magdalena Görtz* More articles by this author , Jan Philipp RadtkeJan Philipp Radtke More articles by this author , Gencay HatibogluGencay Hatiboglu More articles by this author , Viktoria SchützViktoria Schütz More articles by this author , Georgi TosevGeorgi Tosev More articles by this author , Maximilian GüttleinMaximilian Güttlein More articles by this author , Jonas LeichsenringJonas Leichsenring More articles by this author , Albrecht StenzingerAlbrecht Stenzinger More articles by this author , David BonekampDavid Bonekamp More articles by this author , Heinz-Peter SchlemmerHeinz-Peter Schlemmer More articles by this author , Markus HohenfellnerMarkus Hohenfellner More articles by this author , and Joanne Nyaboe Nyarangi-DixJoanne Nyaboe Nyarangi-Dix More articles by this author View All Author Informationhttps://doi.org/10.1097/JU.0000000000000925.07AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookLinked InTwitterEmail Abstract INTRODUCTION AND OBJECTIVE: Multiparametric magnetic resonance imaging (mpMRI) has excellent sensitivity in detecting significant prostate cancer (sPC). Nevertheless, uncertainty exists with the management of PI-RADS 3 lesions. We analysed if PI-RADS 3 lesions in combination with clinical parameters, especially prostate specific antigen density (PSAD), can be used to exclude sPC. METHODS: 455 consecutive biopsy-naïve men underwent MRI-guided transperineal prostate fusion-biopsy at our department between 2017 and 2018. We identified 101 patients who had exclusively ≥1 PI-RADS 3 lesions on mpMRI. sPC was defined as intermediate- and high-risk PC (according to the D’Amico risk classification). Univariate logistic regression analysis was performed to test different clinical factors as predictors of sPC in PI-RADS 3 lesions. RESULTS: In patients with PI-RADS 3 lesions, the parameters age, digital rectal examination, prostate specific antigen, prostate volume or multiple lesions on mpMRI were not statistically significant predictors for sPC (p>0.05 each). PSAD (p=0.005) was a significant predictor of sPC. For PI-RADS 3 lesions, the probability to exclude sPC was 85% (86/101) and increased to 98% (42/43) in combination with a PSAD <0.1 ng/ml/ml. CONCLUSIONS: Including a PSAD <0.1 ng/ml/ml in biopsy-naïve patients with equivocal mpMRI allows a reduction of prostate biopsies in 43% (43/101) of men at the cost of missing a very small number (2%, 1/43) of intermediate-risk PC. At high-volume tertiary care centres with a significant experience in prostate mpMRI immediate biopsies may be safely omitted for men with PI-RADS 3 lesions and a PSAD <0.1 ng/ml/ml. The decision to omit an immediate biopsy should be associated with close monitoring. Source of Funding: None. © 2020 by American Urological Association Education and Research, Inc.FiguresReferencesRelatedDetails Volume 203Issue Supplement 4April 2020Page: e849-e850 Advertisement Copyright & Permissions© 2020 by American Urological Association Education and Research, Inc.MetricsAuthor Information Magdalena Görtz* More articles by this author Jan Philipp Radtke More articles by this author Gencay Hatiboglu More articles by this author Viktoria Schütz More articles by this author Georgi Tosev More articles by this author Maximilian Güttlein More articles by this author Jonas Leichsenring More articles by this author Albrecht Stenzinger More articles by this author David Bonekamp More articles by this author Heinz-Peter Schlemmer More articles by this author Markus Hohenfellner More articles by this author Joanne Nyaboe Nyarangi-Dix More articles by this author Expand All Advertisement PDF downloadLoading ...