Mp44-10 the value of dynamic contrast enhancement for risk-stratification and prostate cancer detection on multiparametric prostate mri

You have accessJournal of UrologyCME1 Apr 2023MP44-10 THE VALUE OF DYNAMIC CONTRAST ENHANCEMENT FOR RISK-STRATIFICATION AND PROSTATE CANCER DETECTION ON MULTIPARAMETRIC PROSTATE MRI Eric Li, Mohammad Siddiqui, Jonathan Aguiar, Parth Shah, Ashorne Mahenthiran, Jasmine Lin, Moataz Soliman, Sai Kumar, Mary Kate Keeter, Clayton Neill, Xinlei Mi, Quan Mai, Edward Schaeffer, Ashley Ross, and Hiten Patel Eric LiEric Li More articles by this author , Mohammad SiddiquiMohammad Siddiqui More articles by this author , Jonathan AguiarJonathan Aguiar More articles by this author , Parth ShahParth Shah More articles by this author , Ashorne MahenthiranAshorne Mahenthiran More articles by this author , Jasmine LinJasmine Lin More articles by this author , Moataz SolimanMoataz Soliman More articles by this author , Sai KumarSai Kumar More articles by this author , Mary Kate KeeterMary Kate Keeter More articles by this author , Clayton NeillClayton Neill More articles by this author , Xinlei MiXinlei Mi More articles by this author , Quan MaiQuan Mai More articles by this author , Edward SchaefferEdward Schaeffer More articles by this author , Ashley RossAshley Ross More articles by this author , and Hiten PatelHiten Patel More articles by this author View All Author Informationhttps://doi.org/10.1097/JU.0000000000003290.10AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookLinked InTwitterEmail Abstract INTRODUCTION AND OBJECTIVE: Positive dynamic contrast enhancement (DCE) on multiparametric prostate MRI (mpMRI) upgrades peripheral zone (PZ) lesions on diffusion weighted imaging (DWI) from PIRADS 3 to 4, whereas these lesions would remain PIRADS 3 for biparametric MRI. It remains unclear if the rate of clinically significant prostate cancer (csPCa, Gleason Grade Group [GG] ≥2) differs for patients with DCE upgraded lesions (3+) compared to lesions rated 3 by DWI with negative DCE (3-), or 4 by DWI. METHODS: Biopsy naïve men presenting with elevated PSA and pre-biopsy MRI from 2018-2022 were identified. Clinicopathologic and MRI data including highest PIRADS lesion and scoring in individual MRI series were obtained. Patients with PIRADS 1 or 2 or transitional zone lesions as their highest PIRADS lesion were excluded. Patients with multiple lesions were included, and categorized by their highest PIRADS lesion. T-test, Chi-squared, and multivariable logistic regression were performed. RESULTS: 2468 men underwent mpMRI, and 1021 patients who underwent prostate biopsy had PZ lesions as their highest PIRADS lesion. csPCa detection rates for PIRADS 3-, 3+ and 4 were 19%, 31%, and 58%, respectively (p=0.01 for 3- vs 3+; p<0.001 for 3+ vs 4). On multivariable analysis, older age, Black race, PHI>36, PSAD>0.16, and highest PIRADS were significant predictors of csPCa. There was a significant difference in csPCa detection comparing 3+ to 3- (OR 1.94, 95% CI 1.13-3.34, p<0.001) and comparing 4 to 3+ (OR 2.38, 95% CI 1.52-3.78, p<0.001). AUCs for csPCa detection were similar for models classifying patients based on biparametric or multiparametric interpretation of PIRADS (82.0% vs. 81.9%). CONCLUSIONS: Patients with PZ lesions upgraded from PIRADS 3 to 4 by DCE have a csPCa detection rate that is higher than those rated as DWI 3 with negative DCE, but lower than those rated as DWI 4. Overall discrimination for biparametric and multiparametric MRI were similar, but DCE findings may aid in individualized cancer risk-stratification and diagnostic decisions. Source of Funding: None © 2023 by American Urological Association Education and Research, Inc.FiguresReferencesRelatedDetails Volume 209Issue Supplement 4April 2023Page: e614 Advertisement Copyright & Permissions© 2023 by American Urological Association Education and Research, Inc.MetricsAuthor Information Eric Li More articles by this author Mohammad Siddiqui More articles by this author Jonathan Aguiar More articles by this author Parth Shah More articles by this author Ashorne Mahenthiran More articles by this author Jasmine Lin More articles by this author Moataz Soliman More articles by this author Sai Kumar More articles by this author Mary Kate Keeter More articles by this author Clayton Neill More articles by this author Xinlei Mi More articles by this author Quan Mai More articles by this author Edward Schaeffer More articles by this author Ashley Ross More articles by this author Hiten Patel More articles by this author Expand All Advertisement PDF downloadLoading ...