Systematic Biopsy Does Not Contribute to Disease Upgrading in Patients Undergoing Targeted Biopsy for PI-RADS 5 Lesions Identified on Magnetic Resonance Imaging in the Course of Active Surveillance for Prostate Cancer.

Authors

Ahmad Arabi, Henry Ford HealthFollow
Mustafa Deebajah, Henry Ford HealthFollow
Grace Yaguchi, Henry Ford HealthFollow
Milan Pantelic, Henry Ford HealthFollow
Sean R. Williamson, Henry Ford HealthFollow
Nilesh S. Gupta, Henry Ford HealthFollow
Hakmin Park, Henry Ford HealthFollow
James O. Peabody, Henry Ford HealthFollow
Mani Menon, Henry Ford HealthFollow
Ali A. Dabaja, Henry Ford HealthFollow
Shaheen Alanee, Henry Ford HealthFollow

Recommended Citation

Arabi A, Deebajah M, Yaguchi G, Pantelic M, Williamson S, Gupta N, Park H, Peabody J, Menon M, Dabaja A, and Alanee S. Systematic Biopsy Does Not Contribute to Disease Upgrading in Patients Undergoing Targeted Biopsy for PI-RADS 5 Lesions Identified on Magnetic Resonance Imaging in the Course of Active Surveillance for Prostate Cancer. Urology 2019; 134:168-172.

Document Type

Article

Publication Date

12-1-2019

Publication Title

Urology

Abstract

OBJECTIVE: To compare the utility of the systematic 12-core prostate biopsy (SB) combined with magnetic resonance imaging (MRI)-targeted lesion biopsy (MRI-TB) vs MRI-TB alone in the diagnosis of high PI-RADS lesions.

MATERIALS AND METHODS: Patients undergoing MRI-TB + SB for suspicious MRI lesions were retrospectively reviewed. These patients had a previous prostate biopsy and were evaluated with MRI to assess the need for a repeat biopsy. Pathologic findings of MRI-TB combined with a SB were compared to those of the patients' previous SB. An upgrade was defined as an increase in the Gleason Score of any prior biopsy. A no-upgrade (NU) MRI-TB was defined as a MRI-TB that did not lead to disease upgrading when compared to SB.

RESULTS: A total of 148 patients were analyzed in this study. Of the 255 total lesions (247 lesions with PI-RADS ≥3), 141 were upgraded from the previous biopsy (55.3%). Of these, 104 were upgraded by the MRI-TB (40.8%), and 87 lesions were upgraded by the SB (34.1%). The MRI-TB had a NU rate of 26.2% for all lesions. On subanalysis, the NU rates of PI-RADS 3, 4, and 5 MRI-TBs were 39.3%, 21.2%, and 3.4%, respectively.

CONCLUSION: The NU rate for the MRI-TB in a PIRADS-5 lesion is meager. Men with a PI-RADS 5 lesion may be safely managed with the MRI-TB alone without combining with SB. Men with PI-RADS 3 and 4 lesions should benefit from SB in addition to MRI-TB for accurate management of their disease.

Medical Subject Headings

Aged; Aged, 80 and over; Biopsy, Needle; Contrast Media; Humans; Magnetic Resonance Imaging; Male; Middle Aged; Neoplasm Grading; Prostatic Neoplasms; Retrospective Studies; Watchful Waiting

PubMed ID

31479660

Volume

134

First Page

168

Last Page

172