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Start Over Author "Macairan, Malu" Journal journal of urology
12 results on '"Macairan, Malu"'

4. V1267 TARGETED BIOPSY WITH MRI-ULTRASOUND FUSION

Author

Sonn, Geoffrey, primary, Natarajan, Shyam, additional, Margolis, Daniel, additional, Chang, Edward, additional, Macairan, Malu, additional, Lieu, Patricia, additional, Huang, Jiaoti, additional, Dorey, Frederick, additional, and Marks, Leonard, additional

Published
2013
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11. Targeted Prostate Biopsy in Select Men for Active Surveillance--Do the Epstein Criteria Still Apply?

Author

Hu, Jim C., Chang, Edward, Natarajan, Shyam, Margolis, Daniel J., Macairan, Malu, Lieu, Patricia, Jiaoti Huang, Sonn, Geoffrey, Dorey, Frederick J., and Marks, Leonard S.

Subjects
PROSTATE diseases, SURVEILLANCE detection, MAGNETIC resonance imaging, ULTRASONIC imaging, BIOPSY, THERAPEUTICS
Abstract

Purpose Established in 1994, the Epstein histological criteria (Gleason score 6 or less, 2 or fewer cores positive and 50% or less of any core) have been widely used to select men for active surveillance. However, with the advent of targeted biopsy, which may be more accurate than conventional biopsy, we reevaluated the likelihood of reclassification upon confirmatory rebiopsy using multiparametric magnetic resonance imaging-ultrasound fusion. Materials and Methods We identified 113 men enrolled in active surveillance at our institution who met Epstein criteria and subsequently underwent confirmatory targeted biopsy via multiparametric magnetic resonance imaging-ultrasound fusion. Median patient age was 64 years, median prostate specific antigen was 4.2 ng/ml and median prostate volume was 46.8 cc. Targets or regions of interest on multiparametric magnetic resonance imaging-ultrasound fusion were graded by suspicion level and biopsied at 3 mm intervals along the longest axis (median 10.5 mm). Also, 12 systematic cores were obtained during confirmatory rebiopsy. Our reporting is consistent with START (Standards of Reporting for MRI-targeted Biopsy Studies) criteria. Results Confirmatory fusion biopsy resulted in reclassification in 41 men (36%), including 26 (23%) due to Gleason grade 6 or greater and 15 (13%) due to high volume Gleason 6 disease. When stratified by suspicion on multiparametric magnetic resonance imaging-ultrasound fusion, the likelihood of reclassification was 24% to 29% for target grade 0 to 3, 45% for grade 4 and 100% for grade 5 (p = 0.001). Men with grade 4 and 5 vs lower grade targets were greater than 3 times more likely to be reclassified (OR 3.2, 95% CI 1.4-7.1, p = 0.006). Conclusions Upon confirmatory rebiopsy using multiparametric magnetic resonance imaging-ultrasound fusion men with high suspicion targets on imaging were reclassified 45% to 100% of the time. Criteria for active surveillance should be reevaluated when multiparametric magnetic resonance imaging-ultrasound fusion guided prostate biopsy is used. [ABSTRACT FROM AUTHOR]

Published
2014
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