Back to Search Start Over

Negative multiparametric magnetic resonance imaging for prostate cancer: further outcome and consequences.

Negative multiparametric magnetic resonance imaging for prostate cancer: further outcome and consequences.

Authors :
Haack, Maximilian
Miksch, Vanessa
Tian, Zhe
Duwe, Gregor
Thomas, Anita
Borkowetz, Angelika
Stroh, Kristina
Thomas, Christian
Haferkamp, Axel
Höfner, Thomas
Boehm, Katharina
Source :
World Journal of Urology. Dec2022, Vol. 40 Issue 12, p2947-2954. 8p.
Publication Year :
2022

Abstract

Purpose: EAU guidelines recommend multiparametric MRI of the prostate (mpMRI) prior to biopsy to increase accuracy and reduce biopsies. Whether biopsy can be avoided in case of negative mpMRI remains unclear. Aim of this study is to evaluate predictors of overall prostate cancer (PCa) in negative mpMRI. Methods: A total of 216 patients from 2018 to 2020 with suspicion of PCa and negative mpMRI (PI-RADS ≤ 2) were interviewed by telephone about outcome and further follow-up. Clinically significant PCa (csPCa) was defined as ISUP ≥ 2. Patients with vs. without biopsy and with vs. without PCa were compared. Univariate and multivariate analyses were performed to evaluate predictors of PCa occurrence in patients with negative mpMRI. Results: 15.7% and 5.1% of patients with PI-RADS ≤ 2 on mpMRI showed PCa and csPCa, respectively. PCa patients had higher PSAD (0.14 vs. 0.09 ng/ml2; p = 0.001) and lower prostate volume (50.5 vs. 74.0 ml; p = 0.003). Patients without biopsy (25%) after MRI were older (69 vs. 65.5 years; p = 0.027), showed lower PSA (5.7 vs. 6.73 ng/ml; p = 0.033) and lower PSA density (0.09 vs. 0.1 ng/ml2; p = 0.027). Multivariate analysis revealed age (OR 1.09 [1.02–1.16]; p = 0.011), prostate volume (OR 0.982 [0.065; 0.997]; p = 0.027), total PSA level (OR 1.22 [1.01–1.47], p = 0.033), free PSA (OR 0.431 [0.177; 0.927]; p = 0.049) and no PI-RADS lesion vs PI-RADS 1–2 lesion (OR 0.38 [0.15–0.91], p = 0.032.) as predictive factors for the endpoint presence of PCa. Conclusions: Biopsy for selected patient groups (higher age, prostate volume and free PSA as well as lower PSA-Density) with negative mpMRI can be avoided, if sufficient follow-up care is guaranteed. Detailed counseling regarding residual risk for undetected prostate cancer should be mandatory. [ABSTRACT FROM AUTHOR]

Details

Language :
English
ISSN :
07244983
Volume :
40
Issue :
12
Database :
Academic Search Index
Journal :
World Journal of Urology
Publication Type :
Academic Journal
Accession number :
160503974
Full Text :
https://doi.org/10.1007/s00345-022-04197-8