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Do 5-Alpha Reductase Inhibitors Influence the Features of Suspicious Lesions on Magnetic Resonance Imaging and Targeted Biopsy Results for Prostate Cancer Diagnosis?

Authors :
Ziv Savin
Avishay Shem-Tov Dlugy
Miri Grinbaum
Tomer Mendelson
Karin Lifshitz
Roy Mano
Gal Keren-Paz
Yuval Bar-Yosef
Rina Neeman
Ofer Yossepowitch
Snir Dekalo
Source :
Diagnostics, Vol 14, Iss 22, p 2567 (2024)
Publication Year :
2024
Publisher :
MDPI AG, 2024.

Abstract

Background: 5-alpha reductase inhibitors (5-ARIs) change hormonal pathways and reduce prostate size. We evaluated the effects of 5-ARIs on prostatic multiparametric magnetic resonance imaging (mpMRI) suspicious findings and in the identification of prostate cancer using targeted biopsies. Methods: We conducted a retrospective study including 600 consecutive patients who, between 2017 and 2021, underwent combined transperineal fusion biopsies. Primary outcomes were Prostate Imaging Reporting and Data System version 2 (PIRADS v2) scores and the identification of clinically significant prostate cancer from suspicious lesions (targeted CSPC). Outcomes were compared between patients treated with 5-ARIs for a minimum of 6 months and the other patients. Results: Patients treated with 5-ARIs were older (p < 0.001) with higher rates of previous prostate biopsies (p = 0.004). PIRADS scores were 3, 4, and 5 in 15 (29%), 28 (54%), and 9 (17%) patients among the 5-ARI group and 130 (24%), 308 (56%), and 110 (20%) patients among the others, and the scores were not different between the groups (p = 0.69). The targeted CSPC identification rate among 5-ARI patients was 31%, not different compared to the non-5-ARI group (p = 1). Rates of targeted CSPC for each PIRADS score were not affected by 5-ARI treatment. The 5-ARI was not associated with neither PIRADS ≥ 4 score nor targeted CSPC on logistic regression analyses (OR = 0.76, 95% CI 0.4–1.4 and OR = 1.02, 95% CI 0.5–1.9, respectively). Conclusions: 5-ARI treatment is not associated with PIRADS score alterations or targeted biopsy results. Patients treated by 5-ARIs with suspicious lesions should not be addressed differently during the mpMRI-related diagnostic process.

Details

Language :
English
ISSN :
20754418
Volume :
14
Issue :
22
Database :
Directory of Open Access Journals
Journal :
Diagnostics
Publication Type :
Academic Journal
Accession number :
edsdoj.0edcbb8085c8488a8564eac81e569c3b
Document Type :
article
Full Text :
https://doi.org/10.3390/diagnostics14222567