This multicenter study included all consecutive men with a PSA <=15 ng/ml who were biopsy naïve or had a previous negative biopsy. All patients underwent both a mpMRI and either a TRUS-biopsy or a transperineal biopsy between 2014 and 2018. The authors used the definitions of clinically significant prostate cancer according to the ones used in the PROMIS study:
- Definition 1 – Gleason score >=4+3, or a maximum core length >=6 mm
- Definition 2 – Gleason score >=3+4 or MCCL >=4 mm
- Any Gleason score 7 at a whole gland level
- PROMIS definition 1 – was 91.4% (Figure 1)
- PROMIS definition 2 – was 83.4%
- Gleason score 7 – was 87.1% (Figure 2)
The authors concluded that in this “real-world” multicenter study, mpMRI was able to detect and rule-out clinically significant prostate cancer. The negative predictive value found in the PROMIS trial was reproducible in this study, reinforcing the use of mpMRI to allow approximately 1 in 3 men to avoid an immediate prostate biopsy.
Figure 1 – PROMIS definition 1 results:
Figure 2 – Any Gleason score 7 results:
Presented by: Tom Stonier King's College Hospital, Dept. of Urology, London, United Kingdom
Written by: Hanan Goldberg, MD, Urologic Oncology Fellow (SUO), University of Toronto, Princess Margaret Cancer Centre @GoldbergHanan at the 34th European Association of Urology (EAU 2019) #EAU19 conference in Barcelona Spain, March 15-19, 2019.