To determine the association between multiple regions of interest (ROI) on pre-biopsy magnetic resonance imaging (MRI) and the detection of clinically significant prostate cancer (CSPC) in men undergoing MRI ultrasound fusion biopsy (Fbx).
We performed a retrospective, single-institution analysis of men who underwent fusion biopsy. Men with prior positive biopsies, MRIs performed at outside institutions and MRIs prior to release of Prostate Imaging Reporting and Data System (PI-RADS) version 2 were excluded, resulting in 381 subjects. Independent variables modeled included age, number of ROIs with PI-RADS categorization ≥ 3, body-mass index (BMI), prostate-specific antigen (PSA), prostate volume, and PI-RADS. Multivariable logistic regression was utilized to determine factors associated with finding CSPC (Gleason ≥ 7) on biopsy.
Median age was 67.2, interquartile range [IQR] (61.6-73.0) years. Median PSA was 6.6 [5.0-10.0] ng/mL. Adjusted analysis demonstrated that age (OR 1.10, 95% CI 1.06-1.15, p = <0.001), BMI (OR 1.08, 95% CI 1.01-1.16, p = 0.038), and PSA (OR 1.06, 95% CI 1.01-1.10, p =0.015) were associated with detection of CSPC. PI-RADS categories 4 OR 4.62 (95% CI 2.23-9.33, p<0.001) and 5 OR 6.75 (95% CI 2.72-16.71, p<0.001) were associated with greater odds of CSPC, respectively. Multiple ROI was not associated with detection of CSPC OR 1.05 (95% CI 0.60-1.84, p = 0.857).
Multiple ROI do not portend a greater likelihood of finding CSPC. Physicians should recognize that multiple ROI should not influence the decision to perform Fbx, and our findings may ease patient anxiety concerning these findings.
The Journal of urology. 2018 Mar 05 [Epub ahead of print]
Neal Patel, Joshua A Halpern, Khushabu Kasabwala, Eliza Cricco-Lizza, Michael Herman, Daniel Margolis, Chris Xu, Brian D Robinson, Yi Wang, Timothy Mcclure, Jim C Hu
Department of Urology, Weill Cornell Medicine, New York, NY., Division of Urology, South Nassau Communities Hospital, Oceanside, NY., Department of Radiology, Weill Cornell Medicine, New York, NY., School of Applied and Engineering Physics, Cornell University, Ithaca NY., Department of Urology, Weill Cornell Medicine, New York, NY; Department of Pathology and Laboratory Medicine, Weill Cornell Medicine, New York, NY., Department of Radiology, Weill Cornell Medicine, Cornell University, New York, NY., Department of Urology, Weill Cornell Medicine, New York, NY. Electronic address: .