We investigated the association of MRI findings in men with a previous diagnosis of ASAP or multifocal HGPIN with pathologic findings on repeat biopsy.
We retrospectively reviewed patients with ASAP/multifocal HGPIN undergoing a repeat biopsy in the Michigan Urological Surgery Improvement Collaborative registry. We included men with and without an MRI after the index biopsy demonstrating ASAP/multifocal HGPIN but before the repeat biopsy. Men with an MRI prior to the index biopsy were excluded. We compared the proportion of men with ≥GG2 CaP on repeat biopsy among the following groups with the chi-squared test: no MRI, PIRADS ≥4, and PIRADS ≤3. Multivariable models were used to estimate the adjusted association between MRI findings and ≥GG2 CaP on repeat biopsy.
Among the 207 men with a previous diagnosis of ASAP/multifocal HGPIN that underwent a repeat biopsy, men with a PIRADS ≥4 lesion had a higher proportion of ≥GG2 CaP (56%) compared with men without an MRI (12%, P < .001). A lower proportion of men with PIRADS ≤3 lesions had ≥GG2 CaP (3.0%) compared with men without a MRI (12%, P = .13). In the adjusted model, men with a PIRADS 4-5 lesion had higher odds (OR:11.4, P < .001) of ≥GG2 CaP on repeat biopsy.
MRI is a valuable diagnostic tool to triage which men with a history of ASAP or multifocal HGPIN on initial biopsy should undergo or avoid repeat biopsy without missing clinically significant CaP.
The Journal of urology. 2023 Nov 06 [Epub ahead of print]
Michael S Sessine, Codrut S Radoiu, Ji Qi, Corinne Labardee, Frank Burks, Arvin K George, Brian R Lane, Kenneth Lim, Ali Dabaja, Todd M Morgan, Michael L Cher, Alice M Semerjian, Kevin B Ginsburg
Wayne State University, Department of Urology, Detroit, Michigan., Univeristy of Michigan, Department of Urology, Ann Arbor, Michigan., Oakland University William Beaumont School of Medicine, Department of Urology, Royal Oak, Michigan., Division of Urology, Corewell Health, Grand Rapids, Michigan., Detroit Medical Center, Detroit, Michigan., Vattikuti Urology Institute, Henry Ford Health System, Detroit, Michigan.