Prior Negative Biopsy, PSA Density, and Anatomic Location Impact Cancer Detection Rate of MRI-Targeted PI-RADS Index Lesions

Ahmad N. Alzubaidi; Amy Zheng; Mohammad Said; Xuanjia Fan; Michael Maidaa; R. Grant Owens; Max Yudovich; Suraj Pursnani; R. Scott Owens; Thomas Stringer; Chad R. Tracy; Jay D. Raman

doi:10.3390/curroncol31080329

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Prior Negative Biopsy, PSA Density, and Anatomic Location Impact Cancer Detection Rate of MRI-Targeted PI-RADS Index Lesions

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Prior Negative Biopsy, PSA Density, and Anatomic Location Impact Cancer Detection Rate of MRI-Targeted PI-RADS Index Lesions

Ahmad N. Alzubaidi, Amy Zheng, Mohammad Said, Xuanjia Fan, Michael Maidaa, R. Grant Owens, Max Yudovich, Suraj Pursnani, R. Scott Owens, Thomas Stringer, …

Current oncology (Toronto), Vol.31(8), pp.4406-4413

08/01/2024

DOI: 10.3390/curroncol31080329

PMCID: PMC11353048

PMID: 39195312

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Abstract

Background: MRI fusion prostate biopsy has improved the detection of clinically significant prostate cancer (CSC). Continued refinements in predicting the pre-biopsy probability of CSC are essential for optimal patient counseling. We investigated potential factors related to improved cancer detection rates (CDR) of CSC in patients with PI-RADS ≥ 3 lesions. Methods: The pathology of 980 index lesions in 980 patients sampled by transrectal mpMRI-targeted prostate biopsy across four medical centers between 2017–2020 was reviewed. PI-RADS lesion distribution included 291 PI-RADS-5, 374 PI-RADS-4, and 315 PI-RADS-3. We compared CDR of index PI-RADS ≥ 3 lesions based on location (TZ) vs. (PZ), PSA density (PSAD), and history of prior negative conventional transrectal ultrasound-guided biopsy (TRUS). Results: Mean age, PSA, prostate volume, and level of prior negative TRUS biopsy were 66 years (43–90), 7.82 ng/dL (5.6–11.2), 54 cm3 (12–173), and 456/980 (46.5%), respectively. Higher PSAD, no prior history of negative TRUS biopsy, and PZ lesions were associated with higher CDR. Stratified CDR highlighted significant variance across subgroups. CDR for a PI-RADS-5 score, PZ lesion with PSAD ≥ 0.15, and prior negative biopsy was 77%. Conversely, the CDR rate for a PI-RADS-4 score, TZ lesion with PSAD < 0.15, and prior negative biopsy was significantly lower at 14%. Conclusions: For index PI-RADS ≥ 3 lesions, CDR varied significantly based on location, prior history of negative TRUS biopsy, and PSAD. Such considerations are critical when counseling on the merits and potential yield of prostate needle biopsy.

fusion prostate biopsy

PI-RADS

magnetic resonance imaging

PSA density

Details

Title: Subtitle: Prior Negative Biopsy, PSA Density, and Anatomic Location Impact Cancer Detection Rate of MRI-Targeted PI-RADS Index Lesions
Creators: Ahmad N. Alzubaidi - Penn State Milton S. Hershey Medical Center
Amy Zheng - Penn State Milton S. Hershey Medical Center
Mohammad Said - University of Iowa Hospitals and Clinics
Xuanjia Fan - Penn State Milton S. Hershey Medical Center
Michael Maidaa - Florida College
R. Grant Owens - University of Iowa
Max Yudovich - Penn State Milton S. Hershey Medical Center
Suraj Pursnani - Penn State Milton S. Hershey Medical Center
R. Scott Owens - UPMC Central Pa
Thomas Stringer - Florida College
Chad R. Tracy - University of Iowa
Jay D. Raman - Penn State Milton S. Hershey Medical Center
Resource Type: Journal article
Publication Details: Current oncology (Toronto), Vol.31(8), pp.4406-4413
Publisher: MDPI
DOI: 10.3390/curroncol31080329
PMID: 39195312
PMCID: PMC11353048
ISSN: 1718-7729
eISSN: 1718-7729
Grant note: Penn State Health No Shave November Education and Research Fund.
Language: English
Date published: 08/01/2024
Academic Unit: Radiology; Urology
Record Identifier: 9984691511902771

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