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Regional Histopathology and Prostate MRI Positivity: A Secondary Analysis of the PROMIS Trial

BACKGROUND: The effects of regional histopathologic changes on prostate MRI scans have not been accurately quantified in men with an elevated prostate-specific antigen (PSA) level and no previous biopsy. PURPOSE: To assess how Gleason grade, maximum cancer core length (MCCL), inflammation, prostatic...

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Autores principales: Stavrinides, Vasilis, Norris, Joseph M., Karapanagiotis, Solon, Giganti, Francesco, Grey, Alistair, Trahearn, Nick, Freeman, Alex, Haider, Aiman, Echeverría, Lina María Carmona, Bott, Simon R. J., Brown, Louise C., Burns-Cox, Nicholas, Dudderidge, Timothy J., Bosaily, Ahmed El-Shater, Ghei, Maneesh, Henderson, Alastair, Hindley, Richard G., Kaplan, Richard S., Oldroyd, Robert, Parker, Chris, Persad, Raj, Rosario, Derek J., Shergill, Iqbal S., Winkler, Mathias, Kirkham, Alex, Punwani, Shonit, Whitaker, Hayley C., Ahmed, Hashim U., Emberton, Mark
Formato: Online Artículo Texto
Lenguaje:English
Publicado: 2023
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7614676/
https://www.ncbi.nlm.nih.gov/pubmed/36511804
http://dx.doi.org/10.1148/radiol.220762
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author Stavrinides, Vasilis
Norris, Joseph M.
Karapanagiotis, Solon
Giganti, Francesco
Grey, Alistair
Trahearn, Nick
Freeman, Alex
Haider, Aiman
Echeverría, Lina María Carmona
Bott, Simon R. J.
Brown, Louise C.
Burns-Cox, Nicholas
Dudderidge, Timothy J.
Bosaily, Ahmed El-Shater
Ghei, Maneesh
Henderson, Alastair
Hindley, Richard G.
Kaplan, Richard S.
Oldroyd, Robert
Parker, Chris
Persad, Raj
Rosario, Derek J.
Shergill, Iqbal S.
Winkler, Mathias
Kirkham, Alex
Punwani, Shonit
Whitaker, Hayley C.
Ahmed, Hashim U.
Emberton, Mark
author_facet Stavrinides, Vasilis
Norris, Joseph M.
Karapanagiotis, Solon
Giganti, Francesco
Grey, Alistair
Trahearn, Nick
Freeman, Alex
Haider, Aiman
Echeverría, Lina María Carmona
Bott, Simon R. J.
Brown, Louise C.
Burns-Cox, Nicholas
Dudderidge, Timothy J.
Bosaily, Ahmed El-Shater
Ghei, Maneesh
Henderson, Alastair
Hindley, Richard G.
Kaplan, Richard S.
Oldroyd, Robert
Parker, Chris
Persad, Raj
Rosario, Derek J.
Shergill, Iqbal S.
Winkler, Mathias
Kirkham, Alex
Punwani, Shonit
Whitaker, Hayley C.
Ahmed, Hashim U.
Emberton, Mark
author_sort Stavrinides, Vasilis
collection PubMed
description BACKGROUND: The effects of regional histopathologic changes on prostate MRI scans have not been accurately quantified in men with an elevated prostate-specific antigen (PSA) level and no previous biopsy. PURPOSE: To assess how Gleason grade, maximum cancer core length (MCCL), inflammation, prostatic intraepithelial neoplasia (PIN), or atypical small acinar proliferation within a Barzell zone affects the odds of MRI visibility. MATERIALS AND METHODS: In this secondary analysis of the Prostate MRI Imaging Study (PROMIS; May 2012 to November 2015), consecutive participants who underwent multiparametric MRI followed by a combined biopsy, including 5-mm transperineal mapping (TPM), were evaluated. TPM pathologic findings were reported at the whole-prostate level and for each of 20 Barzell zones per prostate. An expert panel blinded to the pathologic findings reviewed MRI scans and declared which Barzell areas spanned Likert score 3–5 lesions. The relationship of Gleason grade and MCCL to zonal MRI outcome (visible vs nonvisible) was assessed using generalized linear mixed-effects models with random intercepts for individual participants. Inflammation, PIN, and atypical small acinar proliferation were similarly assessed in men who had negative TPM results. RESULTS: Overall, 161 men (median age, 62 years [IQR, 11 years]) were evaluated and 3179 Barzell zones were assigned MRI status. Compared with benign areas, the odds of MRI visibility were higher when a zone contained cancer with a Gleason score of 3+4 (odds ratio [OR], 3.1; 95% CI: 1.9, 4.9; P < .001) or Gleason score greater than or equal to 4+3 (OR, 8.7; 95% CI: 4.5, 17.0; P < .001). MCCL also determined visibility (OR, 1.24 per millimeter increase; 95% CI: 1.15, 1.33; P < .001), but odds were lower with each prostate volume doubling (OR, 0.7; 95% CI: 0.5, 0.9). In men who were TPM-negative, the presence of PIN increased the odds of zonal visibility (OR, 3.7; 95% CI: 1.5, 9.1; P = .004). CONCLUSION: An incremental relationship between cancer burden and prostate MRI visibility was observed. Prostatic intraepithelial neoplasia contributed to false-positive MRI findings. ClinicalTrials.gov registration no. NCT01292291
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spelling pubmed-76146762023-06-20 Regional Histopathology and Prostate MRI Positivity: A Secondary Analysis of the PROMIS Trial Stavrinides, Vasilis Norris, Joseph M. Karapanagiotis, Solon Giganti, Francesco Grey, Alistair Trahearn, Nick Freeman, Alex Haider, Aiman Echeverría, Lina María Carmona Bott, Simon R. J. Brown, Louise C. Burns-Cox, Nicholas Dudderidge, Timothy J. Bosaily, Ahmed El-Shater Ghei, Maneesh Henderson, Alastair Hindley, Richard G. Kaplan, Richard S. Oldroyd, Robert Parker, Chris Persad, Raj Rosario, Derek J. Shergill, Iqbal S. Winkler, Mathias Kirkham, Alex Punwani, Shonit Whitaker, Hayley C. Ahmed, Hashim U. Emberton, Mark Radiology Article BACKGROUND: The effects of regional histopathologic changes on prostate MRI scans have not been accurately quantified in men with an elevated prostate-specific antigen (PSA) level and no previous biopsy. PURPOSE: To assess how Gleason grade, maximum cancer core length (MCCL), inflammation, prostatic intraepithelial neoplasia (PIN), or atypical small acinar proliferation within a Barzell zone affects the odds of MRI visibility. MATERIALS AND METHODS: In this secondary analysis of the Prostate MRI Imaging Study (PROMIS; May 2012 to November 2015), consecutive participants who underwent multiparametric MRI followed by a combined biopsy, including 5-mm transperineal mapping (TPM), were evaluated. TPM pathologic findings were reported at the whole-prostate level and for each of 20 Barzell zones per prostate. An expert panel blinded to the pathologic findings reviewed MRI scans and declared which Barzell areas spanned Likert score 3–5 lesions. The relationship of Gleason grade and MCCL to zonal MRI outcome (visible vs nonvisible) was assessed using generalized linear mixed-effects models with random intercepts for individual participants. Inflammation, PIN, and atypical small acinar proliferation were similarly assessed in men who had negative TPM results. RESULTS: Overall, 161 men (median age, 62 years [IQR, 11 years]) were evaluated and 3179 Barzell zones were assigned MRI status. Compared with benign areas, the odds of MRI visibility were higher when a zone contained cancer with a Gleason score of 3+4 (odds ratio [OR], 3.1; 95% CI: 1.9, 4.9; P < .001) or Gleason score greater than or equal to 4+3 (OR, 8.7; 95% CI: 4.5, 17.0; P < .001). MCCL also determined visibility (OR, 1.24 per millimeter increase; 95% CI: 1.15, 1.33; P < .001), but odds were lower with each prostate volume doubling (OR, 0.7; 95% CI: 0.5, 0.9). In men who were TPM-negative, the presence of PIN increased the odds of zonal visibility (OR, 3.7; 95% CI: 1.5, 9.1; P = .004). CONCLUSION: An incremental relationship between cancer burden and prostate MRI visibility was observed. Prostatic intraepithelial neoplasia contributed to false-positive MRI findings. ClinicalTrials.gov registration no. NCT01292291 2023-04-01 2022-12-13 /pmc/articles/PMC7614676/ /pubmed/36511804 http://dx.doi.org/10.1148/radiol.220762 Text en https://creativecommons.org/licenses/by/4.0/This work is licensed under a CC BY 4.0 (https://creativecommons.org/licenses/by/4.0/) International license.
spellingShingle Article
Stavrinides, Vasilis
Norris, Joseph M.
Karapanagiotis, Solon
Giganti, Francesco
Grey, Alistair
Trahearn, Nick
Freeman, Alex
Haider, Aiman
Echeverría, Lina María Carmona
Bott, Simon R. J.
Brown, Louise C.
Burns-Cox, Nicholas
Dudderidge, Timothy J.
Bosaily, Ahmed El-Shater
Ghei, Maneesh
Henderson, Alastair
Hindley, Richard G.
Kaplan, Richard S.
Oldroyd, Robert
Parker, Chris
Persad, Raj
Rosario, Derek J.
Shergill, Iqbal S.
Winkler, Mathias
Kirkham, Alex
Punwani, Shonit
Whitaker, Hayley C.
Ahmed, Hashim U.
Emberton, Mark
Regional Histopathology and Prostate MRI Positivity: A Secondary Analysis of the PROMIS Trial
title Regional Histopathology and Prostate MRI Positivity: A Secondary Analysis of the PROMIS Trial
title_full Regional Histopathology and Prostate MRI Positivity: A Secondary Analysis of the PROMIS Trial
title_fullStr Regional Histopathology and Prostate MRI Positivity: A Secondary Analysis of the PROMIS Trial
title_full_unstemmed Regional Histopathology and Prostate MRI Positivity: A Secondary Analysis of the PROMIS Trial
title_short Regional Histopathology and Prostate MRI Positivity: A Secondary Analysis of the PROMIS Trial
title_sort regional histopathology and prostate mri positivity: a secondary analysis of the promis trial
topic Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7614676/
https://www.ncbi.nlm.nih.gov/pubmed/36511804
http://dx.doi.org/10.1148/radiol.220762
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