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Negative multiparametric magnetic resonance imaging for prostate cancer: further outcome and consequences

PURPOSE: EAU guidelines recommend multiparametric MRI of the prostate (mpMRI) prior to biopsy to increase accuracy and reduce biopsies. Whether biopsy can be avoided in case of negative mpMRI remains unclear. Aim of this study is to evaluate predictors of overall prostate cancer (PCa) in negative mp...

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Autores principales: Haack, Maximilian, Miksch, Vanessa, Tian, Zhe, Duwe, Gregor, Thomas, Anita, Borkowetz, Angelika, Stroh, Kristina, Thomas, Christian, Haferkamp, Axel, Höfner, Thomas, Boehm, Katharina
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Springer Berlin Heidelberg 2022
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9712318/
https://www.ncbi.nlm.nih.gov/pubmed/36318314
http://dx.doi.org/10.1007/s00345-022-04197-8
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author Haack, Maximilian
Miksch, Vanessa
Tian, Zhe
Duwe, Gregor
Thomas, Anita
Borkowetz, Angelika
Stroh, Kristina
Thomas, Christian
Haferkamp, Axel
Höfner, Thomas
Boehm, Katharina
author_facet Haack, Maximilian
Miksch, Vanessa
Tian, Zhe
Duwe, Gregor
Thomas, Anita
Borkowetz, Angelika
Stroh, Kristina
Thomas, Christian
Haferkamp, Axel
Höfner, Thomas
Boehm, Katharina
author_sort Haack, Maximilian
collection PubMed
description PURPOSE: EAU guidelines recommend multiparametric MRI of the prostate (mpMRI) prior to biopsy to increase accuracy and reduce biopsies. Whether biopsy can be avoided in case of negative mpMRI remains unclear. Aim of this study is to evaluate predictors of overall prostate cancer (PCa) in negative mpMRI. METHODS: A total of 216 patients from 2018 to 2020 with suspicion of PCa and negative mpMRI (PI-RADS ≤ 2) were interviewed by telephone about outcome and further follow-up. Clinically significant PCa (csPCa) was defined as ISUP ≥ 2. Patients with vs. without biopsy and with vs. without PCa were compared. Univariate and multivariate analyses were performed to evaluate predictors of PCa occurrence in patients with negative mpMRI. RESULTS: 15.7% and 5.1% of patients with PI-RADS ≤ 2 on mpMRI showed PCa and csPCa, respectively. PCa patients had higher PSAD (0.14 vs. 0.09 ng/ml(2); p = 0.001) and lower prostate volume (50.5 vs. 74.0 ml; p = 0.003). Patients without biopsy (25%) after MRI were older (69 vs. 65.5 years; p = 0.027), showed lower PSA (5.7 vs. 6.73 ng/ml; p = 0.033) and lower PSA density (0.09 vs. 0.1 ng/ml(2); p = 0.027). Multivariate analysis revealed age (OR 1.09 [1.02–1.16]; p = 0.011), prostate volume (OR 0.982 [0.065; 0.997]; p = 0.027), total PSA level (OR 1.22 [1.01–1.47], p = 0.033), free PSA (OR 0.431 [0.177; 0.927]; p = 0.049) and no PI-RADS lesion vs PI-RADS 1–2 lesion (OR 0.38 [0.15–0.91], p = 0.032.) as predictive factors for the endpoint presence of PCa. CONCLUSIONS: Biopsy for selected patient groups (higher age, prostate volume and free PSA as well as lower PSA-Density) with negative mpMRI can be avoided, if sufficient follow-up care is guaranteed. Detailed counseling regarding residual risk for undetected prostate cancer should be mandatory.
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spelling pubmed-97123182022-12-02 Negative multiparametric magnetic resonance imaging for prostate cancer: further outcome and consequences Haack, Maximilian Miksch, Vanessa Tian, Zhe Duwe, Gregor Thomas, Anita Borkowetz, Angelika Stroh, Kristina Thomas, Christian Haferkamp, Axel Höfner, Thomas Boehm, Katharina World J Urol Original Article PURPOSE: EAU guidelines recommend multiparametric MRI of the prostate (mpMRI) prior to biopsy to increase accuracy and reduce biopsies. Whether biopsy can be avoided in case of negative mpMRI remains unclear. Aim of this study is to evaluate predictors of overall prostate cancer (PCa) in negative mpMRI. METHODS: A total of 216 patients from 2018 to 2020 with suspicion of PCa and negative mpMRI (PI-RADS ≤ 2) were interviewed by telephone about outcome and further follow-up. Clinically significant PCa (csPCa) was defined as ISUP ≥ 2. Patients with vs. without biopsy and with vs. without PCa were compared. Univariate and multivariate analyses were performed to evaluate predictors of PCa occurrence in patients with negative mpMRI. RESULTS: 15.7% and 5.1% of patients with PI-RADS ≤ 2 on mpMRI showed PCa and csPCa, respectively. PCa patients had higher PSAD (0.14 vs. 0.09 ng/ml(2); p = 0.001) and lower prostate volume (50.5 vs. 74.0 ml; p = 0.003). Patients without biopsy (25%) after MRI were older (69 vs. 65.5 years; p = 0.027), showed lower PSA (5.7 vs. 6.73 ng/ml; p = 0.033) and lower PSA density (0.09 vs. 0.1 ng/ml(2); p = 0.027). Multivariate analysis revealed age (OR 1.09 [1.02–1.16]; p = 0.011), prostate volume (OR 0.982 [0.065; 0.997]; p = 0.027), total PSA level (OR 1.22 [1.01–1.47], p = 0.033), free PSA (OR 0.431 [0.177; 0.927]; p = 0.049) and no PI-RADS lesion vs PI-RADS 1–2 lesion (OR 0.38 [0.15–0.91], p = 0.032.) as predictive factors for the endpoint presence of PCa. CONCLUSIONS: Biopsy for selected patient groups (higher age, prostate volume and free PSA as well as lower PSA-Density) with negative mpMRI can be avoided, if sufficient follow-up care is guaranteed. Detailed counseling regarding residual risk for undetected prostate cancer should be mandatory. Springer Berlin Heidelberg 2022-11-01 2022 /pmc/articles/PMC9712318/ /pubmed/36318314 http://dx.doi.org/10.1007/s00345-022-04197-8 Text en © The Author(s) 2022 https://creativecommons.org/licenses/by/4.0/Open AccessThis article is licensed under a Creative Commons Attribution 4.0 International License, which permits use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons licence, and indicate if changes were made. The images or other third party material in this article are included in the article's Creative Commons licence, unless indicated otherwise in a credit line to the material. If material is not included in the article's Creative Commons licence and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will need to obtain permission directly from the copyright holder. To view a copy of this licence, visit http://creativecommons.org/licenses/by/4.0/ (https://creativecommons.org/licenses/by/4.0/) .
spellingShingle Original Article
Haack, Maximilian
Miksch, Vanessa
Tian, Zhe
Duwe, Gregor
Thomas, Anita
Borkowetz, Angelika
Stroh, Kristina
Thomas, Christian
Haferkamp, Axel
Höfner, Thomas
Boehm, Katharina
Negative multiparametric magnetic resonance imaging for prostate cancer: further outcome and consequences
title Negative multiparametric magnetic resonance imaging for prostate cancer: further outcome and consequences
title_full Negative multiparametric magnetic resonance imaging for prostate cancer: further outcome and consequences
title_fullStr Negative multiparametric magnetic resonance imaging for prostate cancer: further outcome and consequences
title_full_unstemmed Negative multiparametric magnetic resonance imaging for prostate cancer: further outcome and consequences
title_short Negative multiparametric magnetic resonance imaging for prostate cancer: further outcome and consequences
title_sort negative multiparametric magnetic resonance imaging for prostate cancer: further outcome and consequences
topic Original Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9712318/
https://www.ncbi.nlm.nih.gov/pubmed/36318314
http://dx.doi.org/10.1007/s00345-022-04197-8
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