Rui Wang PhD, Presenter: Nothing to Disclose

Xiaoying Wang MD, Abstract Co-Author: Nothing to Disclose

Jian Luo, Abstract Co-Author: Research Grant, General Electric Company

Ping Liu, Abstract Co-Author: Nothing to Disclose

To evaluate the role of MRI with PI-RADS in patients with clinical suspicion of prostate cancer (PCa) but negative initial biopsy by a long-term follow-up.

Patients with clinical suspicion of PCa (elevated serum PSA, abnormal digital rectal examination (DRE) or family history of PCa), undergoing prostate MRI before biopsy between July 2002 and December 2009, were recruited prospectively. Individual patients were followed in 2002-2013. Patients were included only if they met the following criteria: (a) negative initial biopsy; (b) final diagnosis of PCa by biopsy, surgical pathology, TURP or clinical comprehensive diagnosis. The ages and serum total PSA (TPSA) values within 3 months of prostate MRI were recorded. A three-point subjective suspicion score (SSS) based on PI-RADS was assigned to all focal abnormalities: SSS 1 referred to score 1 and 2 in PI-RADS (definitely or likely benign); SSS 2 referred to score 3 in PI-RADS (indeterminate); SSS 3 referred to score 4 and 5 in PI-RADS (likely or definitely malignant). Patients were divided into three groups based on grades of SSS. The times of biopsies, the delay between final diagnosis of PCa and initial negative biopsy, and the delay between final diagnosis of PCa and MRI were recorded. Non-parametric test was used to analyze the difference of biopsy times, delay between the final diagnosis of PCa and initial negative biopsy or MRI.

During 137 months of follow-up, of 1821 patients recruited, 44 patients (male; age: 59-82 years, median follow-up: 77.5 m) met the inclusion criteria. Of 44 patients, group SSS 1, SSS 2 and SSS 3 was 14 (32%), 6 (14%) and 24 (54%), respectively. There was no significant difference in ages or TPSA among three groups (P>0.05). The biopsy times of group SSS 3 were significantly less than group SSS 1 and SSS 2 (P=0.001). The median delay between final diagnosis of PCa and initial negative biopsy in group SSS 3 was 9.5 months, which was much lower than group SSS 1 (40.0 m) and SSS 2 (34.0 m) (P<0.05). Meanwhile, the median delay between final diagnosis of PCa and MRI in group SSS 3 was 11.0 months, which was significantly lower than group SSS 1 (42.0 m) and SSS 2 (34.50 m) (P<0.01).

Patients with SSS 3, even if with negative initial biopsy, still should be very alert to PCa.

MRI with PI-RADS can provide incremental value to patients with clinical suspicion of PCa but negative initial biopsy.

Wang, R, Wang, X, Luo, J, Liu, P, Evaluation of MR Imaging in Patients with Clinical Suspicion of Prostate Cancer but Negative Initial Prostate Biopsy: A Long-term Follow-up Study with PI-RADS.  Radiological Society of North America 2014 Scientific Assembly and Annual Meeting, - ,Chicago IL. http://archive.rsna.org/2014/14013758.html