Triona M. Walshe FFR(RCSI), Presenter: Nothing to Disclose

Rita Chiu MD, Abstract Co-Author: Nothing to Disclose

Hamidreza Abdi, Abstract Co-Author: Nothing to Disclose

Larry Goldenberg MD, Abstract Co-Author: Nothing to Disclose

Peter Black MD, Abstract Co-Author: Nothing to Disclose

Lindsay S. Machan MD, Abstract Co-Author: Medical Advisory Board, Boston Scientific Corporation Medical Advisory Board, Arsenal Medical Inc Steering Committee, Cook Group Incorporated Stockholder, Analytics 4 Life Stockholder, Calgary Scientific, Inc Stockholder, Harmonic Medical Stockholder, IKOMED Technogies Inc Stockholder, Nitinol Devices & Components, Inc

Alison Clare Harris MBChB, Abstract Co-Author: Nothing to Disclose

Silvia D. Chang MD, Abstract Co-Author: Nothing to Disclose

Steven Jepson MBChB, Abstract Co-Author: Nothing to Disclose

Graeme John McNeill MRCP, FFR(RCSI), Abstract Co-Author: Nothing to Disclose

Multi-parametric MRI (mpMRI) is assuming an increasingly important role in the detection of prostate cancer (PCa). PI-RADs (prostate imaging – reporting and data system) score utilizes the characteristics of lesions detected on mpMRI to determine the significance of these lesions. We correlated PI-RADs score and ADC values of lesions detected on mpMRI with the grade of cancer detected at fusion guided prostate biopsy.

We examined the biopsy results of 272 lesions detected by mpMRI (1.5T, no coil) in 165 patients at our institution between Jan 2008 and Aug 2013. The mpMRI was obtained in the context of active surveillance in 109 (40%) lesions and due to a rising PSA after prior negative biopsy in 163 (60%). MRI-guided TRUS biopsy was performed either cognitively (n= 111 (41%)) or with a MRI-US FUSION system from Hologic Inc., Bedford, MA (n= 161 (59%)). The detection of any cancer and of significant cancer (any Gleason pattern 4) was correlated with primary variables including PSA, PSA density, and lesion size, ADC value, and PI-RADS score using logistic regression.  

The mean patient age was 65± 6years (49-81) and the mean PSA was 13.6±10.6 ng/ml (0.3-62). Any PCa and significant PCa were detected in 77 (28%) and 54 (20%) of lesions, respectively. Any PCa and significant PCa were found in 18% and 7% of PI-RADS-3 lesions, 45% and 35% of PI-RADS-4 lesions, and 71% and 64% of PI-RADS-5 lesions, respectively. There was a correlation between PIRADS score and Gleason score (P=0.01). In univariate analysis, PSA density, smaller prostate volume, lesion size, ADC value, and the PI-RADS score were related to detection of both any PCa and significant PCa. All 16 PCa detected in 31 lesions with ADC<695 were significant. In multivariate analysis, statistically significant determinants of PCa and significant PCa were age (p = 0.04), PSA density (p = 0.007), and PI-RADS score (p = 0.01).

Characteristics of detected prostate lesions as determined on mpMRI can be used to predict the likelihood of detecting significant PCa on subsequent MRI-TRUS fusion biopsy. The prediction of the likelihood of significant cancer (any Gleason pattern 4) may help to determine future patient management and follow-up. 

Characteristics of detected prostate lesions as determined on mpMRI can be used to predict the likelihood of detecting significant PCa on subsequent MRI-TRUS fusion biopsy.

Walshe, T, Chiu, R, Abdi, H, Goldenberg, L, Black, P, Machan, L, Harris, A, Chang, S, Jepson, S, McNeill, G, Correlation between PI-RADS Score on mpMRI and Prostate Cancer Grade on Fusion-guided Prostate Biopsies.  Radiological Society of North America 2014 Scientific Assembly and Annual Meeting, - ,Chicago IL. http://archive.rsna.org/2014/14015211.html