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PI‐RADS 3 score: A retrospective experience of clinically significant prostate cancer detection
Rationale and objectives The study aims to propose an optimal workflow in patients with a PI‐RADS 3 (PR‐3) assessment category (AC) through determining the timing and type of pathology interrogation used for the detection of clinically significant prostate cancer (csPCa) in these men based upon a 5‐...
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| Published in: | BJUI compass 2023-07, Vol.4 (4), p.473-481 |
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| creator | Camacho, Andrés Salah, Fatima Bay, Camden P. Waring, Jonathan Umeton, Renato Hirsch, Michelle S. Cole, Alexander P. Kibel, Adam S. Loda, Massimo Tempany, Clare M. Fennessy, Fiona M. |
| description | Rationale and objectives
The study aims to propose an optimal workflow in patients with a PI‐RADS 3 (PR‐3) assessment category (AC) through determining the timing and type of pathology interrogation used for the detection of clinically significant prostate cancer (csPCa) in these men based upon a 5‐year retrospective review in a large academic medical center.
Materials and methods
This United States Health Insurance Probability and Accountability Act (HIPAA)‐compliant, institutional review board‐approved retrospective study included men without prior csPCa diagnosis who received PR‐3 AC on magnetic resonance (MR) imaging (MRI). Subsequent incidence and time to csPCa diagnosis and number/type of prostate interventions was recorded. Categorical data were compared using Fisher's exact test and continuous data using ANOVA omnibus F‐test.
Results
Our cohort of 3238 men identified 332 who received PR‐3 as their highest AC on MRI, 240 (72.3%) of whom had pathology follow‐up within 5 years. csPCa was detected in 76/240 (32%) and non‐csPCa in 109/240 (45%) within 9.0 ± 10.6 months. Using a non‐targeted trans‐rectal ultrasound biopsy as the initial approach (n = 55), another diagnostic procedure was required to diagnose csPCa in 42/55 (76.4%) of men, compared with 3/21(14.3%) men with an initial MR targeted‐biopsy approach (n = 21); (p |
| doi_str_mv | 10.1002/bco2.231 |
| format | article |
| fullrecord | <record><control><sourceid>proquest_doaj_</sourceid><recordid>TN_cdi_doaj_primary_oai_doaj_org_article_3b8230abaeff42dfbb3c80fcff5d522a</recordid><sourceformat>XML</sourceformat><sourcesystem>PC</sourcesystem><doaj_id>oai_doaj_org_article_3b8230abaeff42dfbb3c80fcff5d522a</doaj_id><sourcerecordid>2827664207</sourcerecordid><originalsourceid>FETCH-LOGICAL-c5331-51a36636f2eff6556d8230e563825fb1cf95cf273a2068d9c841ef52f8cb4da03</originalsourceid><addsrcrecordid>eNp1ks1uEzEQxy0EolWoxBMgS1y4bPHH2utwQSEUiFSpiI-z5fWOgyNnvdibQm59BJ6RJ8FLSmmROI3H_s_Po_kPQo8pOaWEsOetjeyUcXoPHTOpVFULJu_fOh-hk5w3pEg55Q0nD9FRCbwmrD5G5v3q59WPD4vXHzHH2cYEL_ACJxhTzAPY0V8Chu8DJA-9BRwdtsH33poQ9jj7de9dSfoRD6VgNCPgkllIuINxKo_9I_TAmZDh5DrO0Oc3Z5-W76rzi7er5eK8soJzWglquJRcOgbOSSFkpxgnICRXTLiWWjcX1rGGG0ak6uZW1RScYE7Ztu4M4TO0OnC7aDZ6SH5r0l5H4_Xvi5jW2qTR2wCatxPbtKZ8VbPOtS23ijjrnOgEY6awXh5Yw67dQmehH5MJd6B3X3r_Ra_jpaakjF0oUQjPrgkpft1BHvXWZwshmB7iLmumWCNlzUhTpE__kW7iLvVlVkU1Jw0pHtZ_gbYMOidwN91Qoqc90NMe6MnjGXpyu_sb4R_Xi6A6CL75APv_gvSr5QWbgL8Ae6u9Bw</addsrcrecordid><sourcetype>Open Website</sourcetype><iscdi>true</iscdi><recordtype>article</recordtype><pqid>2890705264</pqid></control><display><type>article</type><title>PI‐RADS 3 score: A retrospective experience of clinically significant prostate cancer detection</title><source>Publicly Available Content Database (Proquest) (PQ_SDU_P3)</source><source>Wiley_OA刊</source><source>PubMed</source><creator>Camacho, Andrés ; Salah, Fatima ; Bay, Camden P. ; Waring, Jonathan ; Umeton, Renato ; Hirsch, Michelle S. ; Cole, Alexander P. ; Kibel, Adam S. ; Loda, Massimo ; Tempany, Clare M. ; Fennessy, Fiona M.</creator><creatorcontrib>Camacho, Andrés ; Salah, Fatima ; Bay, Camden P. ; Waring, Jonathan ; Umeton, Renato ; Hirsch, Michelle S. ; Cole, Alexander P. ; Kibel, Adam S. ; Loda, Massimo ; Tempany, Clare M. ; Fennessy, Fiona M.</creatorcontrib><description>Rationale and objectives
The study aims to propose an optimal workflow in patients with a PI‐RADS 3 (PR‐3) assessment category (AC) through determining the timing and type of pathology interrogation used for the detection of clinically significant prostate cancer (csPCa) in these men based upon a 5‐year retrospective review in a large academic medical center.
Materials and methods
This United States Health Insurance Probability and Accountability Act (HIPAA)‐compliant, institutional review board‐approved retrospective study included men without prior csPCa diagnosis who received PR‐3 AC on magnetic resonance (MR) imaging (MRI). Subsequent incidence and time to csPCa diagnosis and number/type of prostate interventions was recorded. Categorical data were compared using Fisher's exact test and continuous data using ANOVA omnibus F‐test.
Results
Our cohort of 3238 men identified 332 who received PR‐3 as their highest AC on MRI, 240 (72.3%) of whom had pathology follow‐up within 5 years. csPCa was detected in 76/240 (32%) and non‐csPCa in 109/240 (45%) within 9.0 ± 10.6 months. Using a non‐targeted trans‐rectal ultrasound biopsy as the initial approach (n = 55), another diagnostic procedure was required to diagnose csPCa in 42/55 (76.4%) of men, compared with 3/21(14.3%) men with an initial MR targeted‐biopsy approach (n = 21); (p < 0.0001). Those with csPCa had higher median serum prostate‐specific antigen (PSA) and PSA density, and lower median prostate volume (p < 0.003) compared with non‐csPCa/no PCa.
Conclusion
Most patients with PR‐3 AC underwent prostate pathology exams within 5 years, 32% of whom were found to have csPCa within 1 year of MRI, most often with a higher PSA density and a prior non‐csPCa diagnosis. Addition of a targeted biopsy approach initially reduced the need for a second biopsy to reach a for csPCa diagnosis. Thus, a combination of systematic and targeted biopsy is advised in men with PR‐3 and a co‐existing abnormal PSA and PSA density.</description><identifier>ISSN: 2688-4526</identifier><identifier>EISSN: 2688-4526</identifier><identifier>DOI: 10.1002/bco2.231</identifier><identifier>PMID: 37334024</identifier><language>eng</language><publisher>United States: John Wiley & Sons, Inc</publisher><subject>Biopsy ; clinically significant prostate cancer ; Data collection ; Magnetic resonance imaging ; multiparametric prostate MRI ; Original ; Pathology ; Patients ; PI‐RADS 3 assessment category ; Prostate cancer ; Ultrasonic imaging</subject><ispartof>BJUI compass, 2023-07, Vol.4 (4), p.473-481</ispartof><rights>2023 The Authors. published by John Wiley & Sons Ltd on behalf of BJU International Company.</rights><rights>2023 The Authors. BJUI Compass published by John Wiley & Sons Ltd on behalf of BJU International Company.</rights><rights>2023. This work is published under http://creativecommons.org/licenses/by/4.0/ (the “License”). Notwithstanding the ProQuest Terms and Conditions, you may use this content in accordance with the terms of the License.</rights><lds50>peer_reviewed</lds50><oa>free_for_read</oa><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c5331-51a36636f2eff6556d8230e563825fb1cf95cf273a2068d9c841ef52f8cb4da03</citedby><cites>FETCH-LOGICAL-c5331-51a36636f2eff6556d8230e563825fb1cf95cf273a2068d9c841ef52f8cb4da03</cites><orcidid>0000-0002-6009-3996</orcidid></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktopdf>$$Uhttps://www.proquest.com/docview/2890705264/fulltextPDF?pq-origsite=primo$$EPDF$$P50$$Gproquest$$Hfree_for_read</linktopdf><linktohtml>$$Uhttps://www.proquest.com/docview/2890705264?pq-origsite=primo$$EHTML$$P50$$Gproquest$$Hfree_for_read</linktohtml><link.rule.ids>230,314,727,780,784,885,11562,25753,27924,27925,37012,37013,44590,46052,46476,53791,53793,75126</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/37334024$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Camacho, Andrés</creatorcontrib><creatorcontrib>Salah, Fatima</creatorcontrib><creatorcontrib>Bay, Camden P.</creatorcontrib><creatorcontrib>Waring, Jonathan</creatorcontrib><creatorcontrib>Umeton, Renato</creatorcontrib><creatorcontrib>Hirsch, Michelle S.</creatorcontrib><creatorcontrib>Cole, Alexander P.</creatorcontrib><creatorcontrib>Kibel, Adam S.</creatorcontrib><creatorcontrib>Loda, Massimo</creatorcontrib><creatorcontrib>Tempany, Clare M.</creatorcontrib><creatorcontrib>Fennessy, Fiona M.</creatorcontrib><title>PI‐RADS 3 score: A retrospective experience of clinically significant prostate cancer detection</title><title>BJUI compass</title><addtitle>BJUI Compass</addtitle><description>Rationale and objectives
The study aims to propose an optimal workflow in patients with a PI‐RADS 3 (PR‐3) assessment category (AC) through determining the timing and type of pathology interrogation used for the detection of clinically significant prostate cancer (csPCa) in these men based upon a 5‐year retrospective review in a large academic medical center.
Materials and methods
This United States Health Insurance Probability and Accountability Act (HIPAA)‐compliant, institutional review board‐approved retrospective study included men without prior csPCa diagnosis who received PR‐3 AC on magnetic resonance (MR) imaging (MRI). Subsequent incidence and time to csPCa diagnosis and number/type of prostate interventions was recorded. Categorical data were compared using Fisher's exact test and continuous data using ANOVA omnibus F‐test.
Results
Our cohort of 3238 men identified 332 who received PR‐3 as their highest AC on MRI, 240 (72.3%) of whom had pathology follow‐up within 5 years. csPCa was detected in 76/240 (32%) and non‐csPCa in 109/240 (45%) within 9.0 ± 10.6 months. Using a non‐targeted trans‐rectal ultrasound biopsy as the initial approach (n = 55), another diagnostic procedure was required to diagnose csPCa in 42/55 (76.4%) of men, compared with 3/21(14.3%) men with an initial MR targeted‐biopsy approach (n = 21); (p < 0.0001). Those with csPCa had higher median serum prostate‐specific antigen (PSA) and PSA density, and lower median prostate volume (p < 0.003) compared with non‐csPCa/no PCa.
Conclusion
Most patients with PR‐3 AC underwent prostate pathology exams within 5 years, 32% of whom were found to have csPCa within 1 year of MRI, most often with a higher PSA density and a prior non‐csPCa diagnosis. Addition of a targeted biopsy approach initially reduced the need for a second biopsy to reach a for csPCa diagnosis. Thus, a combination of systematic and targeted biopsy is advised in men with PR‐3 and a co‐existing abnormal PSA and PSA density.</description><subject>Biopsy</subject><subject>clinically significant prostate cancer</subject><subject>Data collection</subject><subject>Magnetic resonance imaging</subject><subject>multiparametric prostate MRI</subject><subject>Original</subject><subject>Pathology</subject><subject>Patients</subject><subject>PI‐RADS 3 assessment category</subject><subject>Prostate cancer</subject><subject>Ultrasonic imaging</subject><issn>2688-4526</issn><issn>2688-4526</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2023</creationdate><recordtype>article</recordtype><sourceid>24P</sourceid><sourceid>PIMPY</sourceid><sourceid>DOA</sourceid><recordid>eNp1ks1uEzEQxy0EolWoxBMgS1y4bPHH2utwQSEUiFSpiI-z5fWOgyNnvdibQm59BJ6RJ8FLSmmROI3H_s_Po_kPQo8pOaWEsOetjeyUcXoPHTOpVFULJu_fOh-hk5w3pEg55Q0nD9FRCbwmrD5G5v3q59WPD4vXHzHH2cYEL_ACJxhTzAPY0V8Chu8DJA-9BRwdtsH33poQ9jj7de9dSfoRD6VgNCPgkllIuINxKo_9I_TAmZDh5DrO0Oc3Z5-W76rzi7er5eK8soJzWglquJRcOgbOSSFkpxgnICRXTLiWWjcX1rGGG0ak6uZW1RScYE7Ztu4M4TO0OnC7aDZ6SH5r0l5H4_Xvi5jW2qTR2wCatxPbtKZ8VbPOtS23ijjrnOgEY6awXh5Yw67dQmehH5MJd6B3X3r_Ra_jpaakjF0oUQjPrgkpft1BHvXWZwshmB7iLmumWCNlzUhTpE__kW7iLvVlVkU1Jw0pHtZ_gbYMOidwN91Qoqc90NMe6MnjGXpyu_sb4R_Xi6A6CL75APv_gvSr5QWbgL8Ae6u9Bw</recordid><startdate>202307</startdate><enddate>202307</enddate><creator>Camacho, Andrés</creator><creator>Salah, Fatima</creator><creator>Bay, Camden P.</creator><creator>Waring, Jonathan</creator><creator>Umeton, Renato</creator><creator>Hirsch, Michelle S.</creator><creator>Cole, Alexander P.</creator><creator>Kibel, Adam S.</creator><creator>Loda, Massimo</creator><creator>Tempany, Clare M.</creator><creator>Fennessy, Fiona M.</creator><general>John Wiley & Sons, Inc</general><general>John Wiley and Sons Inc</general><general>Wiley</general><scope>24P</scope><scope>WIN</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>3V.</scope><scope>7X7</scope><scope>7XB</scope><scope>8FI</scope><scope>8FJ</scope><scope>8FK</scope><scope>ABUWG</scope><scope>AFKRA</scope><scope>AZQEC</scope><scope>BENPR</scope><scope>CCPQU</scope><scope>DWQXO</scope><scope>FYUFA</scope><scope>GHDGH</scope><scope>K9.</scope><scope>M0S</scope><scope>PIMPY</scope><scope>PQEST</scope><scope>PQQKQ</scope><scope>PQUKI</scope><scope>PRINS</scope><scope>7X8</scope><scope>5PM</scope><scope>DOA</scope><orcidid>https://orcid.org/0000-0002-6009-3996</orcidid></search><sort><creationdate>202307</creationdate><title>PI‐RADS 3 score: A retrospective experience of clinically significant prostate cancer detection</title><author>Camacho, Andrés ; Salah, Fatima ; Bay, Camden P. ; Waring, Jonathan ; Umeton, Renato ; Hirsch, Michelle S. ; Cole, Alexander P. ; Kibel, Adam S. ; Loda, Massimo ; Tempany, Clare M. ; Fennessy, Fiona M.</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c5331-51a36636f2eff6556d8230e563825fb1cf95cf273a2068d9c841ef52f8cb4da03</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2023</creationdate><topic>Biopsy</topic><topic>clinically significant prostate cancer</topic><topic>Data collection</topic><topic>Magnetic resonance imaging</topic><topic>multiparametric prostate MRI</topic><topic>Original</topic><topic>Pathology</topic><topic>Patients</topic><topic>PI‐RADS 3 assessment category</topic><topic>Prostate cancer</topic><topic>Ultrasonic imaging</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Camacho, Andrés</creatorcontrib><creatorcontrib>Salah, Fatima</creatorcontrib><creatorcontrib>Bay, Camden P.</creatorcontrib><creatorcontrib>Waring, Jonathan</creatorcontrib><creatorcontrib>Umeton, Renato</creatorcontrib><creatorcontrib>Hirsch, Michelle S.</creatorcontrib><creatorcontrib>Cole, Alexander P.</creatorcontrib><creatorcontrib>Kibel, Adam S.</creatorcontrib><creatorcontrib>Loda, Massimo</creatorcontrib><creatorcontrib>Tempany, Clare M.</creatorcontrib><creatorcontrib>Fennessy, Fiona M.</creatorcontrib><collection>Wiley_OA刊</collection><collection>Wiley Free Archive</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>ProQuest Central (Corporate)</collection><collection>ProQuest_Health & Medical Collection</collection><collection>ProQuest Central (purchase pre-March 2016)</collection><collection>Hospital Premium Collection</collection><collection>Hospital Premium Collection (Alumni Edition)</collection><collection>ProQuest Central (Alumni) (purchase pre-March 2016)</collection><collection>ProQuest Central (Alumni)</collection><collection>ProQuest Central</collection><collection>ProQuest Central Essentials</collection><collection>AUTh Library subscriptions: ProQuest Central</collection><collection>ProQuest One Community College</collection><collection>ProQuest Central Korea</collection><collection>Health Research Premium Collection</collection><collection>Health Research Premium Collection (Alumni)</collection><collection>ProQuest Health & Medical Complete (Alumni)</collection><collection>Health & Medical Collection (Alumni Edition)</collection><collection>Publicly Available Content Database (Proquest) (PQ_SDU_P3)</collection><collection>ProQuest One Academic Eastern Edition (DO NOT USE)</collection><collection>ProQuest One Academic</collection><collection>ProQuest One Academic UKI Edition</collection><collection>ProQuest Central China</collection><collection>MEDLINE - Academic</collection><collection>PubMed Central (Full Participant titles)</collection><collection>Directory of Open Access Journals</collection><jtitle>BJUI compass</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Camacho, Andrés</au><au>Salah, Fatima</au><au>Bay, Camden P.</au><au>Waring, Jonathan</au><au>Umeton, Renato</au><au>Hirsch, Michelle S.</au><au>Cole, Alexander P.</au><au>Kibel, Adam S.</au><au>Loda, Massimo</au><au>Tempany, Clare M.</au><au>Fennessy, Fiona M.</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>PI‐RADS 3 score: A retrospective experience of clinically significant prostate cancer detection</atitle><jtitle>BJUI compass</jtitle><addtitle>BJUI Compass</addtitle><date>2023-07</date><risdate>2023</risdate><volume>4</volume><issue>4</issue><spage>473</spage><epage>481</epage><pages>473-481</pages><issn>2688-4526</issn><eissn>2688-4526</eissn><abstract>Rationale and objectives
The study aims to propose an optimal workflow in patients with a PI‐RADS 3 (PR‐3) assessment category (AC) through determining the timing and type of pathology interrogation used for the detection of clinically significant prostate cancer (csPCa) in these men based upon a 5‐year retrospective review in a large academic medical center.
Materials and methods
This United States Health Insurance Probability and Accountability Act (HIPAA)‐compliant, institutional review board‐approved retrospective study included men without prior csPCa diagnosis who received PR‐3 AC on magnetic resonance (MR) imaging (MRI). Subsequent incidence and time to csPCa diagnosis and number/type of prostate interventions was recorded. Categorical data were compared using Fisher's exact test and continuous data using ANOVA omnibus F‐test.
Results
Our cohort of 3238 men identified 332 who received PR‐3 as their highest AC on MRI, 240 (72.3%) of whom had pathology follow‐up within 5 years. csPCa was detected in 76/240 (32%) and non‐csPCa in 109/240 (45%) within 9.0 ± 10.6 months. Using a non‐targeted trans‐rectal ultrasound biopsy as the initial approach (n = 55), another diagnostic procedure was required to diagnose csPCa in 42/55 (76.4%) of men, compared with 3/21(14.3%) men with an initial MR targeted‐biopsy approach (n = 21); (p < 0.0001). Those with csPCa had higher median serum prostate‐specific antigen (PSA) and PSA density, and lower median prostate volume (p < 0.003) compared with non‐csPCa/no PCa.
Conclusion
Most patients with PR‐3 AC underwent prostate pathology exams within 5 years, 32% of whom were found to have csPCa within 1 year of MRI, most often with a higher PSA density and a prior non‐csPCa diagnosis. Addition of a targeted biopsy approach initially reduced the need for a second biopsy to reach a for csPCa diagnosis. Thus, a combination of systematic and targeted biopsy is advised in men with PR‐3 and a co‐existing abnormal PSA and PSA density.</abstract><cop>United States</cop><pub>John Wiley & Sons, Inc</pub><pmid>37334024</pmid><doi>10.1002/bco2.231</doi><tpages>9</tpages><orcidid>https://orcid.org/0000-0002-6009-3996</orcidid><oa>free_for_read</oa></addata></record> |
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| subjects | Biopsy clinically significant prostate cancer Data collection Magnetic resonance imaging multiparametric prostate MRI Original Pathology Patients PI‐RADS 3 assessment category Prostate cancer Ultrasonic imaging |
| title | PI‐RADS 3 score: A retrospective experience of clinically significant prostate cancer detection |
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