Prostate cancer gene 3 (PCA3) is of additional predictive value in patients with PI-RADS grade III (intermediate) lesions in the MR-guided re-biopsy setting for prostate cancer

• Published in: World journal of urology 2016-04, Vol.34 (4), p.509-515
• Main Authors: Kaufmann, S., Bedke, J., Gatidis, S., Hennenlotter, J., Kramer, U., Notohamiprodjo, M., Nikolaou, K., Stenzl, A., Kruck, S.
• Format: Article
• Language: English
• Subjects: Aged; Antigens, Neoplasm - genetics; Antigens, Neoplasm - urine; Biomarkers, Tumor - genetics; Biomarkers, Tumor - urine; Diagnosis, Differential; Follow-Up Studies; Humans; Image-Guided Biopsy - methods; Magnetic Resonance Imaging - methods; Male; Medicine; Medicine & Public Health; Middle Aged; Nephrology; Oncology; Original Article; Prostate - diagnostic imaging; Prostatic Neoplasms - diagnosis; Prostatic Neoplasms - genetics; Prostatic Neoplasms - urine; Retrospective Studies; RNA, Neoplasm - genetics; ROC Curve; Urology
• ISSN: 0724-4983; 1433-8726
• DOI: 10.1007/s00345-015-1655-8

Purpose Multiparametric magnetic resonance imaging (mpMRI) improves diagnostic accuracy in re-biopsies of men with prostate cancer (PC) suspicion, but predictive value is limited despite the use of the new Prostate Imaging Reporting and Data System (PI-RADS). Prognostic value of the PC-specific biomarker prostate cancer gene 3 (PCA3) added to the PI-RADS score was evaluated. Methods The study was a retrospective analysis of the institutional database for men with MR-guided biopsy (MR-GB) for suspicious lesion in mpMRI and who had an additional pre-MR-GB PCA3 testing for ongoing PC suspicion. All men had ≥1 negative ultrasound GB. Lesions were retrospectively scored by PI-RADS in three MRI sequences (T2w, DCE, and DWI). PCA3 was analyzed with cutoffs of 25 and 35. The prognostic value of mpMRI and PCA3 and the additional value of both were explored. Results Tumor detection rate (49 men, mean PSA 10 ng/ml, lesion size 40 mm 2 ) was 45 % (22/49 patients). In the subgroup of PI-RADS IV°, 17/17 patients had PC; in PI-RADS III° (intermediate) 5/15 had PC, and all 5 had a PCA3 >35. PCA3 >35 had no additional prognostic value in the whole cohort. Out of the 10/15 PC negative patients (PI-RADS III°), PCA3 was