Multiparametric magnetic resonance imaging and follow‐up to avoid prostate biopsy in 4259 men

Objective To determine the proportion of men avoiding biopsy because of negative multiparametric magnetic resonance imaging (mpMRI) findings in a prostate MRI expert centre, and to assess the number of clinically significant prostate cancers (csPCa) detected during follow‐up. Patients and methods Re...

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Bibliographic Details
Published in:BJU international 2019-11, Vol.124 (5), p.775-784
Main Authors: Venderink, Wulphert, Luijtelaar, Annemarijke, Leest, Marloes, Barentsz, Jelle O., Jenniskens, Sjoerd F.M., Sedelaar, Michiel J.P., Hulsbergen‐van de Kaa, Christina, Overduin, Christiaan G., Fütterer, Jurgen J.
Format: Article
Language:English
Subjects:
Biopsy
Lesions
Magnetic resonance imaging
mpMRI
NMR
Nuclear magnetic resonance
PCSM
PI‐RADS
prostate
Prostate cancer
ProstateCancer
Regression analysis
Ultrasound
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Summary:Objective To determine the proportion of men avoiding biopsy because of negative multiparametric magnetic resonance imaging (mpMRI) findings in a prostate MRI expert centre, and to assess the number of clinically significant prostate cancers (csPCa) detected during follow‐up. Patients and methods Retrospective study of 4259 consecutive men having mpMRI of the prostate between January 2012 and December 2017, with either a history of previous negative transrectal ultrasonography‐guided biopsy or biopsy naïve. Patients underwent mpMRI in a referral centre. Lesions were classified according to Prostate Imaging Reporting And Data System (PI‐RADS) versions 1 and 2. Negative mpMRI was defined as an index lesion PI‐RADS ≤2. Follow‐up until 13 October 2018 was collected by searching the Dutch Pathology Registry (PALGA). Gleason score ≥3 + 4 was considered csPCa. Kaplan–Meier analysis and univariable logistic regression models were used in the cohort of patients with negative mpMRI and follow‐up. Results Overall, in 53.6% (2281/4259) of patients had a lesion classified as PI‐RADS ≤2. In 320 patients with PI‐RADS 1 or 2, follow‐up mpMRI was obtained after a median (interquartile range) of 57 (41–63) months. In those patients, csPCa diagnosis‐free survival (DFS) was 99.6% after 3 years. Univariable logistic regression analysis revealed age as a predictor for csPCa during follow‐up (P 
ISSN:1464-4096
1464-410X
DOI:10.1111/bju.14853