Mp19-19 the Impact of Multiple Lesions in Prostate Mri-Insights From the Yau Prostate Cancer Group

You have accessJournal of UrologyProstate Cancer: Detection & Screening I (MP19)1 May 2024MP19-19 THE IMPACT OF MULTIPLE LESIONS IN PROSTATE MRI-INSIGHTS FROM THE YAU PROSTATE CANCER GROUP Fabio Zattoni, Giacomo Novara, Giancarlo Marra, Veeru Kasivisvanathan, Filippo Carletti, Guillaume Ploussard, Jonathan Olivier, Peter K. Chiu, Massimo Valerio, Alessandro Marquis, Paolo Gontero, Hongqian Guo, Junlong Zhuang, Francesco Barletta, Riccardo Leni, Giuseppe Cirulli, Alexander Kretschmer, Maria Apfelbeck, Claudia Kesch, Roderick van den Bergh, Alberto Briganti, Fabrizio Dal Moro, and Giorgio Gandaglia Fabio ZattoniFabio Zattoni , Giacomo NovaraGiacomo Novara , Giancarlo MarraGiancarlo Marra , Veeru KasivisvanathanVeeru Kasivisvanathan , Filippo CarlettiFilippo Carletti , Guillaume PloussardGuillaume Ploussard , Jonathan OlivierJonathan Olivier , Peter K. ChiuPeter K. Chiu , Massimo ValerioMassimo Valerio , Alessandro MarquisAlessandro Marquis , Paolo GonteroPaolo Gontero , Hongqian GuoHongqian Guo , Junlong ZhuangJunlong Zhuang , Francesco BarlettaFrancesco Barletta , Riccardo LeniRiccardo Leni , Giuseppe CirulliGiuseppe Cirulli , Alexander KretschmerAlexander Kretschmer , Maria ApfelbeckMaria Apfelbeck , Claudia KeschClaudia Kesch , Roderick van den BerghRoderick van den Bergh , Alberto BrigantiAlberto Briganti , Fabrizio Dal MoroFabrizio Dal Moro , and Giorgio GandagliaGiorgio Gandaglia View All Author Informationhttps://doi.org/10.1097/01.JU.0001008716.22569.77.19AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookLinked InTwitterEmail Abstract INTRODUCTION AND OBJECTIVE: on behalf of the EAU-YAU Prostate Cancer Working Party.Background:to assess the diagnostic value and risk of prostate cancer (PCa) and significant prostate cancer (csPCa, ISUP≥2) in additional lesions to the index lesion (IL) described at prostate mpMRI. METHODS: We included 1965 men with only one lesion (SL) and 847 men with multiple suspicious lesions (ML) identified in prostate mpMRI. Patients underwent subsequent targeted biopsies (TBx) of each lesion, along with a random biopsy (RBx). We compared TBx alone and TBx+RB biopsy, and evaluated whether the presence of ML increases the risk of PCa and csPCa using a multivariable logistic regression model (MVA) while accounting for confounders. When radical prostatectomy (RP) was performed, we assessed the concordance between biopsy results and final pathology using the interclass correlation coefficient (ICC). RESULTS: Overall, PCa was detected in 54.7% and 51.1% of IL-TBx for the SL and ML groups, respectively (p=0.8). The detection of csPCa with IL-TBx was 43.6% for SL and 36.6% for ML (p<0.01). When combining all TBx and RBx, PCa was detected in 65.7% for SL and 64.7% for ML (p=0.3), while csPCa was detected in 51.7% for SL and 47.8% for ML (p=0.06). Random biopsies yielded PCa detection rates of 55.7% for SL and 55% for ML (p=0.4) and csPCa detection rates of 38.4% for SL and 36.2% for ML (p=0.1). In the ML group, additional TBx revealed PCa in 32 cases (3.8%), and ISUP upgrading occurred in 21 of cases (2.5%). In the MVA, the presence of ML was not found to be an independent predictor of PCa but an independent predictor of csPCa in TBx (OR: 1.1, 95% CI: 1.1-1.7, p<0.01) and TBx+RBx (OR: 1.3, 95% CI: 1.0-1.6, p=0.02). The ICC for prostate biopsy results and final pathology was similar between SL (0.7, 95% CI: 0.6-0.7) and ML (0.7, 95% CI: 0.6-0.7). CONCLUSIONS: Our findings indicate that in case of multiple MRI lesions, TB of the IL lesion+concomitant RB allow diagnosing the vast majority of PCA and csPCA. Although the presence of ML was an independent predictor of csPCA, the added value of a second TB on non-index lesion is modest, including an increase in the diagnosis of csPCA of 2.5% only. Source of Funding: None © 2024 by American Urological Association Education and Research, Inc.FiguresReferencesRelatedDetails Volume 211Issue 5SMay 2024Page: e318 Advertisement Copyright & Permissions© 2024 by American Urological Association Education and Research, Inc.Metrics Author Information Fabio Zattoni More articles by this author Giacomo Novara More articles by this author Giancarlo Marra More articles by this author Veeru Kasivisvanathan More articles by this author Filippo Carletti More articles by this author Guillaume Ploussard More articles by this author Jonathan Olivier More articles by this author Peter K. Chiu More articles by this author Massimo Valerio More articles by this author Alessandro Marquis More articles by this author Paolo Gontero More articles by this author Hongqian Guo More articles by this author Junlong Zhuang More articles by this author Francesco Barletta More articles by this author Riccardo Leni More articles by this author Giuseppe Cirulli More articles by this author Alexander Kretschmer More articles by this author Maria Apfelbeck More articles by this author Claudia Kesch More articles by this author Roderick van den Bergh More articles by this author Alberto Briganti More articles by this author Fabrizio Dal Moro More articles by this author Giorgio Gandaglia More articles by this author Expand All Advertisement PDF downloadLoading ...