Pd26-07 Mri-Guided Active Surveillance in Patients With Isup 1 Prostate Cancer—a Multi-Institutional Validation of the Discrimination of the Precise Score

You have accessJournal of UrologyProstate Cancer: Localized: Active Surveillance II (PD26)1 May 2024PD26-07 MRI-GUIDED ACTIVE SURVEILLANCE IN PATIENTS WITH ISUP 1 PROSTATE CANCER—A MULTI-INSTITUTIONAL VALIDATION OF THE DISCRIMINATION OF THE PRECISE SCORE Nikita Sushentsev, Manuel Wiesenfarth, Martin Dixius, Christof Kastner, Angelika Borkowetz, Ivan Platzek, Christian Thomas, Claudia Kesch, Lale Umutlu, Henning Reis, Tilmann Rau, Lotte Lenders, Martin Spahn, Matthias Boschheidgen, Gerald Antoch, Peter Albers, Tristan Barrett, Lars Schimmöller, Boris Hadaschik, and Jan Philipp Radtke Nikita SushentsevNikita Sushentsev , Manuel WiesenfarthManuel Wiesenfarth , Martin DixiusMartin Dixius , Christof KastnerChristof Kastner , Angelika BorkowetzAngelika Borkowetz , Ivan PlatzekIvan Platzek , Christian ThomasChristian Thomas , Claudia KeschClaudia Kesch , Lale UmutluLale Umutlu , Henning ReisHenning Reis , Tilmann RauTilmann Rau , Lotte LendersLotte Lenders , Martin SpahnMartin Spahn , Matthias BoschheidgenMatthias Boschheidgen , Gerald AntochGerald Antoch , Peter AlbersPeter Albers , Tristan BarrettTristan Barrett , Lars SchimmöllerLars Schimmöller , Boris HadaschikBoris Hadaschik , and Jan Philipp RadtkeJan Philipp Radtke View All Author Informationhttps://doi.org/10.1097/01.JU.0001008556.20565.76.07AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookLinked InTwitterEmail Abstract INTRODUCTION AND OBJECTIVE: There is evidence that multiparametric magnetic resonance imaging (mpMRI) may avoid repeat prostate biopsies in monitoring of patients during active surveillance (AS) for prostate cancer (PC). Particularly, serial MR scans are widely investigated using the PRECISE criteria. To assess the ability of PRECISE criteria to predict ISUP GG upgrading of men with ISUP GG1 on AS in a multi-institutional cohort. METHODS: Retrospective analysis of men from four centers (Cambridge, Düsseldorf, Dresden, Essen). After AS inclusion with mpMRI and MRI/TRUS fusion-guided biopsy, all men underwent serial mpMRI and MRI/TRUS fusion-guided biopsy subsequently. Patients with at least 2 MR scans and two biopsies (baseline and follow-up, the latter after the 2nd scan) were included. PRECISE recommendations evaluate the radiological change on serial imaging using a 1-to-5 scale in which PRECISE 1 or 2 indicates radiological regression, PRECISE 3 stability and PRECISE 4 or 5 imply progression. Sensitivity, specificity, positive (PPV) and negative predictive values (NPV) of MRI progress (PRECISE≥4) for ISUP GG upgrading were calculated and plotted using Cumulative incidence curves, including log-rank tests for equality of cumulative incidence curve. RESULTS: In total, 396 men were available for analysis. Median follow-up was 36 months. Histopathological progression occurred in n=73 men (18%). For PRECISE 1-2 (n=27, 7% of cases) no progression occurred. In PRECISE 3 (n=254, 69%) progression rate was 4% and in PRECISE 4-5 (n=87, 24%) 36%. Sensitivity, specificity, PPV and NPV for PRECISE≥4 was 74%, 88%, 57% and 94%. Accuracy was 85%. Cumulative incidence curves are given in the Figure 1. Log-Rank-test demonstrated statistical significance (p<0.001) for PRECISE 4-5. CONCLUSIONS: This multi-institutional study has validated that a dedicated MRI-based scoring system of serial MRI scans can reliably aid to predict histopathological progress of men on AS within a median follow-up timespan of 36 months. In particular, men with MR progression are significantly at risk of ISUP GG upgrading. Download PPT Source of Funding: None © 2024 by American Urological Association Education and Research, Inc.FiguresReferencesRelatedDetails Volume 211Issue 5SMay 2024Page: e547 Advertisement Copyright & Permissions© 2024 by American Urological Association Education and Research, Inc.Metrics Author Information Nikita Sushentsev More articles by this author Manuel Wiesenfarth More articles by this author Martin Dixius More articles by this author Christof Kastner More articles by this author Angelika Borkowetz More articles by this author Ivan Platzek More articles by this author Christian Thomas More articles by this author Claudia Kesch More articles by this author Lale Umutlu More articles by this author Henning Reis More articles by this author Tilmann Rau More articles by this author Lotte Lenders More articles by this author Martin Spahn More articles by this author Matthias Boschheidgen More articles by this author Gerald Antoch More articles by this author Peter Albers More articles by this author Tristan Barrett More articles by this author Lars Schimmöller More articles by this author Boris Hadaschik More articles by this author Jan Philipp Radtke More articles by this author Expand All Advertisement PDF downloadLoading ...