Association of Baseline MRI PI-RADS Score With Prostate Cancer Active Surveillance Early Biopsy Reclassification: Data From the Michigan Urological Surgery Improvement Collaborative (MUSIC)

No AccessJournal of UrologyOriginal Clinical Article25 Jun 2024Association of Baseline MRI PI-RADS Score With Prostate Cancer Active Surveillance Early Biopsy Reclassification: Data From the Michigan Urological Surgery Improvement Collaborative (MUSIC) Kiran R. Nandalur, Chen Shen, Lil Zhao, Sayf Al-Katib, Joseph Lee, Brian Seifman, Hong Ye, Kevin Ginsburg, Thomas Quinn, Sirisha Nandalur, Arvin George, David Gangwish, Abhay Dhaliwal, Connor Erwin, Amanda Young, Akram Albeer, and Jason Hafron Kiran R. NandalurKiran R. Nandalur Corresponding Author: Kiran R. Nandalur, MD, Department of Radiology and Molecular Imaging, Corewell Health William Beaumont University Hospital, Oakland University William Beaumont School of Medicine, Royal Oak, MI 48073 ( (email protected) ). https://orcid.org/0000-0003-2690-1651 , Chen ShenChen Shen Biostatistics and Health Informatics, Corewell Health Research Institute, Royal Oak, Michigan , Lil ZhaoLil Zhao Biostatistics and Health Informatics, Corewell Health Research Institute, Royal Oak, Michigan , Sayf Al-KatibSayf Al-Katib Department of Radiology and Molecular Imaging, William Beaumont University Hospital, Royal Oak, Michigan , Joseph LeeJoseph Lee Department of Radiation Oncology, William Beaumont University Hospital, Royal Oak, Michigan , Brian SeifmanBrian Seifman Department of Urology, William Beaumont University Hospital, Royal Oak, Michigan Michigan Institute of Urology, West Bloomfield, Michigan , Hong YeHong Ye Department of Radiation Oncology, William Beaumont University Hospital, Royal Oak, Michigan , Kevin GinsburgKevin Ginsburg Department of Urology, Wayne State University, Detroit, Michigan , Thomas QuinnThomas Quinn Department of Radiation Oncology, William Beaumont University Hospital, Royal Oak, Michigan , Sirisha NandalurSirisha Nandalur Department of Radiation Oncology, William Beaumont University Hospital, Royal Oak, Michigan , Arvin GeorgeArvin George Brady Urological Institute, Johns Hopkins University, Baltimore, Maryland , David GangwishDavid Gangwish Department of Urology, William Beaumont University Hospital, Royal Oak, Michigan , Abhay DhaliwalAbhay Dhaliwal Department of Radiology and Molecular Imaging, William Beaumont University Hospital, Royal Oak, Michigan , Connor ErwinConnor Erwin Michigan Institute of Urology, West Bloomfield, Michigan , Amanda YoungAmanda Young Michigan Institute of Urology, West Bloomfield, Michigan , Akram AlbeerAkram Albeer Michigan Institute of Urology, West Bloomfield, Michigan , and Jason HafronJason Hafron Department of Urology, William Beaumont University Hospital, Royal Oak, Michigan Michigan Institute of Urology, West Bloomfield, Michigan View All Author Informationhttps://doi.org/10.1097/JU.0000000000004117AboutPDF Cite Export CitationSelect Citation formatNLMIEEEACMAPAChicagoMLAHarvardTips on citation downloadDownload citationCopy citation ToolsAdd to favoritesTrack Citations ShareFacebookLinked InTwitterEmail Abstract Purpose: The purpose of our study was to evaluate the association of baseline MRI PI-RADS score with biopsy reclassification in a multicenter active surveillance cohort. Methods: We identified men in the Michigan Urological Surgery Improvement Collaborative registry (46 hospital based/academic/private practice urology groups) with NCCN low risk and favorable intermediate risk prostate cancer who underwent MRI within 6 months before or after initial biopsy and enrolled in active surveillance (AS) from June 2016 to January 2021. The primary objective was to determine the association of baseline MRI PI-RADS score (≥4 lesion) with reclassification to high-grade prostate cancer (≥grade group 3) on surveillance biopsy. Multivariable Cox proportional hazards regression models were constructed and adjusted for pathologic, MRI, and clinical/biopsy factors, with landmark time of 6 months from diagnostic biopsy. We included an interaction term between PI-RADS score and NCCN group in the Cox model. Results: Total of 1491 men were included with median age 64 years (interquartile range (IQ): 59-69) with median follow-up 11.0 months (IQ: 6.0-23.0) after landmark. Baseline PI-RADS ≥ 4 lesion was associated with an increased hazard of biopsy reclassification (Hazard ratio (HR): 2.3 (95% confidence interval (CI): 1.6-3.2), P < .001), along with grade group 2 vs 1 (HR: 2.5 (95%CI: 1.7-3.7), P < .001), and increasing age (per 10 years) (HR: 1.8 (95%CI: 1.4-2.4), P < .001). The interaction between NCCN risk group with MRI findings was not significant (P = .7). Conclusion: In this multicenter cohort study of real-world data, baseline MRI PI-RADS score was significantly associated with early biopsy reclassification in men undergoing active surveillance with NCCN low or favorable intermediate risk prostate cancer. © 2024 by American Urological Association Education and Research, Inc.FiguresReferencesRelatedDetails Advertisement Copyright & Permissions© 2024 by American Urological Association Education and Research, Inc.Keywordsprostate canceractive surveillancemagnetic resonance imagingMetrics Author Information Kiran R. Nandalur Corresponding Author: Kiran R. Nandalur, MD, Department of Radiology and Molecular Imaging, Corewell Health William Beaumont University Hospital, Oakland University William Beaumont School of Medicine, Royal Oak, MI 48073 ( (email protected) ). 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