Mp18-05 Echogenicity Enhances Risk Assessment of Lesions on Mp-Mri for Clinically Significant Prostate Cancer

You have accessJournal of UrologyImaging/Uroradiology I (MP18)1 May 2024MP18-05 ECHOGENICITY ENHANCES RISK ASSESSMENT OF LESIONS ON MP-MRI FOR CLINICALLY SIGNIFICANT PROSTATE CANCER Garret Wegner, Amir Khan, Michael Panagos, Shu Wang, Alexa J. Van Besien, Michael Naslund, and Mohummad Minhaj Siddiqui Garret WegnerGarret Wegner , Amir KhanAmir Khan , Michael PanagosMichael Panagos , Shu WangShu Wang , Alexa J. Van BesienAlexa J. Van Besien , Michael NaslundMichael Naslund , and Mohummad Minhaj SiddiquiMohummad Minhaj Siddiqui View All Author Informationhttps://doi.org/10.1097/01.JU.0001008672.83391.ed.05AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookLinked InTwitterEmail Abstract INTRODUCTION AND OBJECTIVE: The combination of Multiparametric Magnetic Resonance Imaging (MP-MRI)/ultrasound-guided fusion biopsy, which is a targeted biopsy technique, is gaining prominence as an alternative for diagnosing Prostate cancer (PCa). Many patients, including those under active surveillance, often require repeated biopsies along with a series of MRIs. Notably, upwards of 80% of PIRADS 3 lesions and 50% of PIRADS 4 lesions are benign. In this context, we tested the hypothesis that echogenicity observed during the fusion of MRI and ultrasound images may be associated with the detection of clinically significant prostate cancer in targeted biopsy of MP-MRI lesions. METHODS: This retrospective study, spanning from March 2017 to February 2022, focused on patients who underwent both standard 12-core random biopsies and targeted MP-MRI/ ultrasound-guided biopsies at our institution. We documented lesion-specific ultrasound echogenicity. Lesions observed during the target biopsy were categorized as strongly, weakly, or not hypoechoic. Clinically significant PCa (csPCA) was defined as a Gleason score ≥7 and intermediate was defined as a Gleason score=6. RESULTS: In an analysis of 221 patients undergoing biopsy, 59.3% were diagnosed with PCa, and among them, 68% had csPCa. Among 429 lesions, 19.1% were strongly hypoechoic, with 45% classified as csPCa. Additionally, 29.8% were weakly hypoechoic, with 25% considered csPCa, while 51.1% were not hypoechoic, with 11.8% being csPCa (p<0.0001). Figure 1 illustrates the distribution of Gleason grades concerning echogenicity and PIRADS score. Notably, for PIRADS≤3, echogenicity improved csPCa detection from 7% (non-hypoechoic) to 27% (strongly hypoechoic). For PIRADS 4, it increased from 13.1% to 35.1%, and for PIRAD 5, it enriched from 42% to 64%. On the ROC curve for the detection of csPCa, the AUCs of PIRADS, Echogenicity, and the combination of the two were 0.69, 0.69, and 0.74 (all p<0.001). CONCLUSIONS: The echogenicity of a lesion detected through ultrasound during a prostate biopsy serves as a valuable complement to PIRADS for diagnosing csPCa. Echogenicity can be harnessed by providers to stratify cancer risk and assist in their decision-making when performing biopsies. Download PPT Source of Funding: Not Applicable © 2024 by American Urological Association Education and Research, Inc.FiguresReferencesRelatedDetails Volume 211Issue 5SMay 2024Page: e302 Advertisement Copyright & Permissions© 2024 by American Urological Association Education and Research, Inc.Metrics Author Information Garret Wegner More articles by this author Amir Khan More articles by this author Michael Panagos More articles by this author Shu Wang More articles by this author Alexa J. Van Besien More articles by this author Michael Naslund More articles by this author Mohummad Minhaj Siddiqui More articles by this author Expand All Advertisement PDF downloadLoading ...