Pd39-12 Follow-Up Modalities After Focal Therapy for Clinically Localized Prostate Cancer: Mri, Ceus, Psa, and Biopsy

You have accessJournal of UrologyProstate Cancer: Localized: Ablative Therapy II (PD39)1 May 2024PD39-12 FOLLOW-UP MODALITIES AFTER FOCAL THERAPY FOR CLINICALLY LOCALIZED PROSTATE CANCER: MRI, CEUS, PSA, AND BIOPSY Masatomo Kaneko, Lorenzo Storino Ramacciotti, Divyangi Paralkar, Alireza Ghoreifi, Samuel Peretsman, Jessica Brooks, Giovanni E. Cacciamani, Michelle Hopstone, Manju Aron, Osamu Ukimura, Duke Bahn, Inderbir S. Gill, and Andre Luis Abreu Masatomo KanekoMasatomo Kaneko , Lorenzo Storino RamacciottiLorenzo Storino Ramacciotti , Divyangi ParalkarDivyangi Paralkar , Alireza GhoreifiAlireza Ghoreifi , Samuel PeretsmanSamuel Peretsman , Jessica BrooksJessica Brooks , Giovanni E. CacciamaniGiovanni E. Cacciamani , Michelle HopstoneMichelle Hopstone , Manju AronManju Aron , Osamu UkimuraOsamu Ukimura , Duke BahnDuke Bahn , Inderbir S. GillInderbir S. Gill , and Andre Luis AbreuAndre Luis Abreu View All Author Informationhttps://doi.org/10.1097/01.JU.0001008924.16121.42.12AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookLinked InTwitterEmail Abstract INTRODUCTION AND OBJECTIVE: To assess diagnostic performance of multiparametric magnetic resonance imaging (mpMRI), contrast-enhanced ultrasound (CEUS), prostate specific antigen (PSA), PSA density (PSAD), and digital rectal examination (DRE) for clinically significant prostate cancer (CSPCa, ISUP Grade Group GG ≥2) early recurrence after focal therapy (FT). METHODS: Patients who underwent primary hemi-gland cryoablation (CRYO) or High-Intensity Focused Ultrasound (HIFU) for clinically localized prostate cancer (PCa) were identified from our multicentric database (IRB# HS-17-00749). Patients were followed by PSA, PSAD, mpMRI, CEUS, and DRE before mandatory follow-up prostate biopsy (FU-PBx) at 6-12M after FT. All patients of this cohort underwent FU-PBx. Suspicion for recurrence on imaging was assessed by 3-point Likert score (1-3). Diagnostic performance of CSPCa recurrence detection was analyzed by receiver operating characteristic (ROC). Optimal cutoff was determined by Youden index. Statistically significant if p<0.05. RESULTS: A total of 205 patients (121 59% CRYO and 84 41% HIFU) met the inclusion criteria. The baseline characteristics were, as follows: median age 65yr; PSA 6.2ng/mL; PSA density (PSAD) 0.17ng/mL2; 29% GG 1, 63% GG2-3, and 7.8% GG 4-5; 24% low-risk, 65% intermediate-risk, 10% high-risk. All patients underwent FU-PBx. CSPCa recurrence on FU-PBx were: 25% per patient; 11% infield (treated lobe); and 16% outfield (preserved lobe). Patient-level area under the ROC curve (AUC), sensitivity, and specificity were: 0.62, 39%, and 87% for MRI; 0.59, 94%, and 25% for CEUS; 0.65, 36%, and 95% for DRE; 0.69, 88%, and 50% for PSA; 0.75, 70%, and 74% for PSAD, respectively (Figure 1). Infield AUC, sensitivity, and specificity were: 0.73, 35%, and 97% for MRI; 0.91, 89%, and 95% for CEUS; 0.64, 71%, and 94% for DRE, respectively. Outfield AUC, sensitivity, and specificity were: 0.64, 41%, and 94% for MRI; 0.56, 100%, and 11% for CEUS; 0.66, 33%, and 97% for DRE, respectively. CONCLUSIONS: Follow-up modalities after focal therapy were assessed. PSA density outperforms MRI for the detection of CSPCa early recurrence after focal therapy. Contrast enhanced ultrasound is a reliable modality to detect infield CSPCa recurrence. Download PPT Source of Funding: None © 2024 by American Urological Association Education and Research, Inc.FiguresReferencesRelatedDetails Volume 211Issue 5SMay 2024Page: e818 Advertisement Copyright & Permissions© 2024 by American Urological Association Education and Research, Inc.Metrics Author Information Masatomo Kaneko More articles by this author Lorenzo Storino Ramacciotti More articles by this author Divyangi Paralkar More articles by this author Alireza Ghoreifi More articles by this author Samuel Peretsman More articles by this author Jessica Brooks More articles by this author Giovanni E. Cacciamani More articles by this author Michelle Hopstone More articles by this author Manju Aron More articles by this author Osamu Ukimura More articles by this author Duke Bahn More articles by this author Inderbir S. Gill More articles by this author Andre Luis Abreu More articles by this author Expand All Advertisement PDF downloadLoading ...