Mp31-14 Predictors of Clinically Significant Prostate Cancer Amongst African American Men With Pi-Rads 3 Index Lesion Undergoing Mri-Targeted Biopsy

You have accessJournal of UrologyProstate Cancer: Detection & Screening III (MP31)1 May 2024MP31-14 PREDICTORS OF CLINICALLY SIGNIFICANT PROSTATE CANCER AMONGST AFRICAN AMERICAN MEN WITH PI-RADS 3 INDEX LESION UNDERGOING MRI-TARGETED BIOPSY Zachary S. Feuer, Dylane N. Davis, Austin Coale, Samuel L. Tate, Marc A. Bjurlin, Eric M. Wallen, David C. Johnson, Angela B. Smith, Matthew E. Nielsen, and Hung-Jui Tan Zachary S. FeuerZachary S. Feuer , Dylane N. DavisDylane N. Davis , Austin CoaleAustin Coale , Samuel L. TateSamuel L. Tate , Marc A. BjurlinMarc A. Bjurlin , Eric M. WallenEric M. Wallen , David C. JohnsonDavid C. Johnson , Angela B. SmithAngela B. Smith , Matthew E. NielsenMatthew E. Nielsen , and Hung-Jui TanHung-Jui Tan View All Author Informationhttps://doi.org/10.1097/01.JU.0001008936.35187.0b.14AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookLinked InTwitterEmail Abstract INTRODUCTION AND OBJECTIVE: African American (AA) men are more likely to be diagnosed with and to die from prostate cancer. Despite this, evidence regarding predictors of clinically significant prostate cancer (csPCa) amongst AA men in the era of MRI-targeted biopsy (MRI-TB) is sparse, while no studies have characterized predictors of csPCa in AA men with equivocal pre-biopsy MRI. In this study, we aim to identify and characterize predictors of csPCa amongst AA men with PI-RADS 3 pre-biopsy MRI. METHODS: All AA men undergoing initial MRI-TB between 2016-2023 with a PI-RADS 3 index lesion on pre-biopsy MRI were included. Men were excluded if they had an additional PI-RADS 4/5 lesion or incomplete data. Pre-biopsy data including PSA, MRI-based prostate volume (MRIPV), PSA density (PSAD), and lesion location were extracted. csPCa was defined as Gleason Grade Group (GGG) ≥2. Univariate analysis was employed to determine odds ratios (OR) for predictors of csPCa. PSAD was rescaled wherein OR reflects an increase in PSAD of 0.01. Receiver operating characteristic (ROC) curves and area under the ROC (AUC) were calculated to determine the sensitivity and specificity including 95% confidence intervals (CI). RESULTS: 64 AA men were included. Median age was 65 (IQR 62-67) and median PSA was 9.0 (IQR 5.7-11.4). PSAD (OR 1.18, p=0.001) was the sole predictor of csPCa, while MRIPV was inversely associated (OR 0.95, p=0.001) with csPCa diagnosis. The AUC for PSAD was 0.805 (CI 0.688-0.922) in this cohort. Cut-off values for PSAD were calculated using ROC curve (Figure 1), wherein optimal accuracy of 81.3% occurred at threshold PSAD=0.18, with sensitivity 60.0% and specificity 94.87%. Notably, sensitivity was optimized at threshold PSAD=0.08, where sensitivity was 96.0% and specificity 30.8%. PSA and lesion location were not predictors of csPCa in this cohort. CONCLUSIONS: Amongst AA men with a PI-RADS 3 lesion undergoing initial MRI-TB, PSAD was a predictor of csPCa diagnosis. PSAD≥0.18 was the threshold that optimized accuracy for prediction of csPCa with high specificity, while sensitivity was optimized at PSAD≥0.08. This study represents the largest cohort of AA men with PI-RADS 3 lesion in the literature. Findings can be used to counsel AA men with PI-RADS 3 MRI regarding pre-biopsy risk of csPCa diagnosis. Download PPT Source of Funding: N/A © 2024 by American Urological Association Education and Research, Inc.FiguresReferencesRelatedDetails Volume 211Issue 5SMay 2024Page: e509 Advertisement Copyright & Permissions© 2024 by American Urological Association Education and Research, Inc.Metrics Author Information Zachary S. Feuer More articles by this author Dylane N. Davis More articles by this author Austin Coale More articles by this author Samuel L. Tate More articles by this author Marc A. Bjurlin More articles by this author Eric M. Wallen More articles by this author David C. Johnson More articles by this author Angela B. Smith More articles by this author Matthew E. Nielsen More articles by this author Hung-Jui Tan More articles by this author Expand All Advertisement PDF downloadLoading ...