Pd26-01 Performance of Mri at Surveillance Biopsy in Men With Low-Risk Prostate Cancer and Prior Mri-Informed Biopsy

You have accessJournal of UrologyProstate Cancer: Localized: Active Surveillance II (PD26)1 May 2024PD26-01 PERFORMANCE OF MRI AT SURVEILLANCE BIOPSY IN MEN WITH LOW-RISK PROSTATE CANCER AND PRIOR MRI-INFORMED BIOPSY Meera R. Chappidi, Lisa F. Newcomb, Menghan Liu, Jeannette M. Schenk, Yingye Zheng, Kehao Zhu, Claire M. de la Calle, and Daniel W. Lin Meera R. ChappidiMeera R. Chappidi , Lisa F. NewcombLisa F. Newcomb , Menghan LiuMenghan Liu , Jeannette M. SchenkJeannette M. Schenk , Yingye ZhengYingye Zheng , Kehao ZhuKehao Zhu , Claire M. de la CalleClaire M. de la Calle , and Daniel W. LinDaniel W. Lin View All Author Informationhttps://doi.org/10.1097/01.JU.0001008556.20565.76.01AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookLinked InTwitterEmail Abstract INTRODUCTION AND OBJECTIVE: AUA guidelines recommend MRI after diagnostic biopsy (Bx) for patients on active surveillance (AS) if MRI was not performed prior to diagnostic Bx. Beyond this however, no clinical guidelines exist to help guide use of MRI in AS because performance of MRI at surveillance biopsies (sBx) is not well understood. Our objectives were to evaluate performance of MRI at sBx and determine whether MRI performance differed based on whether patients had undergone a prior MRI-informed Bx in low-risk prostate cancer patients on AS. METHODS: Patients in Canary Prostate Active Surveillance Study with Grade group (GG) 1 disease on AS with MRI-informed sBxs from 8/2008 to 8/2022 were identified. Patients were separated into two groups (prior MRI vs. no prior MRI) based on if they had a prior baseline MRI-informed Bxs (diagnostic and/or confirmatory Bx). First MRI-informed sBx was defined as first sBx with an associated MRI performed after confirmatory Bx. Primary outcome was reclassification at first MRI-informed sBx defined as ≥GG2. Positive MRI was defined as PI-RADS 3 or higher. Reclassification rates and location were compared in the prior vs. no prior MRI groups. Among the prior MRI group, multivariable logistic regression controlling for clinical variables was used to identify predictors of reclassification. RESULTS: The analytic cohort included 442 patients, 25% (n=109) with prior MRI-informed Bx and 75% (n=333) without. Reclassification rate at first MRI-informed sBx was comparable between patients with vs. without prior MRI (22% n=23/109 vs. 29% n=96/333, p=0.1, respectively). Among Bxs with reclassification, 78% (n=18/23) vs. 80% (n=77/96) had a positive MRI. In these, reclassification location was 44% (n=8/18) in targeted cores only and 17% (n=3/18) in systematic cores only for patients with prior MRI and 32% (n=25/77) in targeted cores only and 48% (n=37/77) in systematic cores only for patients without prior MRI. Among the prior MRI group, if both prior MRI and surveillance MRI were positive (vs. both negative) there was an increased odds of reclassification (OR=9.20 95%CI 2.13, 50.35) in the multivariable model. CONCLUSIONS: Of the reclassification events, the high percentage of reclassifications in targeted cores only demonstrates a benefit of MRI at sBx in both patients with and without prior MRI-informed Bxs. The percentage of reclassifications in systematic cores only was also high in both groups suggesting both targeted and systematic Bxs need to be performed at first MRI-informed sBx regardless of whether patients underwent a prior MRI-informed Bx. Source of Funding: The Canary Foundation, NIH U01 CA224255 grant, Urology Care Foundation Research Scholar Award © 2024 by American Urological Association Education and Research, Inc.FiguresReferencesRelatedDetails Volume 211Issue 5SMay 2024Page: e543 Advertisement Copyright & Permissions© 2024 by American Urological Association Education and Research, Inc.Metrics Author Information Meera R. Chappidi More articles by this author Lisa F. Newcomb More articles by this author Menghan Liu More articles by this author Jeannette M. Schenk More articles by this author Yingye Zheng More articles by this author Kehao Zhu More articles by this author Claire M. de la Calle More articles by this author Daniel W. Lin More articles by this author Expand All Advertisement PDF downloadLoading ...