Category: Basic Science: Oncology

MP1-1 - Multiparametric MRI Features Identify Aggressive Prostate Cancer at the Phenotypic and Transcriptomic Level

Thu, Sep 20
4:00 PM - 6:00 PM

Introduction & Objective :

Multiparametric magnetic resonance imaging (mpMRI) is a diagnostic tool for prostate cancer with limited data on prognostic use. We sought to determine whether mpMRI can predict aggressive prostate cancer features.


Methods : We performed a retrospective analysis of 206 patients who underwent radical prostatectomy between 2013 and 2017. All patients had available RNA expression data from the final pathology specimen, obtained from a location corresponding to a lesion location on mpMRI. The association between Prostate Imaging Reporting and Data System (PI-RADS) score and adverse pathology features  were analyzed. We also performed a differential transcriptomic analysis between PI-RADS groups. Factors associated with adverse pathology were analyzed using a multivariable logistic regression model.


Results : Lesion size (p = 0.03), PI-RADS score (p = 0.02), and extraprostatic extension (p = 0.01) associated significantly with the Decipher score. Multivariable analysis showed that PI-RADS score (Ref: PI-RADS 3; odds ratio [OR]: 8.1; 95% confidence interval [CI]: 1.2–57.5, p = 0.04), Gleason group (Ref: Gleason 3; OR: 5.6; 95% CI: 1.5–21.1; p = 0.01) and prostate-specific antigen (OR:1.103; 95% CI: 1.011–1.203) were risk factors for adverse pathology. Although the difference between PI-RADS 4 and 5 did not reach significance (OR: 1.9, 95% CI: 0.8–4.5; p = 0.12), the PI3K-AKT-mTOR, WNT-beta, and E2F signaling pathways were more active in PI-RADS 5 compared with PI-RADS 4.


Conclusions : PI-RADS score is associated with adverse pathology, increased metastatic risk, and differential genomic pathway activation.  

Alp Tuna Beksac

Fellow
Icahn School of Medicine at Mount Sinai
New York, New York

Endourological Society Fellow in Minimally Invasive and Robotic Surgery at Icahn School of Medicine at Mount Sinai.

Shivaram Cumarasamy

Icahn School of Medicine at Mount Sinai
New York, New York

Ugo Falagario

University of Foggia
New York, New York

Paige Xu

New York, New York

Mandeep Takhar

San Diego, California

Mohamed Alshalalfa

Vancouver, British Columbia, Canada

Akriti Gupta

New York, New York

Sonya Prasad

New York, New York

Alberto Martini

Fellow
Icahn School of Medicine at Mount Sinai
New York, New York

Stephanie Hectors

New York, New York

Jennifer Jordan

New York, New York

Elai Davicioni

Vancouver, British Columbia, Canada

Sujit Nair

New York, New York

Kenneth Haines

New York, New York

Sara C. Lewis

Assistant Professor of Radiology
Icahn School of Medicine at Mount Sinai
New York, New York

Art Rastinehad

The Icahn School of Medicine at Mount Sinai, Department of Urology
New York, New York

Kamlesh Yadav

New York, New York

Isuru Jayaratna

New York, New York

Bachir Taouli

Professor of Radiology
Icahn School of Medicine at Mount Sinai
New York, New York

Ashutosh K. Tewari

Icahn School of Medicine at Mount Sinai
New York, New York