Presentation Authors: Maria Becerra*, Miami , FL, Feng Miao, Isildinha Reis, Miami, FL, Daniel Furlong, Taylor Johnson, Nachiketh Soodana-Prakash, Dipen Parekh, Chad Ritch, Bruno Nahar, Mark Gonzalgo, Sanoj Punnen, Miami , FL
Introduction: Multiparametric MRI fusion guided biopsy (FBx) has been shown to reliably improve the prostate cancer (PCa) detection. We aim to evaluate if the detection of prostate cancer on targeted biopsy varied based on the time interval between the MRI and the FBx.
Methods: A prospectively maintained database of patient undergoing MRI followed by FBx for elevated PSA between 10/2014 and 07/2018 at our institution was reviewed. Patients with previously diagnosed PCa were excluded from the analysis. Time between MRI and FBx were evaluated as a continuous variable and as categorical variable as follows â‰¤5, 5-10, >10 weeks (w). Data were documented on a per lesion basis and each target in the MRI was classified for the level of suspicion of malignancy based on the Prostate Imaging-Reporting and Data System (PI-RADS). Generalized estimating equation models for correlated binary outcome data was fitted to assess the effect of time (or time intervals) between MRI and FBx on the histopathological findings in the defined MRI targets. Separated models were fitted for the detection of any cancer or Gleason 7 or higher PCa (Gleason 7 or greater) with adjustment for relevant characteristics.
Results: A total 1,181 lesions from 806 men were analyzed. Prostate cancer was detected in 34.5% (407) of lesions, with 21.4% (253), 13% (154) and 65.5% (774) of lesions detecting clinically significant cancer (CSC), indolent (Gleason 6) PCa, or benign pathology, respectively. The MRI was performed < 5w apart from the FBx in 423 patients, within 5-10 w in 261 and >10w in 122 patients. Adjusting for level of suspicion, previous biopsy result, age at MRI, race/ethnicity and marital status, the detection rates of any or CSC were not statistically different in any of the time intervals between the MRI/FBx (p=0.931 and p=0.538, respectively). Furthermore, when analyzing time as a continuous variable (per week increase) there was no association between time from MRI to FBx and PCa detection (p=0.849 and p=0.666, respectively).
Conclusions: Our data suggests that the time from MRI to fusion biopsy was not a predictor of prostate cancer detection on targeted biopsy. While these findings require further validation in cohorts with longer time intervals between MRI and fusion biopsy, it provides important information for patients and providers about the timing of biopsy after MRI.