Presentation Authors: Michelle Yu*, Avinash Maganty, Pittsburgh, PA, Mina M. Fam, Neptune, NJ, Jonathan G. Yabes, Liam C. Macleod, Jathin Bandari, Alessandro Furlan, Pittsburgh, PA, Christopher P. Filson, Atlanta, GA, Benjamin J. Davies, Bruce L. Jacobs, Pittsburgh, PA
Introduction: Multi-parametric resonance imaging (mpMRI) has emerged as a tool that may improve risk-stratification and decrease repeated biopsies in men on active surveillance. However, the extent to which mpMRI has been implemented in active surveillance has not been established. Therefore, we sought to characterize the use of multiparametric magnetic resonance imaging (mpMRI) in Medicare beneficiaries electing active surveillance for prostate cancer.
Methods: Using SEER-Medicare claims data, we identified men with localized prostate cancer diagnosed between 2008-2013 and managed with active surveillance. We classified men into two treatment groups: active surveillance without mpMRI and active surveillance with mpMRI. We then fit multivariable logistic regression models to examine changing mpMRI utilization over time and assess factors associated with the receipt of mpMRI.
Results: We identified 9,467 men on active surveillance. Of these, 8,178 (86%) did not receive an mpMRI and 1,289 (14%) received mpMRI. The likelihood of receiving an mpMRI over the entire study period increased by 3.7% (p=0.004). On multivariable logistic regression, patients who were younger, white, had lower comorbidity burden, lived in the northeast and west, had higher incomes and lived in more urban areas had greater odds of receiving an mpMRI (all p < 0.05).
Conclusions: From 2008-2013, use of mpMRI in active surveillance increased gradually. Receipt of mpMRI among men on surveillance for prostate cancer varied significantly across demographic, geographic and socioeconomic strata. Going forward, studies should investigate causes for this variation and define ideal strategies for equitable, cost-effective dissemination of mpMRI technology.
Source of Funding: Bruce L. Jacobs is supported in part by the American Urological Association Data Grant and the University of Pittsburgh Physicians Foundation. The views expressed in this abstract do not reflect the views of the Federal government.