Presentation Authors: Hye Jin Byun*, Wonho Jung, Ji Yong Ha, Byung Hoon Kim, Chol Hee Park, Chun Il Kim, Daegu, Korea, Republic of
Introduction: Despite advancements in radiological imaging of the prostate with prebiopsy multiparametric magnetic resonance imaging (mpMRI), clinically significant prostate cancer (CSPCa) can still be missed.
Methods: We retrospectively analyzed all patients who underwent prebiopsy prostate mpMRI for suspicion of prostate cancer from January 2016 to June 2018. Negative mpMRI was defined as Prostate Imaging Reporting and Data System version 2 (PI-RADSv2) < 3. CSPCa defined as a Gleason score â‰¥ 3+4. We analyzed the final pathologic finding in men with negative mpMRI but positive findings of prostate adenocarcinoma after prostatectomy.
Results: Overall, 337 patients underwent MRI-TRUS fusion biopsy between January 2016 and June 2018. 53% (178/337) patients had negative mpMRI. Among them, 24% (42/178) patients had prostate cancer (GS6: 50%, CSPCa: 50%) (figure 1). On these patients, 19 patients underwent prostatectomy (RALP in 17, RRP in 2). Their mean age was 65.6 (58 â€“ 77) years, median PSA was 6.8 (4 â€“12.4) ng/mL, median PSA density was 0.18 (0.07- 0.44) ng/mL2. On final surgical pathology, 84% (16/19) patients had CSPCa (Gleason 7 (3+4) : 11, Gleason 7 (4+3) : 3 and Gleason 8 (4+4) : 2). 31% (6/19) patients upgraded on surgical pathology from biopsy pathology, and 31% (6/19) patients had extra prostatic extension including 1 seminal vesicle extension.
Conclusions: In negative mpMRI, 24% (42/178) patient had prostate cancer. Among them, 50% (21/42) had CSPCa. Thus, our study shows the importance of a systemic biopsy despite negative mpMRI findings in patients with suspicion for prostate cancer.