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Multiparametric magnetic resonance imaging and follow‐up to avoid prostate biopsy in 4259 men
Author(s) -
Venderink Wulphert,
Luijtelaar Annemarijke,
Leest Marloes,
Barentsz Jelle O.,
Jenniskens Sjoerd F.M.,
Sedelaar Michiel J.P.,
Hulsbergenvan de Kaa Christina,
Overduin Christiaan G.,
Fütterer Jurgen J.
Publication year - 2019
Publication title -
bju international
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.773
H-Index - 148
eISSN - 1464-410X
pISSN - 1464-4096
DOI - 10.1111/bju.14853
Subject(s) - medicine , prostate , interquartile range , biopsy , magnetic resonance imaging , logistic regression , prostate cancer , radiology , prostate biopsy , cohort , surgery , cancer
Objective To determine the proportion of men avoiding biopsy because of negative multiparametric magnetic resonance imaging (mp MRI) findings in a prostate MRI expert centre, and to assess the number of clinically significant prostate cancers (cs PC a) detected during follow‐up. Patients and methods Retrospective study of 4259 consecutive men having mp MRI of the prostate between January 2012 and December 2017, with either a history of previous negative transrectal ultrasonography‐guided biopsy or biopsy naïve. Patients underwent mp MRI in a referral centre. Lesions were classified according to Prostate Imaging Reporting And Data System ( PI ‐ RADS ) versions 1 and 2. Negative mp MRI was defined as an index lesion PI ‐ RADS ≤2. Follow‐up until 13 October 2018 was collected by searching the Dutch Pathology Registry ( PALGA ). Gleason score ≥3 + 4 was considered cs PC a. Kaplan–Meier analysis and univariable logistic regression models were used in the cohort of patients with negative mp MRI and follow‐up. Results Overall, in 53.6% (2281/4259) of patients had a lesion classified as PI‐RADS ≤2. In 320 patients with PI ‐ RADS 1 or 2, follow‐up mp MRI was obtained after a median (interquartile range) of 57 (41–63) months. In those patients, cs PC a diagnosis‐free survival (DFS) was 99.6% after 3 years. Univariable logistic regression analysis revealed age as a predictor for cs PC a during follow‐up ( P < 0.05). In biopsied patients, cs PC a was detected in 15.8% (19/120), 43.2% (228/528) and 74.5% (483/648) with PI ‐ RADS 3, 4 and 5, respectively. Conclusion More than half of patients having mp MRI of the prostate avoided biopsy. In those patients, cs PC a DFS was 99.6% after 3 years.