| Title: |
False Positive Multiparametric Magnetic Resonance Imaging Phenotypes in the Biopsy-naïve Prostate: Are They Distinct from Significant Cancer-associated Lesions? Lessons from PROMIS. |
| Authors: |
Stavrinides, V; Syer, T; Hu, Y; Giganti, F; Freeman, A; Karapanagiotis, S; Bott, SRJ; Brown, LC; Burns-Cox, N; Dudderidge, TJ; Bosaily, AE-S; Frangou, E; Ghei, M; Henderson, A; Hindley, RG; Kaplan, RS; Oldroyd, R; Parker, C; Persad, R; Rosario, DJ; Shergill, IS; Echeverria, LMC; Norris, JM; Winkler, M; Barratt, D; Kirkham, A; Punwani, S; Whitaker, HC; Ahmed, HU; Emberton, M; PROMIS group |
| Contributors: |
Parker, Christopher |
| Publisher Information: |
ELSEVIER |
| Publication Year: |
2021 |
| Collection: |
The Institute of Cancer Research (ICR): Publications Repository |
| Subject Terms: |
PROMIS group |
| Description: |
BACKGROUND: False positive multiparametric magnetic resonance imaging (mpMRI) phenotypes prompt unnecessary biopsies. The Prostate MRI Imaging Study (PROMIS) provides a unique opportunity to explore such phenotypes in biopsy-naïve men with raised prostate-specific antigen (PSA) and suspected cancer. OBJECTIVE: To compare mpMRI lesions in men with/without significant cancer on transperineal mapping biopsy (TPM). DESIGN, SETTING, AND PARTICIPANTS: PROMIS participants (n=235) underwent mpMRI followed by a combined biopsy procedure at University College London Hospital, including 5-mm TPM as the reference standard. Patients were divided into four mutually exclusive groups according to TPM findings: (1) no cancer, (2) insignificant cancer, (3) definition 2 significant cancer (Gleason ≥3+4 of any length and/or maximum cancer core length ≥4mm of any grade), and (4) definition 1 significant cancer (Gleason ≥4+3 of any length and/or maximum cancer core length ≥6mm of any grade). OUTCOME MEASUREMENTS AND STATISTICAL ANALYSIS: Index and/or additional lesions present in 178 participants were compared between TPM groups in terms of number, conspicuity, volume, location, and radiological characteristics. RESULTS AND LIMITATIONS: Most lesions were located in the peripheral zone. More men with significant cancer had two or more lesions than those without significant disease (67% vs 37%; p< 0.001). In the former group, index lesions were larger (mean volume 0.68 vs 0.50 ml; p< 0.001, Wilcoxon test), more conspicuous (Likert 4-5: 79% vs 22%; p< 0.001), and diffusion restricted (mean apparent diffusion coefficient [ADC]: 0.73 vs 0.86; p< 0.001, Wilcoxon test). In men with Likert 3 index lesions, log2PSA density and index lesion ADC were significant predictors of definition 1/2 disease in a logistic regression model (mean cross-validated area under the receiver-operator characteristic curve: 0.77 [95% confidence interval: 0.67-0.87]). CONCLUSIONS: Significant cancer-associated MRI lesions in biopsy-naïve men have ... |
| Document Type: |
article in journal/newspaper |
| File Description: |
Print-Electronic; 29; application/pdf |
| Language: |
English |
| ISSN: |
1873-7560; 0302-2838 |
| Relation: |
European urology, 2021, 79 (1), pp. 20 - 29; https://repository.icr.ac.uk/handle/internal/4375 |
| DOI: |
10.1016/j.eururo.2020.09.043 |
| Availability: |
https://doi.org/10.1016/j.eururo.2020.09.043; https://repository.icr.ac.uk/handle/internal/4375 |
| Rights: |
https://creativecommons.org/licenses/by/4.0 |
| Accession Number: |
edsbas.FA176CC4 |
| Database: |
BASE |