Role of PSA density (PSAD) and PIRADS score v2 as co-variables in the identification of clinically significant prostate cancers: our experience

Congress:

ECR 2019

Poster Number:

C-1133

Type:

Scientific Exhibit

Keywords:

Genital / Reproductive system male, MR, Diagnostic procedure, Neoplasia

Authors:

C. Gianneramo¹, L. Panebianco¹, A. pace¹, A. Izzo², M. Martino³, F. Formiconi¹, R. Manetta¹, C. Masciocchi¹; ¹L'Aquila/IT, ²vallata/IT, ³Rome, ITALY/IT

DOI:

10.26044/ecr2019/C-1133

DOI-Link:

https://dx.doi.org/10.26044/ecr2019/C-1133

Fig. 2: Correlation between PI-RADS 3 and Gleason score

Fig. 3: Correlation between PI-RADS 4 and Gleason score

Fig. 4: Correlation between PI-RADS 5 and Gleason score

Table 1: Correlation between PSA density and Gleason Score

Aims and objectives

Prostate cancer accounts for about 20% of all cancers diagnosed among men aged 50 and older. At the base of this phenomenon, there is the greatest probability of diagnosing this disease, which is present in a latent form in 15-30% of the subjects over 50 years and in about 70% of the octogenarians. In recent years, enormous progress has been made in prostate imaging thanks to multiparametric MRI (mpMRI), which provides a high spatial resolution(<1mm) morphological images and functional images, with information on cellularity and...

Methods and materials

We retrospectively analyzed 250 multiparametric resonances of the prostate (mpMRI) performed between January 2017 and July 2018 with previous negative systematic biopsy. To describe the results of mpMRI we used PI-RADS score v2 scoring system. Based on PI-RADS score, 60 patients resulted positive for mpMRI. 37 patients had PI-RADS 3. 15 patients had PI-RADS 4 8 patients had PI-RADS 5. All subjects were subsequently submitted to target biopsy with MRI-TRUS fusion technique [Fig.1].

Results

Among 37 patients with PI-RADS 3, 10 had negative biopsy; 21 had GS 6 / ASAP / PIN; 5 had GS 7 and 1 had GS 8 [Fig. 2]. Among 15 patients with PI-RADS 4, 10 had GS 7, 3 had GS 8 and 2 had GS 6 [Fig. 3]. All patients with PI-RADS 5 had GS>7; one was positive for bone metastases [Fig.4]. For each patient we calculated the PSAD = PSA/ prostate volume(maximum APD) × (maximum TD) × (maximum LD) × 0.52). Multivariate...

Conclusion

PSA density can be identified as a further parameter to classify clinically significant tumors. The combination of PI-RADS score v2 and PSAD score can help in decision-making before prostate biopsy and follow-up strategy by avoiding unnecessary biopsies. According to our experience patients with PI-RADS≤3 and PSAD<0.15 can avoid unnecessary biopsies.

Personal information

References

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