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.
References
[1] Fouad,
Ahmed,
Kotb Shelley,
Spaner Tra,
Crump Matthew,
and Eric Hyndman.
2018.
“The Role of mpMRI and PSA Density in Patients with an Initial Negative Prostatic Biopsy.” (123456789).
[2] Hansen,
Nienke L.
et al.
2017.
“The in Fl Uence of Prostate-Speci Fi c Antigen Density on Positive and Negative Predictive Values of Multiparametric Magnetic Resonance Imaging to Detect Gleason Score 7 – 10 Prostate Cancer in a Repeat Biopsy Setting.” 724–30.
[3] Armstrong,
Andrew J.
2016.
“Prostate Cancer.”
[4] Sim,
Ki Choon et al....