Please use this identifier to cite or link to this item:
http://doi.org/10.25358/openscience-8413
Authors: | Haack, Maximilian Miksch, Vanessa Tian, Zhe Duwe, Gregor Thomas, Anita Borkowetz, Angelika Stroh, Kristina Thomas, Christian Haferkamp, Axel Höfner, Thomas Boehm, Katharina |
Title: | Negative multiparametric magnetic resonance imaging for prostate cancer : further outcome and consequences |
Online publication date: | 18-Jan-2023 |
Year of first publication: | 2022 |
Language: | english |
Abstract: | Purpose EAU guidelines recommend multiparametric MRI of the prostate (mpMRI) prior to biopsy to increase accuracy and reduce biopsies. Whether biopsy can be avoided in case of negative mpMRI remains unclear. Aim of this study is to evaluate predictors of overall prostate cancer (PCa) in negative mpMRI. Methods A total of 216 patients from 2018 to 2020 with suspicion of PCa and negative mpMRI (PI-RADS ≤ 2) were interviewed by telephone about outcome and further follow-up. Clinically significant PCa (csPCa) was defined as ISUP ≥ 2. Patients with vs. without biopsy and with vs. without PCa were compared. Univariate and multivariate analyses were performed to evaluate predictors of PCa occurrence in patients with negative mpMRI. Results 15.7% and 5.1% of patients with PI-RADS ≤ 2 on mpMRI showed PCa and csPCa, respectively. PCa patients had higher PSAD (0.14 vs. 0.09 ng/ml2; p = 0.001) and lower prostate volume (50.5 vs. 74.0 ml; p = 0.003). Patients without biopsy (25%) after MRI were older (69 vs. 65.5 years; p = 0.027), showed lower PSA (5.7 vs. 6.73 ng/ml; p = 0.033) and lower PSA density (0.09 vs. 0.1 ng/ml2; p = 0.027). Multivariate analysis revealed age (OR 1.09 [1.02–1.16]; p = 0.011), prostate volume (OR 0.982 [0.065; 0.997]; p = 0.027), total PSA level (OR 1.22 [1.01–1.47], p = 0.033), free PSA (OR 0.431 [0.177; 0.927]; p = 0.049) and no PI-RADS lesion vs PI-RADS 1–2 lesion (OR 0.38 [0.15–0.91], p = 0.032.) as predictive factors for the endpoint presence of PCa. Conclusions Biopsy for selected patient groups (higher age, prostate volume and free PSA as well as lower PSA-Density) with negative mpMRI can be avoided, if sufficient follow-up care is guaranteed. Detailed counseling regarding residual risk for undetected prostate cancer should be mandatory. |
DDC: | 610 Medizin 610 Medical sciences |
Institution: | Johannes Gutenberg-Universität Mainz |
Department: | FB 04 Medizin |
Place: | Mainz |
ROR: | https://ror.org/023b0x485 |
DOI: | http://doi.org/10.25358/openscience-8413 |
Version: | Published version |
Publication type: | Zeitschriftenaufsatz |
License: | CC BY |
Information on rights of use: | https://creativecommons.org/licenses/by/4.0/ |
Journal: | World journal of urology 40 |
Pages or article number: | 2947 2954 |
Publisher: | Springer |
Publisher place: | Berlin u.a. |
Issue date: | 2022 |
ISSN: | 1433-8726 |
Publisher DOI: | 10.1007/s00345-022-04197-8 |
Appears in collections: | DFG-491381577-H |
Files in This Item:
File | Description | Size | Format | ||
---|---|---|---|---|---|
![]() | negative_multiparametric_magn-20230118133434948.pdf | 683.46 kB | Adobe PDF | View/Open |