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• W2040982878 abstract "You have accessJournal of UrologyProstate Cancer: Detection and Screening IV1 Apr 20122051 PREBIOPSY MULTI-PARAMETRIC MRI POTENTIALLY REDUCES UNNECESSARY PROSTATE BIOPSY IN MEN WITH PSA LESS THAN 10 NG/ML AND A NORMAL DIGITAL RECTAL EXAMINATION Noboru Numao, Soichiro Yoshida, Yoshinobu Komai, Chikako Ishii, Makoto Kagawa, Yoh Matsuoka, Fumitaka Koga, Kazutaka Saito, Hitoshi Masuda, Satoru Kawakami, and Kazunori Kihara Noboru NumaoNoboru Numao Tokyo, Japan More articles by this author , Soichiro YoshidaSoichiro Yoshida Tokyo, Japan More articles by this author , Yoshinobu KomaiYoshinobu Komai Tokyo, Japan More articles by this author , Chikako IshiiChikako Ishii Tokyo, Japan More articles by this author , Makoto KagawaMakoto Kagawa Tokyo, Japan More articles by this author , Yoh MatsuokaYoh Matsuoka Tokyo, Japan More articles by this author , Fumitaka KogaFumitaka Koga Tokyo, Japan More articles by this author , Kazutaka SaitoKazutaka Saito Tokyo, Japan More articles by this author , Hitoshi MasudaHitoshi Masuda Tokyo, Japan More articles by this author , Satoru KawakamiSatoru Kawakami Saitama, Japan More articles by this author , and Kazunori KiharaKazunori Kihara Tokyo, Japan More articles by this author View All Author Informationhttps://doi.org/10.1016/j.juro.2012.02.2216AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookTwitterLinked InEmail INTRODUCTION AND OBJECTIVES The aim of our study is to explore whether prebiopsy multi-parametric MRI (MPMRI) can reduce the rate of unnecessary prostate biopsy in men with prostate-specific antigen (PSA) < 10 ng/mL and a normal digital rectal examination (DRE). METHODS The study included 320 men with PSA < 10 ng/mL and a normal DRE who underwent prebiopsy MPMRI and then extended biopsy (14 cores or more) as an initial biopsy (IB) or a repeat biopsy (RB). MPMRI was performed using a 1.5-T MR imager, and the data, which in principle included T1/T2 weighted imaging, diffusion-weighted imaging and dynamic contrast imaging, were interpreted by one radiologist. Subjects were categorized into two groups (MRI+ve group and MRI−ve group) according to the presence or absence of suspicious findings for cancer on MPMRI. We evaluated the cancer detection rate and clinicopathologic findings in the two groups. We analyzed the data obtained through IB separately from that obtained through RB. Pathological specimens were evaluated according to the 2005 ISUP Consensus. RESULTS A total of 245/75 men in the IB/RB cohorts were analyzed. Median age and PSA were 64/66 years and 5.7/6.7 ng/ml in the IB/RB cohorts, respectively. Cancer detection rates in the MRI+ve/MRI−ve groups were 56% (53/94) / 22% (33/151) in the IB cohort, and 65% (17/26) / 25% (12/49) in the RB cohort. In the IB cohort, biopsy Gleason scores (BGS) of cancers detected in the MRI+ve and MRI-ve groups were 5-6/3+4/4+3/8-10 in 12/21/11/9 cases and in 17/12/4/0 cases, respectively. In the RB cohort, BGS of cancers detected in the MRI+ve and MRI-ve groups were 5-6/3+4/4+3/8-10 in 7/5/1/4 cases and in 4/5/1/1 cases, respectively. The median percent positive core in detected cancers in the MRI-ve group was only 8% in both IB and RB cohorts. In radical prostatectomy specimens, the frequency of extraprostatic extension in the MRI+ve group was 30% (10/33) / 27% (3/11) in the IB/RB cohorts, respectively, while that in the MRI−ve group was only 10% (1/10) / 0% (0/7) in the IB/RB cohorts, respectively. CONCLUSIONS Our results suggest that prebiopsy MPMRI potentially reduces unnecessary prostate biopsy in men with PSA < 10 ng/mL and a normal DRE. Negative MPMRI findings suggests the absence of cancer or the presence of only low-grade and/or low-volume cancer at both initial and repeat biopsy in the majority of men with PSA < 10 ng/mL and a normal DRE. Therefore follow-up without prostate biopsy can be a reasonable and recommended option in men who meet these three requirements. © 2012 by American Urological Association Education and Research, Inc.FiguresReferencesRelatedDetails Volume 187Issue 4SApril 2012Page: e827-e828 Advertisement Copyright & Permissions© 2012 by American Urological Association Education and Research, Inc.MetricsAuthor Information Noboru Numao Tokyo, Japan More articles by this author Soichiro Yoshida Tokyo, Japan More articles by this author Yoshinobu Komai Tokyo, Japan More articles by this author Chikako Ishii Tokyo, Japan More articles by this author Makoto Kagawa Tokyo, Japan More articles by this author Yoh Matsuoka Tokyo, Japan More articles by this author Fumitaka Koga Tokyo, Japan More articles by this author Kazutaka Saito Tokyo, Japan More articles by this author Hitoshi Masuda Tokyo, Japan More articles by this author Satoru Kawakami Saitama, Japan More articles by this author Kazunori Kihara Tokyo, Japan More articles by this author Expand All Advertisement Advertisement PDF downloadLoading ..." @default.
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• W2040982878 title "2051 PREBIOPSY MULTI-PARAMETRIC MRI POTENTIALLY REDUCES UNNECESSARY PROSTATE BIOPSY IN MEN WITH PSA LESS THAN 10 NG/ML AND A NORMAL DIGITAL RECTAL EXAMINATION" @default.
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