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• W3022536878 abstract "You have accessJournal of UrologyImaging/Radiology: Uroradiology II (MP42)1 Apr 2020MP42-20 CLINICAL PREDICTORS FOR DETECTION OF SIGNIFICANT CANCER IN FOLLOW-UP BIOPSY AFTER FOCAL THERAPY WITH HIGH-INTENSITY FOCUSED ULTRASOUND FOR LOCALIZED PROSTATE CANCER: A MULTI-INSTITUTIONAL STUDY Sunao Shoji*, Koichiro Yamada, Jun Naruse, Hanada Izumi, Tatsuya Otaki, Takahiro Ogawa, Masayoshi Kawakami, Mayura Nakano, Hakushi Kim, Masahiro Nitta, Masanori Hasegawa, Yoshiaki Kawamura, Kohei Uemura, and Akira Miyajima Sunao Shoji*Sunao Shoji* More articles by this author , Koichiro YamadaKoichiro Yamada More articles by this author , Jun NaruseJun Naruse More articles by this author , Hanada IzumiHanada Izumi More articles by this author , Tatsuya OtakiTatsuya Otaki More articles by this author , Takahiro OgawaTakahiro Ogawa More articles by this author , Masayoshi KawakamiMasayoshi Kawakami More articles by this author , Mayura NakanoMayura Nakano More articles by this author , Hakushi KimHakushi Kim More articles by this author , Masahiro NittaMasahiro Nitta More articles by this author , Masanori HasegawaMasanori Hasegawa More articles by this author , Yoshiaki KawamuraYoshiaki Kawamura More articles by this author , Kohei UemuraKohei Uemura More articles by this author , and Akira MiyajimaAkira Miyajima More articles by this author View All Author Informationhttps://doi.org/10.1097/JU.0000000000000891.020AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookLinked InTwitterEmail Abstract INTRODUCTION AND OBJECTIVE: To evaluate clinical features in patients diagnosed with significant cancer (SCa) in follow-up biopsy after focal therapy with high-intensity focused ultrasound (HIFU) for the patients with localized prostate cancer (PCa). METHODS: This was a multi-institutional study. We prospectively recruited patients with localized PCa; located SCa using MRI-transrectal ultrasound (TRUS) fusion image-guided transperineal prostate biopsies; and treated with transrectal HIFU. Serum prostate-specific antigen (PSA) levels were measured every 3 months after treatment. Multi-parametric (mp) MRI was performed at 2 weeks and 6 months after treatment of all patients. Three-dimensional (3D) reconstructed MRI analyzed morphological change of the prostate. At 6 months, all patients underwent follow-up MRI–TRUS fusion image-guided prostate biopsies of the treated areas and any cancer suspicious lesions with ≥ category 3 of PI-RADS ver. 2, and 12-core systematic biopsies, regardless of PSA level. Clinical findings were analyzed longitudinally. RESULTS: In 100 patients, median age was 70 years, PSA level 7.26 ng/mL, and prostate volume (PV) 23 mL. There were 62, 16, and 22 patients with clinical stage T2a, T2b, and T2c PCa, and 49, 22, 15, and 14 with Gleason score 3+3, 3+4, 4+3, and 4+4, respectively. There were 33, 51, 16 patients with low, intermediate, and high-risk D’Amico risk classification, respectively. At 2 weeks after treatment, blood flow disappeared in all treated areas. In the 3D analysis of mpMRI at 6 months after treatment, treated areas had shrunk, and median PV was significantly decreased to 21 mL (p<0.0001). In follow-up biopsy, 9% of patients had SCa detected outside the treated area. The number of patients with SCa detected in PI-RADS categories 1–4 was 0/43, 0/43, 5/10, and 4/4, respectively. In univariate analysis, linear correlation between PI-RADS category and SCa was significant (p<0.0001), and PSA density (PSAD) at 6 months after treatment was significant in the logistic model for SCa (p=0.0036, odds ratio of units=0.1 [95% CI]: 1.95 [1.24–3.05]). ROC curves using the classification with PI-RADS category and PSAD showed that AUCs were significantly greater than non-discrimination (AUC 0.975, 95% CI 0.947–1.000; p<0.0001). Sensitivity and specificity of combination of PI-RADS category ≥3 and PSAD ≥0.067 ng/mL/cc were 63% and 95% for the detection of SCa, respectively. CONCLUSIONS: PI-RADS category ≥3 and PSAD ≥0.067 ng/mL/cc at 6 months after treatment were significant predictive factors for detection of SCa after focal therapy with HIFU. It may be possible to avoid follow-up biopsy for patients without these factors. Source of Funding: none © 2020 by American Urological Association Education and Research, Inc.FiguresReferencesRelatedDetails Volume 203Issue Supplement 4April 2020Page: e611-e611 Advertisement Copyright & Permissions© 2020 by American Urological Association Education and Research, Inc.MetricsAuthor Information Sunao Shoji* More articles by this author Koichiro Yamada More articles by this author Jun Naruse More articles by this author Hanada Izumi More articles by this author Tatsuya Otaki More articles by this author Takahiro Ogawa More articles by this author Masayoshi Kawakami More articles by this author Mayura Nakano More articles by this author Hakushi Kim More articles by this author Masahiro Nitta More articles by this author Masanori Hasegawa More articles by this author Yoshiaki Kawamura More articles by this author Kohei Uemura More articles by this author Akira Miyajima More articles by this author Expand All Advertisement PDF downloadLoading ..." @default.
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• W3022536878 title "MP42-20 CLINICAL PREDICTORS FOR DETECTION OF SIGNIFICANT CANCER IN FOLLOW-UP BIOPSY AFTER FOCAL THERAPY WITH HIGH-INTENSITY FOCUSED ULTRASOUND FOR LOCALIZED PROSTATE CANCER: A MULTI-INSTITUTIONAL STUDY" @default.
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