Early experience in avoiding biopsies for biopsy-naïve men with clinical suspicion of prostate cancer but non-suspicious biparametric magnetic resonance imaging results and prostate-specific antigen density < 0.15 ng/mL2: A 2-year follow-up study. (12th April 2022)

• Record Type: Journal Article
• Authors: Kortenbach, Karen-Cecilie; Løgager, Vibeke; Thomsen, Henrik S; Boesen, Lars
• Is Part Of: Acta radiologica open. Volume 11:Number 4(2022)
• Publication Date: 2022-04-12
• Subjects: Biomarkers -- biparametric magnetic resonance imaging -- diagnostic imaging -- magnetic resonance imaging -- outcome assessment -- prostate cancer; Radiology -- Periodicals; Diagnostic Imaging -- Periodicals; Radiology; Periodicals; 616.075705
• DOI: 10.1177/20584601221094825
• Languages: English
• ISSNs: 2058-4601

Abstract

Background: Only limited data have been published on the diagnostic accuracy of combining biparametric (bp) magnetic resonance imaging (MRI) and prostate-specific antigen density (PSAd) to rule out biopsies. Purpose: The purpose is to assess the 2-year risk of being diagnosed with sPCa following the strategy of avoiding immediate biopsies in men with non-suspicious bp MRIs and a PSAd &lt;0.15 ng/mL 2 . Material and Methods: Two hundred biopsy-naïve men with clinical suspicion of PCa underwent a pre-biopsy bp MRI from March to July 2019. Of these, 109 men had a Prostate Imaging Reporting and Data System (PI-RADS) score of 1–3 including 77 men with calculated PSAd &lt;0.15 ng/mL 2 . As a result, no biopsies were performed in these 77 men, who were clinically followed up for at least 2 years and re-examined in case of rising suspicion of sPCa. The remaining 32 men with a calculated PSAd ≥0.15 ng/mL 2 underwent systematic biopsies and targeted biopsies of any PI-RADS 3 lesion. Results: One of the 77 men (1.3%) had an sPCa diagnosed within 2 years of follow-up. All men were referred back to their general practitioner within 1 year and 9% (7/77) were re-referred to the urology department during follow-up. Among these men, 43% (3/7) continued to have PSA levels that were above their individual thresholds at confirmatory testing and underwent secondary MRI scans. Conclusions: No biopsies for men with bpMRI results exhibiting maximum PI-RADS 3 and with a PSAd &lt;0.15 ng/mL 2 resulted in a 2-year risk of being diagnosed with sPCa of 1.3%.