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Changes in Magnetic Resonance Imaging Using the Prostate Cancer Radiologic Estimation of Change in Sequential Evaluation Criteria to Detect Prostate Cancer Progression for Men on Active Surveillance

  1. Author:
    O'Connor, Luke P
    Wang, Alex Z
    Yerram, Nitin K
    Long, Lori
    Ahdoot, Michael
    Lebastchi, Amir H
    Gurram, Sandeep
    Zeng, Johnathan
    Harmon,Stephanie
    Mehralivand, Sherif
    Merino, Maria J
    Parnes, Howard L
    Choyke, Peter L
    Shih, Joanna H
    Wood, Bradford J
    Turkbey, Baris
    Pinto, Peter A

  2. Author Address

    Urologic Oncology Branch, National Cancer Institute, National Institutes of Health, Bethesda, MD, USA., Division of Cancer Treatment and Diagnosis, National Cancer Institute, National Institutes of Health, Bethesda, MD, USA., Center for Interventional Oncology, National Cancer Institute, National Institutes of Health, Bethesda, MD, USA., Clinical Research Directorate, Frederick National Laboratory for Cancer Research sponsored by the National Cancer Institute, Bethesda, MD, USA., Molecular Imaging Program, National Cancer Institute, National Institutes of Health, Bethesda, MD, USA., Laboratory of Pathology, National Cancer Institute, National Institutes of Health, Bethesda, MD, USA., Division of Cancer Prevention, National Cancer Institutes, National Institutes of Health, Bethesda, MD, USA., Urologic Oncology Branch, National Cancer Institute, National Institutes of Health, Bethesda, MD, USA. Electronic address: pintop@mail.nih.gov.,
    1. Year: 2021
    2. Date: Apr
    3. Epub Date: 2020 Oct 21
  2. Journal: European Urology Oncology
    1. 4
    2. 2
    3. Pages: 227-234
  4. Type of Article: Article
  1. Abstract:

    The ability of serial magnetic resonance imaging (MRI) to capture pathologic progression during active surveillance (AS) remains in question. To determine whether changes in MRI are associated with pathologic progression for patients on AS. From July 2007 through January 2020, we identified all patients evaluated for AS at our institution. Following confirmatory biopsy, a total of 391 patients who underwent surveillance MRI and biopsy at least once were identified (median follow-up of 35.6 mo, interquartile range 19.7-60.6). All MRI intervals were scored using the "Prostate Cancer Radiologic Estimation of Change in Sequential Evaluation" (PRECISE) criteria, with PRECISE scores =4 considered a positive change in MRI. A generalized estimating equation-based logistic regression analysis was conducted for all intervals with a PRECISE score of < 4 to determine the predictors of Gleason grade group (GG) progression despite stable MRI. A total of 621 MRI intervals were scored by PRECISE and validated by biopsy. The negative predictive value of stable MRI (PRECISE score < 4) was greatest for detecting GG1 to?=?GG3 disease (0.94 [0.91-0.97]). If 2-yr surveillance biopsy were performed exclusively for a positive change in MRI, 3.7% (4/109) of avoided biopsies would have resulted in missed progression from GG1 to?=?GG3 disease. Prostate-specific antigen (PSA) density (odds ratio 1.95 [1.17-3.25], p?=? 0.01) was a risk factor for progression from GG1 to =GG3 disease despite stable MRI. In patients with GG1 disease and stable MRI (PRECISE score < 4) on surveillance, grade progression to?=?GG3 disease is not common. In patients with grade progression detected on biopsy despite stable MRI, elevated PSA density appeared to be a risk factor for progression to?=?GG3 disease. For patients with low-risk prostate cancer on active surveillance, the risk of progressing to grade group 3 disease is low with a stable magnetic resonance image (MRI) after 2?yr. Having higher prostate-specific antigen density increases the risk of progression, despite having a stable MRI. Copyright © 2020. Published by Elsevier B.V.

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External Sources

  1. View Full Text
  2. DOI: 10.1016/j.euo.2020.09.004
  3. PMID: 33867045
  4. PII : S2588-9311(20)30144-9

Library Notes

  1. Fiscal Year: FY2020-2021
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