Multicenter analysis of clinical and MRI characteristics associated with detecting clinically significant prostate cancer in PI-RADS (v2.0) category 3 lesions

Bashir Al Hussein Al Awamlh, Leonard S. Marks, Geoffrey A. Sonn, Shyam Natarajan, Richard E. Fan, Michael D. Gross, Elizabeth Mauer, Samprit Banerjee, Stefanie Hectors, Sigrid Carlsson, Daniel J. Margolis, Jim C. Hu

Research output: Contribution to journalArticlepeer-review

10 Scopus citations

Abstract

Objectives: We sought to identify clinical and magnetic resonance imaging (MRI) characteristics in men with the Prostate Imaging - Reporting and Data System (PI-RADS) category 3 index lesions that predict clinically significant prostate cancer (CaP) on MRI targeted biopsy. Materials and Methods: Multicenter study of prospectively collected data for biopsy-naive men (n = 247) who underwent MRI-targeted and systematic biopsies for PI-RADS 3 index lesions. The primary endpoint was diagnosis of clinically significant CaP (Grade Group ≥2). Multivariable logistic regression models assessed for factors associated with clinically significant CaP. The probability distributions of clinically significant CaP based on different levels of predictors of multivariable models were plotted in a heatmap. Results: Men with clinically significant CaP had smaller prostate volume (39.20 vs. 55.10 ml, P < 0.001) and lower apparent diffusion coefficient (ADC) values (973 vs. 1068 μm2/s, P = 0.013), but higher prostate-specific antigen (PSA) density (0.21 vs. 0.13 ng/ml2, P = 0.027). On multivariable analyses, lower prostate volume (odds ratio [OR]: 0.95, 95% confidence interval [CI]: 0.92–0.97), lower ADC value (OR: 0.99, 95% CI: 0.99–1.00), and Prostate-specific antigen density >0.15 ng/ml2 (OR: 3.51, 95% CI 1.61–7.68) were independently associated with significant CaP. Conclusion: Higher PSA density, lower prostate volume and ADC values are associated with clinically significant CaP in biopsy-naïve men with PI-RADS 3 lesions. We present regression-derived probabilities of detecting clinically significant CaP based on various clinical and imaging values that can be used in decision-making. Our findings demonstrate an opportunity for MRI refinement or biomarker discovery to improve risk stratification for PI-RADS 3 lesions.

Original languageEnglish
Pages (from-to)637.e9-637.e15
JournalUrologic Oncology: Seminars and Original Investigations
Volume38
Issue number7
DOIs
StatePublished - Jul 2020
Externally publishedYes

Keywords

  • Magnetic resonance imaging
  • Prostate cancer

Fingerprint

Dive into the research topics of 'Multicenter analysis of clinical and MRI characteristics associated with detecting clinically significant prostate cancer in PI-RADS (v2.0) category 3 lesions'. Together they form a unique fingerprint.

Cite this