PURPOSE: We sought to determine whether there is a subset of men who can avoid prostate biopsy based on multiparametric magnetic resonance imaging and clinical characteristics. MATERIALS AND METHODS: Of 1,149 consecutive men who underwent prostate biopsy from October 2011 to March 2017, 135 had prebiopsy negative multiparametric magnetic resonance imaging with PI-RADS™ (Prostate Imaging Reporting and Data System) score less than 3. The detection rate of clinically significant prostate cancer was evaluated according to prostate specific antigen density and prior biopsy history. Clinically significant prostate cancer was defined as Grade Group 2 or greater. Multivariable logistic regression analysis was performed to identify predictors of nonclinically significant prostate cancer on biopsy. RESULTS: The prostate cancer and clinically significant prostate cancer detection rates were 38% and 18%, respectively. Men with biopsy detected, clinically significant prostate cancer had a smaller prostate (p = 0.004), higher prostate specific antigen density (p = 0.02) and no history of prior negative biopsy (p = 0.01) compared to the nonclinically significant prostate cancer cohort. Prostate specific antigen density less than 0.15 ng/ml/cc (p <0.001) and prior negative biopsy (p = 0.005) were independent predictors of absent clinically significant prostate cancer on biopsy. The negative predictive value of multiparametric magnetic resonance imaging for biopsy detection of clinically significant prostate cancer improved with decreasing prostate specific antigen density, primarily in men with prior negative biopsy (p = 0.001) but not in biopsy naïve men. Of the men 32% had the combination of negative multiparametric magnetic resonance imaging, prostate specific antigen density less than 0.15 ng/ml/cc and negative prior biopsy, and none had clinically significant prostate cancer on repeat biopsy. The incidence of biopsy identified, clinically significant prostate cancer was 18%, 10% and 0% in men with negative multiparametric magnetic resonance imaging only, men with negative multiparametric magnetic resonance imaging and prostate specific antigen density less than 0.15 ng/ml/cc, and men with negative multiparametric magnetic resonance imaging, prostate specific antigen density less than 0.15 ng/ml/cc and negative prior biopsy, respectively. CONCLUSIONS: We propose that a subset of men with negative multiparametric magnetic resonance imaging, prostate specific antigen density less than 0.15 ng/ml/cc and prior negative biopsy may safely avoid rebiopsy. Conversely prostate biopsy should be considered in biopsy naïve men regardless of negative multiparametric magnetic resonance imaging, particularly those with prostate specific antigen density greater than 0.15 ng/ml/cc.
PURPOSE: We sought to determine whether there is a subset of men who can avoid prostate biopsy based on multiparametric magnetic resonance imaging and clinical characteristics. MATERIALS AND METHODS: Of 1,149 consecutive men who underwent prostate biopsy from October 2011 to March 2017, 135 had prebiopsy negative multiparametric magnetic resonance imaging with PI-RADS™ (Prostate Imaging Reporting and Data System) score less than 3. The detection rate of clinically significant prostate cancer was evaluated according to prostate specific antigen density and prior biopsy history. Clinically significant prostate cancer was defined as Grade Group 2 or greater. Multivariable logistic regression analysis was performed to identify predictors of nonclinically significant prostate cancer on biopsy. RESULTS: The prostate cancer and clinically significant prostate cancer detection rates were 38% and 18%, respectively. Men with biopsy detected, clinically significant prostate cancer had a smaller prostate (p = 0.004), higher prostate specific antigen density (p = 0.02) and no history of prior negative biopsy (p = 0.01) compared to the nonclinically significant prostate cancer cohort. Prostate specific antigen density less than 0.15 ng/ml/cc (p <0.001) and prior negative biopsy (p = 0.005) were independent predictors of absent clinically significant prostate cancer on biopsy. The negative predictive value of multiparametric magnetic resonance imaging for biopsy detection of clinically significant prostate cancer improved with decreasing prostate specific antigen density, primarily in men with prior negative biopsy (p = 0.001) but not in biopsy naïve men. Of the men 32% had the combination of negative multiparametric magnetic resonance imaging, prostate specific antigen density less than 0.15 ng/ml/cc and negative prior biopsy, and none had clinically significant prostate cancer on repeat biopsy. The incidence of biopsy identified, clinically significant prostate cancer was 18%, 10% and 0% in men with negative multiparametric magnetic resonance imaging only, men with negative multiparametric magnetic resonance imaging and prostate specific antigen density less than 0.15 ng/ml/cc, and men with negative multiparametric magnetic resonance imaging, prostate specific antigen density less than 0.15 ng/ml/cc and negative prior biopsy, respectively. CONCLUSIONS: We propose that a subset of men with negative multiparametric magnetic resonance imaging, prostate specific antigen density less than 0.15 ng/ml/cc and prior negative biopsy may safely avoid rebiopsy. Conversely prostate biopsy should be considered in biopsy naïve men regardless of negative multiparametric magnetic resonance imaging, particularly those with prostate specific antigen density greater than 0.15 ng/ml/cc.
Authors: Andrew B Rosenkrantz; Sadhna Verma; Peter Choyke; Steven C Eberhardt; Scott E Eggener; Krishnanath Gaitonde; Masoom A Haider; Daniel J Margolis; Leonard S Marks; Peter Pinto; Geoffrey A Sonn; Samir S Taneja Journal: J Urol Date: 2016-06-16 Impact factor: 7.450
Authors: Jeffrey C Weinreb; Jelle O Barentsz; Peter L Choyke; Francois Cornud; Masoom A Haider; Katarzyna J Macura; Daniel Margolis; Mitchell D Schnall; Faina Shtern; Clare M Tempany; Harriet C Thoeny; Sadna Verma Journal: Eur Urol Date: 2015-10-01 Impact factor: 20.096
Authors: Ivo G Schoots; Monique J Roobol; Daan Nieboer; Chris H Bangma; Ewout W Steyerberg; M G Myriam Hunink Journal: Eur Urol Date: 2014-12-03 Impact factor: 20.096
Authors: James S Wysock; Neil Mendhiratta; Fabio Zattoni; Xiaosong Meng; Marc Bjurlin; William C Huang; Herbert Lepor; Andrew B Rosenkrantz; Samir S Taneja Journal: BJU Int Date: 2016-02-25 Impact factor: 5.588
Authors: Alessandro Tafuri; Akbar N Ashrafi; Suzanne Palmer; Aliasger Shakir; Giovanni E Cacciamani; Atsuko Iwata; Tsuyoshi Iwata; Jie Cai; Akash Sali; Chhavi Gupta; Luis G Medina; Mariana C Stern; Vinay Duddalwar; Manju Aron; Inderbir S Gill; Andre Abreu Journal: World J Urol Date: 2019-06-07 Impact factor: 4.226
Authors: Masatomo Kaneko; Dordaneh Sugano; Amir H Lebastchi; Vinay Duddalwar; Jamal Nabhani; Christopher Haiman; Inderbir S Gill; Giovanni E Cacciamani; Andre Luis Abreu Journal: Curr Urol Rep Date: 2021-03-22 Impact factor: 3.092
Authors: Anwar R Padhani; Jelle Barentsz; Geert Villeirs; Andrew B Rosenkrantz; Daniel J Margolis; Baris Turkbey; Harriet C Thoeny; François Cornud; Masoom A Haider; Katarzyna J Macura; Clare M Tempany; Sadhna Verma; Jeffrey C Weinreb Journal: Radiology Date: 2019-06-11 Impact factor: 11.105
Authors: Dordaneh Sugano; Masatomo Kaneko; Wesley Yip; Amir H Lebastchi; Giovanni E Cacciamani; Andre Luis Abreu Journal: Cancers (Basel) Date: 2021-03-22 Impact factor: 6.639