Identifying Risk Factors for MRI-Invisible Prostate Cancer in Patients Undergoing Transperineal Saturation Biopsy
Alberto Artiles Medina, Rafael Rodríguez-Patrón Rodríguez, Mercedes Ruiz Hernández, Marina Mata Alcaraz, Silvia García Barreras, Guillermo Fernández Conejo, Agustín Fraile Poblador, Enrique Sanz Mayayo, Francisco Javier Burgos Revilla Department of Urology, Hospital Universitario Ramón y Cajal, Univ...
| Main Authors: | , , , , , , , , |
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| Format: | Article |
| Language: | English |
| Published: |
Dove Medical Press
2021-09-01
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| Series: | Research and Reports in Urology |
| Subjects: | |
| Online Access: | https://www.dovepress.com/identifying-risk-factors-for-mri-invisible-prostate-cancer-in-patients-peer-reviewed-fulltext-article-RRU |
| _version_ | 1818621757671604224 |
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| author | Artiles Medina A Rodríguez-Patrón Rodríguez R Ruiz Hernández M Mata Alcaraz M García Barreras S Fernández Conejo G Fraile Poblador A Sanz Mayayo E Burgos Revilla FJ |
| author_facet | Artiles Medina A Rodríguez-Patrón Rodríguez R Ruiz Hernández M Mata Alcaraz M García Barreras S Fernández Conejo G Fraile Poblador A Sanz Mayayo E Burgos Revilla FJ |
| author_sort | Artiles Medina A |
| collection | DOAJ |
| description | Alberto Artiles Medina, Rafael Rodríguez-Patrón Rodríguez, Mercedes Ruiz Hernández, Marina Mata Alcaraz, Silvia García Barreras, Guillermo Fernández Conejo, Agustín Fraile Poblador, Enrique Sanz Mayayo, Francisco Javier Burgos Revilla Department of Urology, Hospital Universitario Ramón y Cajal, University of Alcalá, Madrid, SpainCorrespondence: Alberto Artiles MedinaDepartment of Urology, Hospital Universitario Ramón y Cajal, M-607, km. 9, 100, Madrid, 28034, SpainTel +91.336.87.60Fax +91.336.87.59Email alberc.artiles@gmail.comPurpose: Prostatic multi-parametric magnetic resonance imaging (mpMRI) has markedly improved the assessment of men with suspected prostate cancer (PCa). Nevertheless, as mpMRI exhibits a high negative predictive value, a negative MRI may represent a diagnostic dilemma. The aim of this study was to evaluate the incidence of positive transperineal saturation biopsy in men who have negative mpMRI and to analyse the factors associated with positive biopsy in this scenario.Patients and Methods: A retrospective study of men with normal mpMRI and suspicion of PCa who underwent saturation biopsy (≥ 20 cores) was carried out. A total of 580 patients underwent transperineal MRI/transrectal ultrasound fusion targeted biopsies or saturation prostate biopsies from January 2017 to September 2020. Of them, 73 had a pre-biopsy negative mpMRI (with Prostate Imaging – Reporting and Data System, PI-RADS, ≤ 2) and were included in this study. Demographics, clinical characteristics, data regarding biopsy results and potential predictive factors of positive saturation biopsy were collected. Univariate and multivariate logistic regression analyses were used to identify independent risk factors for MRI-invisible PCa.Results: The detection rate of PCa with saturation biopsy in patients with negative MRI was 34/73 (46.58%). Out of 34 MRI-invisible prostate cancers detected, 12 (35.29%) were clinically significant PCa (csPCa) forms. Regarding factors of positive biopsy, in univariate analysis, the use of 5-alpha reductase inhibitors and free:total prostate-specific antigen (PSA) ratio were associated with the result of the saturation biopsy. In multivariate analysis, only an unfavourable free:total PSA ratio remained a risk factor (OR 11.03, CI95% 1.93– 63.15, p=0.01). Furthermore, multivariate logistic analysis demonstrated that prostate volume > 50mL significantly predicts the absence of csPCa on saturation biopsy (OR 0.11, 95% CI 0.01– 0.94, p=0.04).Conclusion: A free:total PSA ratio < 20% is a risk factor for MRI-invisible PCa. Saturation biopsy could be considered in patients with suspected PCa, despite having a negative MRI.Keywords: clinically significant prostate cancer, multi-parametric magnetic resonance imaging, negative MRI, prostate cancer, saturation biopsy |
| first_indexed | 2024-12-16T18:14:21Z |
| format | Article |
| id | doaj.art-f51c3cb3c39f427881260df58c692bbd |
| institution | Directory Open Access Journal |
| issn | 2253-2447 |
| language | English |
| last_indexed | 2024-12-16T18:14:21Z |
| publishDate | 2021-09-01 |
| publisher | Dove Medical Press |
| record_format | Article |
| series | Research and Reports in Urology |
| spelling | doaj.art-f51c3cb3c39f427881260df58c692bbd2022-12-21T22:21:42ZengDove Medical PressResearch and Reports in Urology2253-24472021-09-01Volume 1372373169201Identifying Risk Factors for MRI-Invisible Prostate Cancer in Patients Undergoing Transperineal Saturation BiopsyArtiles Medina ARodríguez-Patrón Rodríguez RRuiz Hernández MMata Alcaraz MGarcía Barreras SFernández Conejo GFraile Poblador ASanz Mayayo EBurgos Revilla FJAlberto Artiles Medina, Rafael Rodríguez-Patrón Rodríguez, Mercedes Ruiz Hernández, Marina Mata Alcaraz, Silvia García Barreras, Guillermo Fernández Conejo, Agustín Fraile Poblador, Enrique Sanz Mayayo, Francisco Javier Burgos Revilla Department of Urology, Hospital Universitario Ramón y Cajal, University of Alcalá, Madrid, SpainCorrespondence: Alberto Artiles MedinaDepartment of Urology, Hospital Universitario Ramón y Cajal, M-607, km. 9, 100, Madrid, 28034, SpainTel +91.336.87.60Fax +91.336.87.59Email alberc.artiles@gmail.comPurpose: Prostatic multi-parametric magnetic resonance imaging (mpMRI) has markedly improved the assessment of men with suspected prostate cancer (PCa). Nevertheless, as mpMRI exhibits a high negative predictive value, a negative MRI may represent a diagnostic dilemma. The aim of this study was to evaluate the incidence of positive transperineal saturation biopsy in men who have negative mpMRI and to analyse the factors associated with positive biopsy in this scenario.Patients and Methods: A retrospective study of men with normal mpMRI and suspicion of PCa who underwent saturation biopsy (≥ 20 cores) was carried out. A total of 580 patients underwent transperineal MRI/transrectal ultrasound fusion targeted biopsies or saturation prostate biopsies from January 2017 to September 2020. Of them, 73 had a pre-biopsy negative mpMRI (with Prostate Imaging – Reporting and Data System, PI-RADS, ≤ 2) and were included in this study. Demographics, clinical characteristics, data regarding biopsy results and potential predictive factors of positive saturation biopsy were collected. Univariate and multivariate logistic regression analyses were used to identify independent risk factors for MRI-invisible PCa.Results: The detection rate of PCa with saturation biopsy in patients with negative MRI was 34/73 (46.58%). Out of 34 MRI-invisible prostate cancers detected, 12 (35.29%) were clinically significant PCa (csPCa) forms. Regarding factors of positive biopsy, in univariate analysis, the use of 5-alpha reductase inhibitors and free:total prostate-specific antigen (PSA) ratio were associated with the result of the saturation biopsy. In multivariate analysis, only an unfavourable free:total PSA ratio remained a risk factor (OR 11.03, CI95% 1.93– 63.15, p=0.01). Furthermore, multivariate logistic analysis demonstrated that prostate volume > 50mL significantly predicts the absence of csPCa on saturation biopsy (OR 0.11, 95% CI 0.01– 0.94, p=0.04).Conclusion: A free:total PSA ratio < 20% is a risk factor for MRI-invisible PCa. Saturation biopsy could be considered in patients with suspected PCa, despite having a negative MRI.Keywords: clinically significant prostate cancer, multi-parametric magnetic resonance imaging, negative MRI, prostate cancer, saturation biopsyhttps://www.dovepress.com/identifying-risk-factors-for-mri-invisible-prostate-cancer-in-patients-peer-reviewed-fulltext-article-RRUclinically significant prostate cancermulti-parametric magnetic resonance imagingnegative mriprostate cancersaturation biopsy |
| spellingShingle | Artiles Medina A Rodríguez-Patrón Rodríguez R Ruiz Hernández M Mata Alcaraz M García Barreras S Fernández Conejo G Fraile Poblador A Sanz Mayayo E Burgos Revilla FJ Identifying Risk Factors for MRI-Invisible Prostate Cancer in Patients Undergoing Transperineal Saturation Biopsy Research and Reports in Urology clinically significant prostate cancer multi-parametric magnetic resonance imaging negative mri prostate cancer saturation biopsy |
| title | Identifying Risk Factors for MRI-Invisible Prostate Cancer in Patients Undergoing Transperineal Saturation Biopsy |
| title_full | Identifying Risk Factors for MRI-Invisible Prostate Cancer in Patients Undergoing Transperineal Saturation Biopsy |
| title_fullStr | Identifying Risk Factors for MRI-Invisible Prostate Cancer in Patients Undergoing Transperineal Saturation Biopsy |
| title_full_unstemmed | Identifying Risk Factors for MRI-Invisible Prostate Cancer in Patients Undergoing Transperineal Saturation Biopsy |
| title_short | Identifying Risk Factors for MRI-Invisible Prostate Cancer in Patients Undergoing Transperineal Saturation Biopsy |
| title_sort | identifying risk factors for mri invisible prostate cancer in patients undergoing transperineal saturation biopsy |
| topic | clinically significant prostate cancer multi-parametric magnetic resonance imaging negative mri prostate cancer saturation biopsy |
| url | https://www.dovepress.com/identifying-risk-factors-for-mri-invisible-prostate-cancer-in-patients-peer-reviewed-fulltext-article-RRU |
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