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Evaluation of Prostate Imaging Reporting and Data System Classification in the Prediction of Tumor Aggressiveness in Targeted Magnetic Resonance Imaging/Ultrasound-Fusion BiopsyBorkowetz, Angelika, Platzek, Ivan, Toma, Marieta, Renner, Theresa, Herout, Roman, Baunacke, Martin, Laniado, Michael, Baretton, Gustavo B., Froehner, Michael, Zastrow, Stefan, Wirth, Manfred P. 22 May 2020 (has links)
Objectives: The study aimed to evaluate the prediction of Prostate Imaging Reporting and Data System (PI-RADS) with respect to the prostate cancer (PCa) detection rate and tumor aggressiveness in magnetic resonance imaging (MRI)/ultrasound-fusion-biopsy (fusPbx) and in systematic biopsy (sysPbx). Materials and Methods: Six hundred and twenty five patients undergoing multiparametric MRI were investigated. MRI findings were classified using PI-RADS v1 or v2. All patients underwent fusPbx combined with sysPbx (comPbx). The lesion with the highest PI-RADS was defined as maximum PI-RADS (maxPI-RADS). Gleason Score ≥ 7 (3 + 4) was defined as significant PCa. Results: The overall PCa detection rate was 51% ( n = 321; 39% significant PCa). The detection rate was 43% in fusPbx ( n = 267; 34% significant PCa) and 36% in sysPbx ( n = 223; 27% significant PCa). Nine percentage of significant PCa were detected by sysPbx alone. A total of 1,162 lesions were investigated. The detection rate of significant PCa in lesions with PI-RADS 2, 3, 4, and 5 were 9% (18/206), 12% (56/450), 27% (98/358), and 61% (90/148) respectively. maxPI-RADS ≥ 4 was the strongest predictor for the detection of significant PCa in comPbx (OR 2.77; 95% CI 1.81–4.24; p < 0.005). Conclusions: maxPI-RADS is the strongest predictor for the detection of significant PCa in comPbx. Due to a high detection rate of additional significant PCa in sysPbx, fusPbx should still be combined with sysPbx.
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