Medium term outcomes in men with a non-suspicious mpMRI within the RAPID pathway
BAUS ePoster online library. Bertoncelli Tanaka M. 11/10/20; 304164; P9-5 Disclosure(s): Ahmed receives core support from the NIHR (UK) Imperial Biomedical Research Centre. Ahmed reports grants from Wellcome Trust, Medical Research Council, Cancer Research UK (CRUK), Prostate Cancer UK, The Urology Foundation, BMA Foundation and NIHR (UK) Imperial Biomedical Research Centre. Commercial grants were previously received for trial work outside the scope of this work from Trod Medical, as well as grants and personal fees from Sonacare Inc, Sophiris Biocorp and Boston Scientific, outside the submitted work. Winkler reports personal fees and non-financial support from Zicom Biobot, outside the submitted work.
Ms. Mariana Bertoncelli Tanaka
Ms. Mariana Bertoncelli Tanaka
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Medium term outcomes in men with a non-suspicious mpMRI within the RAPID pathway

Bertoncelli Tanaka M2, Eldred-Evans D1, Bass E1, Connor M1, Hosking-Jervis F1, Reddy D1, Bhola-Stewart H2, Powell L3, Natarajan M3, Lee J3, Sri D3, Ahmad S4, Joshi S5, Pegers E5, Patel A6, Sahadevan K6, Wong K4, Tam H2, Hrouda D2, Winkler M2, McCracken S6, Qazi H3, Gordon S4, Ahmed H1,2
1Imperial College London, London, United Kingdom, 2Imperial College Healthcare NHS Trust, London, United Kigndom, 3St George's University Hospitals NHS Foundation Trust, London, United Kingdom, 4Epsom and St Helier University Hospitals, London, United Kingdom, 5RM Partners: West London Cancer Alliance, London, United Kingdom, 6Sunderland Royal Hospital, United Kingdom

Introduction:
The 2019 NICE guideline recommend omitting biopsy in men with a non-suspicious MRI. We investigated the re-referral rates of men who have been discharged with a non-suspicious mpMRI from the Rapid Access Prostate Imaging and Diagnosis (RAPID) pathway.

Patients and Methods:
2448 patients have been investigated through the RAPID pathway between April 2017 to December 2019. Men were discharged from the pathway with an mpMRI score 1 or 2 or a score of 3 with PSA density ≤ 0.12. Non-suspicious MRIs had second mpMRI review 1-2 weeks after the initial report within a MDT setting. On discharge, primary care are advised on an individualised PSA re-referral threshold.

Results:
The median age was 66 [IQR 60-72] and median PSA was 6.7 [4.9-9.9]. In total, 34.2% [838/2448] were discharge without a suspicion of cancer and 0.02% [20/838] were re-referred by their GP. Of these, 4 patients required a biopsy due to a new mpMRI lesion or a persistently raised PSA density. There were 2 patients who had a new diagnosis of Gleason 3+4 (ISUP ≥ 2).

Conclusions:
After 2 years of follow-up, the mpMRI diagnostic pathway has a low re-referral rate and mpMRI triage remains a safe and effective approach. Re-referral rates may increase with longer follow-up.
Medium term outcomes in men with a non-suspicious mpMRI within the RAPID pathway

Bertoncelli Tanaka M2, Eldred-Evans D1, Bass E1, Connor M1, Hosking-Jervis F1, Reddy D1, Bhola-Stewart H2, Powell L3, Natarajan M3, Lee J3, Sri D3, Ahmad S4, Joshi S5, Pegers E5, Patel A6, Sahadevan K6, Wong K4, Tam H2, Hrouda D2, Winkler M2, McCracken S6, Qazi H3, Gordon S4, Ahmed H1,2
1Imperial College London, London, United Kingdom, 2Imperial College Healthcare NHS Trust, London, United Kigndom, 3St George's University Hospitals NHS Foundation Trust, London, United Kingdom, 4Epsom and St Helier University Hospitals, London, United Kingdom, 5RM Partners: West London Cancer Alliance, London, United Kingdom, 6Sunderland Royal Hospital, United Kingdom

Introduction:
The 2019 NICE guideline recommend omitting biopsy in men with a non-suspicious MRI. We investigated the re-referral rates of men who have been discharged with a non-suspicious mpMRI from the Rapid Access Prostate Imaging and Diagnosis (RAPID) pathway.

Patients and Methods:
2448 patients have been investigated through the RAPID pathway between April 2017 to December 2019. Men were discharged from the pathway with an mpMRI score 1 or 2 or a score of 3 with PSA density ≤ 0.12. Non-suspicious MRIs had second mpMRI review 1-2 weeks after the initial report within a MDT setting. On discharge, primary care are advised on an individualised PSA re-referral threshold.

Results:
The median age was 66 [IQR 60-72] and median PSA was 6.7 [4.9-9.9]. In total, 34.2% [838/2448] were discharge without a suspicion of cancer and 0.02% [20/838] were re-referred by their GP. Of these, 4 patients required a biopsy due to a new mpMRI lesion or a persistently raised PSA density. There were 2 patients who had a new diagnosis of Gleason 3+4 (ISUP ≥ 2).

Conclusions:
After 2 years of follow-up, the mpMRI diagnostic pathway has a low re-referral rate and mpMRI triage remains a safe and effective approach. Re-referral rates may increase with longer follow-up.
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