How safe is it to omit prostate biopsies in patients with inflammation on multiparametric MRI?
BAUS ePoster online library. Hamami H. 06/22/21; 319138; pCU-1
Disclosure(s): None
Ms. Heba Hamami
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Abstract
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Introduction
Multiparametric MRI (mpMRI) has improved the diagnosis of prostate cancer and allowed for targeted biopsies. Currently, NICE and European Association of Urology guidelines recommend omitting biopsies when the mpMRI is negative and the clinical suspicion for cancer is low. However, some of the features of inflammation seen on mpMRI can mimic prostate cancer. The aim of this study was to assess the safety of omitting prostate biopsies in biopsy naïve patients with reported inflammation on mpMRI.
Methods
This was a retrospective study that included all patients referred with a raised prostate specific antigen (PSA) or abnormal digital rectal examination, that had a prostate mpMRI between 2017 and 2020 in our unit, with reported inflammation or prostatitis. Data was collected on age, PSA level, prostate volume, PSA density and biopsy outcome. The biopsy, if felt indicated, was performed after the mpMRI.
Results
A total of 134 patients had inflammation/prostatitis on mpMRI, of which, 68 patients had prostate biopsies. 50% of the biopsies were malignant and in 31% of cases there was no inflammation or malignancy. 84% of patient with malignancy went to have radical treatment. The median PSA level in malignant cases was 5.22ng/mL with a median PSAD of 0.158 ng/mL/cm3, compared with 4.31ng/mL and 0.1ng/mL/cm3 in the benign group, respectively.
Conclusion
Inflammation can mimic cancer on mpMRI, but cancer can also mimic inflammation. The decision to offer a prostate biopsy should be made on mpMRI findings in conjunction with other factors including PSA density.
Multiparametric MRI (mpMRI) has improved the diagnosis of prostate cancer and allowed for targeted biopsies. Currently, NICE and European Association of Urology guidelines recommend omitting biopsies when the mpMRI is negative and the clinical suspicion for cancer is low. However, some of the features of inflammation seen on mpMRI can mimic prostate cancer. The aim of this study was to assess the safety of omitting prostate biopsies in biopsy naïve patients with reported inflammation on mpMRI.
Methods
This was a retrospective study that included all patients referred with a raised prostate specific antigen (PSA) or abnormal digital rectal examination, that had a prostate mpMRI between 2017 and 2020 in our unit, with reported inflammation or prostatitis. Data was collected on age, PSA level, prostate volume, PSA density and biopsy outcome. The biopsy, if felt indicated, was performed after the mpMRI.
Results
A total of 134 patients had inflammation/prostatitis on mpMRI, of which, 68 patients had prostate biopsies. 50% of the biopsies were malignant and in 31% of cases there was no inflammation or malignancy. 84% of patient with malignancy went to have radical treatment. The median PSA level in malignant cases was 5.22ng/mL with a median PSAD of 0.158 ng/mL/cm3, compared with 4.31ng/mL and 0.1ng/mL/cm3 in the benign group, respectively.
Conclusion
Inflammation can mimic cancer on mpMRI, but cancer can also mimic inflammation. The decision to offer a prostate biopsy should be made on mpMRI findings in conjunction with other factors including PSA density.
Introduction
Multiparametric MRI (mpMRI) has improved the diagnosis of prostate cancer and allowed for targeted biopsies. Currently, NICE and European Association of Urology guidelines recommend omitting biopsies when the mpMRI is negative and the clinical suspicion for cancer is low. However, some of the features of inflammation seen on mpMRI can mimic prostate cancer. The aim of this study was to assess the safety of omitting prostate biopsies in biopsy naïve patients with reported inflammation on mpMRI.
Methods
This was a retrospective study that included all patients referred with a raised prostate specific antigen (PSA) or abnormal digital rectal examination, that had a prostate mpMRI between 2017 and 2020 in our unit, with reported inflammation or prostatitis. Data was collected on age, PSA level, prostate volume, PSA density and biopsy outcome. The biopsy, if felt indicated, was performed after the mpMRI.
Results
A total of 134 patients had inflammation/prostatitis on mpMRI, of which, 68 patients had prostate biopsies. 50% of the biopsies were malignant and in 31% of cases there was no inflammation or malignancy. 84% of patient with malignancy went to have radical treatment. The median PSA level in malignant cases was 5.22ng/mL with a median PSAD of 0.158 ng/mL/cm3, compared with 4.31ng/mL and 0.1ng/mL/cm3 in the benign group, respectively.
Conclusion
Inflammation can mimic cancer on mpMRI, but cancer can also mimic inflammation. The decision to offer a prostate biopsy should be made on mpMRI findings in conjunction with other factors including PSA density.
Multiparametric MRI (mpMRI) has improved the diagnosis of prostate cancer and allowed for targeted biopsies. Currently, NICE and European Association of Urology guidelines recommend omitting biopsies when the mpMRI is negative and the clinical suspicion for cancer is low. However, some of the features of inflammation seen on mpMRI can mimic prostate cancer. The aim of this study was to assess the safety of omitting prostate biopsies in biopsy naïve patients with reported inflammation on mpMRI.
Methods
This was a retrospective study that included all patients referred with a raised prostate specific antigen (PSA) or abnormal digital rectal examination, that had a prostate mpMRI between 2017 and 2020 in our unit, with reported inflammation or prostatitis. Data was collected on age, PSA level, prostate volume, PSA density and biopsy outcome. The biopsy, if felt indicated, was performed after the mpMRI.
Results
A total of 134 patients had inflammation/prostatitis on mpMRI, of which, 68 patients had prostate biopsies. 50% of the biopsies were malignant and in 31% of cases there was no inflammation or malignancy. 84% of patient with malignancy went to have radical treatment. The median PSA level in malignant cases was 5.22ng/mL with a median PSAD of 0.158 ng/mL/cm3, compared with 4.31ng/mL and 0.1ng/mL/cm3 in the benign group, respectively.
Conclusion
Inflammation can mimic cancer on mpMRI, but cancer can also mimic inflammation. The decision to offer a prostate biopsy should be made on mpMRI findings in conjunction with other factors including PSA density.
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