Impact of prebiopsy magnetic resonance imaging on biopsy and radical prostatectomy grade concordance.
image-guided biopsy
magnetic resonance imaging
prostatic neoplasms
Journal
Cancer
ISSN: 1097-0142
Titre abrégé: Cancer
Pays: United States
ID NLM: 0374236
Informations de publication
Date de publication:
01 07 2020
01 07 2020
Historique:
received:
08
10
2019
revised:
24
01
2020
accepted:
06
02
2020
pubmed:
23
4
2020
medline:
14
5
2021
entrez:
23
4
2020
Statut:
ppublish
Résumé
Adoption of prostate magnetic resonance imaging (MRI) before biopsy is based on evidence demonstrating superior detection of clinically significant prostate cancer on biopsy. Whether this is due to the detection of otherwise occult higher grade cancers or preferential sampling of higher grade areas within an otherwise low-grade cancer is unknown. To distinguish these two possibilities, this study examined the effect of prebiopsy MRI on the rate of pathologic upgrading and downgrading at prostatectomy in Surveillance, Epidemiology, and End Results-Medicare linked data from 2010 to 2015. Logistic regression was performed to assess the effect of MRI use on the Gleason grade change between biopsy and prostatectomy. Among biopsy-naive men, those who underwent prebiopsy MRI had higher odds of downgrading at prostatectomy (odds ratio [OR], 1.32; 95% confidence interval [CI], 1.05-1.66). In contrast, the odds of upgrading were significantly lower for men who underwent prebiopsy MRI (OR, 0.78; 95% CI, 0.61-0.99). Limitations included a low overall rate of MRI-utilization prior to biopsy and an inability to distinguish between template, software-assisted and cognitive fusion biopsy. Prebiopsy MRI is associated with both oversampling of higher grade areas, which results in downgrading at prostatectomy, and the detection of otherwise occult higher grade lesions, which results in less upgrading at prostatectomy.
Sections du résumé
BACKGROUND
Adoption of prostate magnetic resonance imaging (MRI) before biopsy is based on evidence demonstrating superior detection of clinically significant prostate cancer on biopsy. Whether this is due to the detection of otherwise occult higher grade cancers or preferential sampling of higher grade areas within an otherwise low-grade cancer is unknown.
METHODS
To distinguish these two possibilities, this study examined the effect of prebiopsy MRI on the rate of pathologic upgrading and downgrading at prostatectomy in Surveillance, Epidemiology, and End Results-Medicare linked data from 2010 to 2015. Logistic regression was performed to assess the effect of MRI use on the Gleason grade change between biopsy and prostatectomy.
RESULTS
Among biopsy-naive men, those who underwent prebiopsy MRI had higher odds of downgrading at prostatectomy (odds ratio [OR], 1.32; 95% confidence interval [CI], 1.05-1.66). In contrast, the odds of upgrading were significantly lower for men who underwent prebiopsy MRI (OR, 0.78; 95% CI, 0.61-0.99). Limitations included a low overall rate of MRI-utilization prior to biopsy and an inability to distinguish between template, software-assisted and cognitive fusion biopsy.
CONCLUSIONS
Prebiopsy MRI is associated with both oversampling of higher grade areas, which results in downgrading at prostatectomy, and the detection of otherwise occult higher grade lesions, which results in less upgrading at prostatectomy.
Substances chimiques
Prostate-Specific Antigen
EC 3.4.21.77
Types de publication
Journal Article
Research Support, Non-U.S. Gov't
Langues
eng
Sous-ensembles de citation
IM
Pagination
2986-2990Subventions
Organisme : Frederick J. and Theresa Dow Wallace Fund of the New York Community Trust
Organisme : Damon Runyon Physician-Scientist Training Award
Commentaires et corrections
Type : CommentIn
Type : CommentIn
Informations de copyright
© 2020 American Cancer Society.
Références
Narayan P, Gajendran V, Taylor SP, et al. The role of transrectal ultrasound-guided biopsy-based staging, preoperative serum prostate-specific antigen, and biopsy Gleason score in prediction of final pathologic diagnosis in prostate cancer. Urology. 1995;46:205-212.
Eifler JB, Feng Z, Lin BM, Partin MT, Huphreys EB, Han M. An updated prostate cancer staging nomogram (Partin tables) based on cases from 2006 to 2011. BJU Int. 2013;111:22-29.
Cooperberg MR, Pasta DJ, Elkin EP, et al. The University of California, San Francisco Cancer of the Prostate Risk Assessment score: a straightforward and reliable preoperative predictor of disease recurrence after radical prostatectomy. J Urol. 2005;173:1938-1942.
Stephenson AJ, Scardino PT, Eastham JA, et al. Preoperative nomogram predicting the 10-year probability of prostate cancer recurrence after radical prostatectomy. J Natl Cancer Inst. 2006;98:715-717.
Hamdy FC, Donovan JL, Lane JA, et al. 10-year outcomes after monitoring, surgery, or radiotherapy for localized prostate cancer. N Engl J Med. 2016;375:1415-1424.
Kim SP, Shah ND, Meropol NJ, et al. Recommendations of active surveillance for intermediate-risk prostate cancer: results from a national survey of radiation oncologists and urologists. Eur Urol Oncol. 2019;2:189-195.
Loeb S, Folkvaljon Y, Bratt O, Robinson D, Stattin P. Defining intermediate risk prostate cancer suitable for active surveillance. J Urol. 2019;201:292-299.
Dall'Era MA, Klotz L. Active surveillance for intermediate-risk prostate cancer. Prostate Cancer Prostatic Dis. 2017;20:1-6.
Musunuru HB, Yamamoto T, Klotz L, et al. Active surveillance for intermediate risk prostate cancer: survival outcomes in the Sunnybrook experience. J Urol. 2016;196:1651-1658.
Siddiqui MM, Rais-Bahrami S, Truong H, et al. Magnetic resonance imaging/ultrasound-fusion biopsy significantly upgrades prostate cancer versus systematic 12-core transrectal ultrasound biopsy. Eur Urol. 2013;64:713-719.
Kasivisvanathan V, Rannikko AS, Borghi M, et al. MRI-targeted or standard biopsy for prostate-cancer diagnosis. N Engl J Med. 2018;378:1767-1777.
Siddiqui MM, Rais-Bahrami S, Turkbey B, et al. Comparison of MR/ultrasound fusion-guided biopsy with ultrasound-guided biopsy for the diagnosis of prostate cancer. JAMA. 2015;313:390-397.
Goel S, Shoag JE, Gross MD, et al. Concordance between biopsy and radical prostatectomy pathology in the era of targeted biopsy: a systematic review and meta-analysis. Eur Urol Oncol. 2020;3:10-20.
Calio BP, Sidana A, Sugano D, et al. Risk of upgrading from prostate biopsy to radical prostatectomy pathology-does saturation biopsy of index lesion during multiparametric magnetic resonance imaging-transrectal ultrasound fusion biopsy help? J Urol. 2018;199:976-982.
Gansler T, Fedewa S, Qi R, Lin CC, Jemal A, Moul JW. Most Gleason 8 biopsies are downgraded at prostatectomy-does 4 + 4 = 7? J Urol. 2018;199:706-712.
Moore CM, Kasivisvanathan V, Eggener S, et al. Standards of Reporting for MRI-Targeted Biopsy Studies (START) of the prostate: recommendations from an international working group. Eur Urol. 2013;64:544-552.
Sommariva S, Tarricone R, Lazzeri M, Ricciardi W, Montorsi R. Prognostic value of the cell cycle progression score in patients with prostate cancer: a systematic review and meta-analysis. Eur Urol. 2016;69:107-115.
Cullen J, Rosner IL, Brand TC, et al. A biopsy-based 17-gene genomic prostate score predicts recurrence after radical prostatectomy and adverse surgical pathology in a racially diverse population of men with clinically low- and intermediate-risk prostate cancer. Eur Urol. 2015;68:123-131.
Townsend NC, Ruth K, Al-Saleem T, et al. Gleason scoring at a comprehensive cancer center: what's the difference? J Natl Compr Canc Netw. 2013;11:812-819.
Kuroiwa K, Shiraishi T, Ogawa O, Usami M, Hirao Y, Naito S. Discrepancy between local and central pathological review of radical prostatectomy specimens. J Urol. 2010;183:952-957.
Sonn GA, Fan RE, Ghanouni P, et al. Prostate magnetic resonance imaging interpretation varies substantially across radiologists. Eur Urol Focus. 2019;5:592-599.