Yu, JinxingFulcher, Ann S.Winks, SarahTurner, Mary A.Behl, WilliamWare, Anna LeeMukhopadhyay, Nitai D.Kim, CandiceJackson, ChristopherBajaj, Harnek S.Hampton, Lance J.2020-06-302020-06-302020-06-29Yu, J.; Fulcher, A.S.; Winks, S.; Turner, M.A.; Behl, W.; Ware, A.L.; Mukhopadhyay, N.D.; Kim, C.; Jackson, C.; Bajaj, H.S.; Hampton, L.J. Utilization of Multiparametric MRI of Prostate in Patients under Consideration for or Already in Active Surveillance: Correlation with Imaging Guided Target Biopsy. Diagnostics 2020, 10, 441.http://hdl.handle.net/10919/99199This study sought to assess the value of multiparametric magnetic resonance image (mp-MRI) in patients with a prostate cancer (PCa) Gleason score of 6 or less under consideration for or already in active surveillance and to determine the rate of upgrading by target biopsy. Three hundred and fifty-four consecutive men with an initial transrectal ultrasound-guided (TRUS) biopsy-confirmed PCa Gleason score of 6 or less under clinical consideration for or already in active surveillance underwent mp-MRI and were retrospectively reviewed. One hundred and nineteen of 354 patients had cancer-suspicious regions (CSRs) at mp-MRI. Each CSR was assigned a Prostate Imaging Reporting and Data System (PI-RADS) score based on PI-RADS v2. One hundred and eight of 119 patients underwent confirmatory imaging-guided biopsy for CSRs. Pathology results including Gleason score (GS) and percentage of specimens positive for PCa were recorded. Associations between PI-RADS scores and findings at target biopsy were evaluated using logistic regression. At target biopsy, 81 of 108 patients had PCa (75%). Among them, 77 patients had upgrading (22%, 77 of 354 patients). One hundred and forty-six CSRs in 108 patients had PI-RADS 3 <i>n</i> = 28, 4 <i>n</i> = 66, and 5 <i>n</i> = 52. The upgraded rate for each category of CSR was for PI-RADS 3 (5 of 28, 18%), 4 (47 of 66, 71%) and 5 (49 of 52, 94%). Using logistic regression analysis, differences in PI-RADS scores from 3 to 5 are significantly associated with the probability of disease upgrade (20%, 73%, and 96% for PI-RADS score of 3, 4, and 5, respectively). Adding mp-MRI to patients under consideration for or already in active surveillance helps to identify undiagnosed PCa of a higher GS or higher volume resulting in upgrading in 22%.application/pdfenCreative Commons Attribution 4.0 Internationalprostate canceractive surveillancemultiparametric MRIPI-RADS scoreimaging-guided target prostate biopsyArticle - Refereed2020-06-30https://doi.org/10.3390/diagnostics10070441