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Authors: Juho Eineluoto, Petrus Järvinen, Anu Kenttämies, Tuomas Kilpeläinen, Hanna Vasarainen, Kevin Sandeman, Andrew Erickson, Tuomas Mirtti, Antti Rannikko
Summary: Introduction: This study was conducted to describe the repeat multiparametric MRI (mpMRI)
changes occurring in prostate cancer (PCa) patients during active surveillance (AS), and to study
possible associations between mpMRI-related parameters in predicting prostate biopsy (Bx)
Gleason score (GS) upgrading >3+3 (GU) and protocol-based treatment change (TC).
Materials and methods: The study cohort consisted of 76 AS patients with GS 3+3 PCa
and at least two consecutive mpMRIs of the prostate performed between 2006 and 2015. Patients
were followed according to the Prostate Cancer Research International Active Surveillance (PRIAS) protocol and additional mpMRIs. The primary end points were GS upgrading (GU) (>3+3) in protocol-based biopsies and protocol-based TC.
Results: 53/76 (69%) patients had progression (PIRADS upgrade, size increase or new
lesion[s]), 18/76 (24%) had radiologically stable disease, and 5/76 (7%) had regression
(PIRADS or size decrease, disappearance of lesion[s]) in repeat mpMRIs during AS. PIRADS
scores 4 to 5 in the initial mpMRI was associated with GU (p=0.008) and protocol-based TC
(p=0.009). Tumour progression on repeat mpMRIs was associated with TC (p=0.045) but not with
GU (p=1.00). PIRADS scores 4-5 predict GU (sensitivity 0.80 [95% confidence interval (CI);
0.51-0.95, specificity 0.62 [95% CI; 0.52-0.77]) with PPV and NPV values of 0.34 (95% CI;
0.21-0.55) and 0.93 (95% CI; 0.80-0.98), respectively.
Conclusion: mpMRI is a useful tool not only to select but also to monitor PCa
patients on AS.
Proper citation: Juho Eineluoto, Petrus Järvinen, Anu Kenttämies, Tuomas Kilpeläinen, Hanna Vasarainen, Kevin Sandeman, Andrew Erickson, Tuomas Mirtti, Antti Rannikko 2017. Repeat multiparametric MRI in prostate cancer patients on active surveillance. protocols.io dx.doi.org/10.17504/protocols.io.j5jcq4n Copy
Authors: Juho Eineluoto, Petrus Järvinen, Anu Kenttämies, Tuomas Kilpeläinen, Hanna Vasarainen, Kevin Sandeman, Andrew Erickson, Tuomas Mirtti, Antti Rannikko
Summary: Introduction: This study was conducted to describe the repeat multiparametric MRI (mpMRI)
changes occurring in prostate cancer (PCa) patients during active surveillance (AS), and to study
possible associations between mpMRI-related parameters in predicting prostate biopsy (Bx)
Gleason score (GS) upgrading >3+3 (GU) and protocol-based treatment change (TC).
Materials and methods: The study cohort consisted of 76 AS patients with GS 3+3 PCa
and at least two consecutive mpMRIs of the prostate performed between 2006 and 2015. Patients
were followed according to the Prostate Cancer Research International Active Surveillance (PRIAS) protocol and additional mpMRIs. The primary end points were GS upgrading (GU) (>3+3) in protocol-based biopsies and protocol-based TC.
Results: 53/76 (69%) patients had progression (PIRADS upgrade, size increase or new
lesion[s]), 18/76 (24%) had radiologically stable disease, and 5/76 (7%) had regression
(PIRADS or size decrease, disappearance of lesion[s]) in repeat mpMRIs during AS. PIRADS
scores 4 to 5 in the initial mpMRI was associated with GU (p=0.008) and protocol-based TC
(p=0.009). Tumour progression on repeat mpMRIs was associated with TC (p=0.045) but not with
GU (p=1.00). PIRADS scores 4-5 predict GU (sensitivity 0.80 [95% confidence interval (CI);
0.51-0.95, specificity 0.62 [95% CI; 0.52-0.77]) with PPV and NPV values of 0.34 (95% CI;
0.21-0.55) and 0.93 (95% CI; 0.80-0.98), respectively.
Conclusion: mpMRI is a useful tool not only to select but also to monitor PCa
patients on AS.
Proper citation: Juho Eineluoto, Petrus Järvinen, Anu Kenttämies, Tuomas Kilpeläinen, Hanna Vasarainen, Kevin Sandeman, Andrew Erickson, Tuomas Mirtti, Antti Rannikko 2017. Repeat multiparametric MRI in prostate cancer patients on active surveillance. protocols.io dx.doi.org/10.17504/protocols.io.j66crhe Copy
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