The Added Value of Prostate Magnetic Resonance Imaging to Patient Selection.

Publisher: Permanente Press Country of Publication: United States NLM ID: 9800474 Publication Model: Print-Electronic Cited Medium: Internet ISSN: 1552-5775 (Electronic) Linking ISSN: 15525767 NLM ISO Abbreviation: Perm J Subsets: MEDLINE

Publication: Fall 2010- : Portland, OR : Permanente Press
Original Publication: Portland, Or. : Kaiser Permanente,

Prostatic Neoplasms*/diagnostic imaging ; Prostatic Neoplasms*/pathology ; Magnetic Resonance Imaging*/statistics & numerical data ; Magnetic Resonance Imaging*/methods ; Neoplasm Grading* ; Patient Selection*; Humans ; Male ; Retrospective Studies ; Aged ; Middle Aged ; Prostate/pathology ; Prostate/diagnostic imaging ; Biopsy/statistics & numerical data

Introduction: There has been a rapid increase in the utilization of magnetic resonance imaging (MRI) for prostate cancer detection. The objective of this study was to measure the increase in utilization of MRI before prostate biopsy and the effects on the distribution of Prostate Imaging Reporting and Data System (PI-RAD) scores and Gleason grades over a 5-year interval in an integrated health system.
Methods: The authors conducted a retrospective analysis of prostate MRI studies prior to biopsy in the calendar years of 2017 and 2022. Peak PI-RADS score, peak Gleason grade of suspected prostatic lesions, and the number of biopsy cores were collected from radiology reports and pathology reports from patients' electronic health records, respectively. All statistical tests were 2-tailed with a significance level set at p < 0.05. Categorical data analyses were performed using Mann-Whitney tests. Continuous data analyses were performed using t-tests.
Results: The total number of prostate MRIs and the number of MRIs with subsequent biopsy respectively increased by 178% and 215% over a 5-year interval (2017-2022). There was a higher proportion of MRI studies with an associated biopsy given a PI-RADS score of ≥ 3 (91%) and a Gleason grade of ≥ 7 (61%) in 2022 than in 2017 (PI-RADS: 75%; Gleason: 28%).
Conclusions: Increased utilization of prostate MRI has been associated with a higher proportion of biopsies with high PI-RADS and Gleason scores consistent with improved patient selection in this integrated health system.
Competing Interests: Conflicts of Interest None declared

Med Clin North Am. 2020 Nov;104(6):1051-1062. (PMID: 33099450)
Lancet. 2017 Feb 25;389(10071):815-822. (PMID: 28110982)
Urol Oncol. 2023 Feb;41(2):92-95. (PMID: 34602360)
Eur Urol. 2019 Sep;76(3):340-351. (PMID: 30898406)
AJR Am J Roentgenol. 2021 Aug;217(2):389-394. (PMID: 34161136)
Abdom Radiol (NY). 2023 Jul;48(7):2401-2405. (PMID: 37160472)
Eur J Radiol. 2023 Jul;164:110852. (PMID: 37167683)
Insights Imaging. 2018 Feb;9(1):87-101. (PMID: 29063480)
BMJ Open. 2022 Nov 8;12(11):e059482. (PMID: 36351725)
AJR Am J Roentgenol. 2019 Aug;213(2):384-396. (PMID: 31039022)
J Urol. 2023 Jul;210(1):46-53. (PMID: 37096582)
Eur Urol Focus. 2021 Jan;7(1):86-94. (PMID: 31047904)
Eur Radiol. 2020 Jun;30(6):3383-3392. (PMID: 32052171)

Keywords: Gleason grade; MRI; PI-RADS; prostate biopsy; prostate cancer

Date Created: 20240424 Date Completed: 20240709 Latest Revision: 20241007

20241007

PMC11232905

10.7812/TPP/23.178

38654626