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Surveillance one year post focal cryotherapy for clinically significant prostate cancer using mpMRI and PIRADS v2.1: An initial experience from a prospective phase II mandatory biopsy study.

Publication ,  Journal Article
Velaga, J; Tay, KJ; Hang, G; Tan, YG; Yuen, JS; Chua, M; Gupta, RT; Polascik, TJ; Ngo, NT; Law, YM
Published in: Eur J Radiol Open
December 2023

OBJECTIVES: Multiparametric magnetic resonance imaging (mpMRI) surveillance post focal cryotherapy (FT) of prostate cancer is challenging as post treatment artefacts alter mpMRI findings. In this initial experience, we assessed diagnostic performance of mpMRI in detecting clinically significant prostate cancer (csPCa) after FT. MATERIALS AND METHODS: This single-centre phase II prospective clinical trial recruited 28 men with localized csPCa for FT between October 2019 and April 2021. 12-months post FT mpMRI were performed prior to biopsy and sensitivity, specificity, positive predictive value (PPV) and negative predictive value (NPV) of all mpMRI positive subjects were analysed. Chi square goodness of fit test correlated biopsy positive PIRADS3 (P3) and PIRADS4/5 lesions with histology grade group. One way ANOVA test assessed performance of ADC values in differentiating csPCa, non csPCa and benign lesions. RESULTS: Sensitivity, specificity, PPV and NPV of mpMRI were 100%, 14.28%, 53.84% and 100% for subjects with histologically proven cancer. Correlation of PIRADS v2.1 scores with histologically proven prostate cancer was statistically significant (p < 0.5). Correlation of P3 lesions with non-csPCa was statistically significant (p < 0.02535). Higher ADC value was associated with benign histology (adjusted odds ratio OR 0.97, 95% confidence interval: 0.94, 0.99) (p = 0.008). Among the malignant lesions, higher ADC value was associated with non-csPCa (adjusted OR: 0.97; 95% CI: 0.95, 0.99) (p = 0.032). CONCLUSION: mpMRI is highly sensitive in detecting residual cancer. ADC values and PIRADS scores may be of value in differentiating csPCa from non-csPCa with a potential for risk stratification of men requiring re-biopsy versus non-invasive surveillance of remnant prostate.

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Published In

Eur J Radiol Open

DOI

ISSN

2352-0477

Publication Date

December 2023

Volume

11

Start / End Page

100529

Location

England
 

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Velaga, J., Tay, K. J., Hang, G., Tan, Y. G., Yuen, J. S., Chua, M., … Law, Y. M. (2023). Surveillance one year post focal cryotherapy for clinically significant prostate cancer using mpMRI and PIRADS v2.1: An initial experience from a prospective phase II mandatory biopsy study. Eur J Radiol Open, 11, 100529. https://doi.org/10.1016/j.ejro.2023.100529
Velaga, Jyothirmayi, Kae Jack Tay, Guanqi Hang, Yu Guang Tan, John Sp Yuen, Melvin Chua, Rajan T. Gupta, Thomas J. Polascik, Nye Thane Ngo, and Yan Mee Law. “Surveillance one year post focal cryotherapy for clinically significant prostate cancer using mpMRI and PIRADS v2.1: An initial experience from a prospective phase II mandatory biopsy study.Eur J Radiol Open 11 (December 2023): 100529. https://doi.org/10.1016/j.ejro.2023.100529.
Velaga J, Tay KJ, Hang G, Tan YG, Yuen JS, Chua M, Gupta RT, Polascik TJ, Ngo NT, Law YM. Surveillance one year post focal cryotherapy for clinically significant prostate cancer using mpMRI and PIRADS v2.1: An initial experience from a prospective phase II mandatory biopsy study. Eur J Radiol Open. 2023 Dec;11:100529.
Journal cover image

Published In

Eur J Radiol Open

DOI

ISSN

2352-0477

Publication Date

December 2023

Volume

11

Start / End Page

100529

Location

England