Can MRI Help Inform Which Men With a History of Multifocal High-Grade Prostatic Intraepithelial Neoplasia or Atypical Small Acinar Proliferation Remain at an Elevated Risk for Clinically Significant Prostate Cancer?
The Journal of urology
PURPOSE: We investigated the association of MRI findings in men with a previous diagnosis of atypical small acinar proliferation (ASAP) or multifocal high-grade intraepithelial neoplasia (HGPIN) with pathologic findings on repeat biopsy.
MATERIALS AND METHODS: We retrospectively reviewed patients with ASAP/multifocal HGPIN undergoing a repeat biopsy in the Michigan Urological Surgery Improvement Collaborative registry. We included men with and without an MRI after the index biopsy demonstrating ASAP/multifocal HGPIN but before the repeat biopsy. Men with an MRI prior to the index biopsy were excluded. We compared the proportion of men with ≥GG2 CaP (Grade Group 2 prostate cancer) on repeat biopsy among the following groups with the χ
RESULTS: Among the 207 men with a previous diagnosis of ASAP/multifocal HGPIN that underwent a repeat biopsy, men with a PIRADS ≥4 lesion had a higher proportion of ≥GG2 CaP (56%) compared with men without an MRI (12%,
CONCLUSIONS: MRI is a valuable diagnostic tool to triage which men with a history of ASAP or multifocal HGPIN on initial biopsy should undergo or avoid repeat biopsy without missing clinically significant CaP.
Sessine MS, Radoiu CS, Qi J, Labardee C, Burks F, George AK, et al. Can MRI help inform which men with a history of multifocal high-grade prostatic intraepithelial neoplasia or atypical small acinar proliferation remain at an elevated risk for clinically significant prostate cancer? J Urol. 2023:101097ju0000000000003775. PMID: 37930976