Does Size Matter? A Retrospective Study Analysing the Size of PI-RADS 4 Lesions and Its Associated Prostate Cancer Positivity with Transperineal Prostate Biopsy

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Autor(es): dc.contributorTauranga Hospital-
Autor(es): dc.contributorUniversity of Auckland-
Autor(es): dc.contributorUniversidade Estadual Paulista (UNESP)-
Autor(es): dc.creatorHooshyari, Ali-
Autor(es): dc.creatorScholtz, David-
Autor(es): dc.creatorMaoate, Keu-
Autor(es): dc.creatorRobertson, Samuel-
Autor(es): dc.creatorVermeulen, Lodewikus Petrus-
Autor(es): dc.creatorDe Andrade, Luiz Gustavo Modelli-
Autor(es): dc.creatorKawano, Paulo Roberto-
Autor(es): dc.creatorGilling, Peter-
Autor(es): dc.creatorFraundorfer, Mark-
Autor(es): dc.creatorOrdones, Flavio Vasconcelos-
Data de aceite: dc.date.accessioned2025-08-21T17:48:33Z-
Data de disponibilização: dc.date.available2025-08-21T17:48:33Z-
Data de envio: dc.date.issued2025-04-29-
Data de envio: dc.date.issued2024-12-31-
Fonte completa do material: dc.identifierhttp://dx.doi.org/10.2147/RRU.S499930-
Fonte completa do material: dc.identifierhttps://hdl.handle.net/11449/297513-
Fonte: dc.identifier.urihttp://educapes.capes.gov.br/handle/11449/297513-
Descrição: dc.descriptionIntroduction: Magnetic resonance imaging (MRI) is an essential tool in Prostate Cancer (PCa) diagnosis. PI-RADS v2.1 score correlates with clinically significant prostate cancer (CSPCa) and according to the most recent guidelines, prevalence of CSPCa with PI-RADS 4 is 33–41%, while PI-RADS 5 is 62–79%. These groups are separated only by a size of 15 mm yet the difference in risk is significant. This study aims to find a size threshold associated with CSPCa within the PI-RADS 4 group, which may be used in combination with other prostatic parameters, such as PSA density in order to help with risk stratification and patient counselling in the pre-biopsy setting. This may also aid with surveillance of smaller PI-RADS 4 lesions in the setting of a negative biopsy and avoid unnecessary repeat biopsies unless triggered by a size threshold. Methods: A retrospective study was performed with data from 407 patients undergoing transperineal prostate biopsy (TPPB) between April 2022 and November 2023. A subgroup of patients with PI-RADS 4 was included for analysis. A ROC-AUC was obtained. Results: Median age was 67 (interquartile range: 61–71) and PSA density 0.20 (interquartile range 0.13–0.28). PI-RADS score correlated with CSPCa: for PI-RADS 1 and 2, the frequency of CSPCa was 10%; for PI-RADS 3, it was 20%; for PI-RADS 4, it was 60%; and for PI-RADS 5, it was 80%, Pearson correlation = 0.51, p < 0.001. The Receiver Operating Characteristic Area Under the Curve (ROC-AUC) was determined to be 0.664 [0.579–0.7499]. The optimal cut-off point was 8.5 mm. Patients with lesions larger than 8.5 mm had 2.31 times higher risk CSPCa. Conclusion: PI-RADS 4 size does matter and is a useful predictor of CSPCa. In our study, a cut-off of 8.5 mm was identified. The combination of PI-RADS 4 with PSA density provides a specificity higher than 80% for CSPCa detection.-
Descrição: dc.descriptionUrology Department Tauranga Hospital-
Descrição: dc.descriptionSurgical Department University of Auckland-
Descrição: dc.descriptionRenal Department Botucatu School of Medicine São Paulo State University-
Descrição: dc.descriptionUrology Department Botucatu School of Medicine São Paulo State University-
Descrição: dc.descriptionRenal Department Botucatu School of Medicine São Paulo State University-
Descrição: dc.descriptionUrology Department Botucatu School of Medicine São Paulo State University-
Formato: dc.format49-57-
Idioma: dc.languageen-
Relação: dc.relationResearch and Reports in Urology-
???dc.source???: dc.sourceScopus-
Palavras-chave: dc.subjectmpMRI-
Palavras-chave: dc.subjectPI-RADS 4-
Palavras-chave: dc.subjectprostate cancer-
Palavras-chave: dc.subjectsize-
Palavras-chave: dc.subjecttransperineal prostate biopsy-
Título: dc.titleDoes Size Matter? A Retrospective Study Analysing the Size of PI-RADS 4 Lesions and Its Associated Prostate Cancer Positivity with Transperineal Prostate Biopsy-
Tipo de arquivo: dc.typelivro digital-
Aparece nas coleções:Repositório Institucional - Unesp

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