Associate Professor The Chinese University of Hong Kong
Introduction: To evaluate the additional role of systematic biopsy in predicting clinically significant prostate cancer(csPCa) among Asian men with MRI-guided prostate biopsies performed. Methods: The analyses were done in 5240 Asian men in a multicenter MRI-guided biopsy database of 21 Asian centers in Hong Kong, Shanghai, Beijing, Taiwan, Singapore, Japan, and the Philippines. Each men underwent MRI-targeted and systematic biopsy. The role of systematic biopsy in various PI-RADS and PSA levels in predicting clinically significant prostate cancer(ISUP>=2) was evaluated. Results: 3080 men with prostate volume and PI-RADS score available, and systematic and targeted biopsies reported separately, were included. 4.9%, 42.6%, 35.8% and 14.7% patients had highest PI-RADS score 2, 3, 4 and 5, respectively. The median PSA, PSA density, targeted cores, and systematic cores were 8.2, 0.19, 3 and 12 respectively. 54.9% had PCa and 41.1% had csPCa. csPCa was diagnosed in 9.7%, 22.5%, 57.2% and 78.1% of men with PI-RADS score 2,3,4 and 5, respectively. csPCa diagnosed only on systematic biopsy but not on targeted biopsy is shown in Table 1. Conclusions: csPCa on additional systematic biopsy was only 5.6% in men with PSA density <0.15. Additional systematic biopsy has limited role in men with highest PI-RADS score of 2 or 3, and PI-RADS 4 with PSA density <0.15. SOURCE OF Funding: None
