Interaction of patient age and high-grade prostate cancer on targeted biopsies of MRI suspicious lesions.

Area of Science:

• Urology
• Radiology
• Oncology

Background:

• Prostate cancer (PCa) detection in older men often relies on magnetic resonance imaging (MRI) and targeted biopsies.
• The interplay between patient age and PI-RADS scores in determining PCa grade requires further investigation.

Purpose of the Study:

• To evaluate how patient age and PI-RADS scores interact in determining the grade of PCa found via MRI-targeted biopsy in older men.
• To assess the association of age and PI-RADS score with clinically significant and high-risk PCa.

Main Methods:

• A prospectively accrued cohort of 2677 men with PI-RADS ≥3 lesions on pre-biopsy MRI and no prior PCa history were analyzed.
• Ordinal and binomial logistic regression analyses were performed to assess associations.
• Data included patient age, PI-RADS score, and biopsy outcomes (clinically significant PCa, high-risk PCa).

Main Results:

• Clinically significant PCa was found in 47% and high-risk PCa in 12% of men.
• Older age groups showed a significantly higher prevalence of clinically significant and high-risk PCa.
• While age correlated with clinically significant PCa, PI-RADS score and its interaction with age were significantly associated with high-risk PCa.

Conclusions:

• High-risk PCa is prevalent in older men undergoing MRI-targeted biopsy.
• MRI findings, particularly PI-RADS score and its interaction with age, are significant predictors of high-risk PCa.
• Pre-biopsy MRI is valuable for localizing potentially lethal PCa in older men.