Long-Term Risk of Clinically Significant Prostate Cancer in Biopsy-Negative Patients With Baseline Biparametric...

Area of Science:

• Radiology
• Oncology
• Urology

Background:

• The long-term prevalence of clinically significant prostate cancer (csPCa) after an initial negative prostate biopsy remains unclear.
• Accurate risk stratification is crucial for managing patients with suspected prostate cancer.

Purpose of the Study:

• To determine the incidence of csPCa in men with initially negative prostate biopsies.
• To evaluate the role of baseline biparametric MRI (bpMRI) and Prostate Imaging Reporting Data System (PI-RADS) scores in predicting csPCa development.

Main Methods:

• Retrospective analysis of prospectively collected data from 197 men with negative initial biopsies and baseline bpMRI.
• BpMRI interpretation using PI-RADS v2.1; biopsy results served as the reference standard.
• Statistical analysis included Kruskal-Wallis, Fisher's exact, Pearson's chi-square tests, and regression analysis; Kaplan-Meier method for time to diagnosis.

Main Results:

• Of 197 men, 38% had PI-RADS 1-2, 29% had PI-RADS 3, and 34% had PI-RADS 4-5.
• During a median follow-up of 52 months, csPCa developed in 8.1% (PI-RADS 1-2), 5.3% (PI-RADS 3), and 18.2% (PI-RADS 4-5) of men.
• Baseline PI-RADS score was the only significant predictor of csPCa diagnosis during follow-up.

Conclusions:

• Men with negative initial biopsies and low baseline bpMRI PI-RADS scores (1-3) exhibit a low rate of csPCa development.
• These findings support a more conservative follow-up strategy for select patient groups.
• Further research with extended follow-up is recommended to validate these observations.