Baseline MRI PI-RADS Linked to Biopsy Reclassification in Prostate Cancer

WEDNESDAY, Aug. 14, 2024 (HealthDay News) — The baseline magnetic resonance imaging (MRI) Prostate Imaging Reporting and Data System (PI-RADS) score is associated with biopsy reclassification among men with prostate cancer undergoing active surveillance (AS), according to a study published online June 25 in The Journal of Urology.

Kiran R. Nandalur, M.D., from William Beaumont University Hospital in Royal Oak, Michigan, and colleagues identified men in the Michigan Urological Surgery Improvement Collaborative registry with National Comprehensive Cancer Network (NCCN) low-risk and favorable intermediate-risk prostate cancer who underwent MRI within six months before or after initial biopsy and enrolled in AS. Data were included for 1,491 men with a median age of 64 years and median follow-up of 11.0 months after a landmark time of six months from diagnostic biopsy.

The researchers found associations with an increased risk for biopsy reclassification for baseline PI-RADS ≥4 lesions, grade group 2 versus 1, and increasing age (per 10 years; hazard ratios, 2.3, 2.5, and 1.8, respectively). There was no significant interaction observed between NCCN risk group and MRI findings.

“Clinical implications include improved upfront AS risk stratification with MRI, particularly important in the NCCN favorable intermediate-risk group, along with tailoring intensity of surveillance,” the authors write.

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