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Tristan Manalac, 18 Nov 2020
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Men with negative MRI after negative biopsy do not harbour prostate cancer

17 Nov 2020

A negative magnetic resonance imaging (MRI) following an initial negative MRI-guided biopsy is unlikely to lead to clinically significant prostate cancer and repeat biopsy, suggests a study. However, repeat MRI-guided biopsy is needed when lesions are seen on follow-up MRI.

A total of 2,716 men were identified, of whom 733 had a negative initial MRI-guided biopsy. Of these, 73 underwent follow-up MRI-guided biopsy. Participants had a median age of 64 years (interquartile range [IQR], 59–67) and prostate-specific antigen density of 0.12 ng/ml/cc (IQR, 0.08–0.17). Baseline Prostate Imaging Reporting and Data System (PI-RADS) score was 3 in 74 percent of men.

Seventeen of 73 participants (23 percent) were diagnosed with clinically significant prostate cancer at follow-up MRI-guided biopsy (median, 2.4 years; IQR, 1.3–3.6). Clinically significant prostate cancer was also found in 17 of 53 men (32 percent) when follow-up MRI showed a lesion (PI-RADS 3). However, cancer was not detected (0/10; p<0.01) when follow-up MRI was negative (PI-RADS <3).

Notably, more than half (54 percent) of men with PI-RADS 5 at follow-up MRI-guided biopsy were diagnosed with clinically significant prostate cancer.

This study included all men with a negative initial MRI-guided biopsy who underwent at least one more MRI-guided biopsy due to continued suspicion of clinically significant prostate cancer between September 2009 and July 2019. Biopsies were MRI-ultrasound fusion with targeted and systematic cores. The investigators targeted regions of interest from initial MRI and other new regions of interest at follow-up MRI-guided biopsy.

“MRI-guided biopsy which reveals no cancer may impart reassurance beyond that offered by ultrasound-guided biopsy. However, follow-up of men after a negative magnetic resonance imaging guided biopsy has been mostly by prostate-specific antigen testing and reports of follow-up tissue confirmation are few,” the investigators noted.

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Most Read Articles
4 days ago
Ivermectin confers benefits in the treatment of COVID-19, with a recent study showing that its use helps reduce the risk of death especially in patients with severe pulmonary involvement.
3 days ago
Mental health comorbidities are common among patients with type 2 diabetes mellitus and may lead to worse outcomes, a recent study has found.
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Diabetes is a key risk factor for heart failure (HF), which is the leading cause of hospitalization in patients with or without diabetes. SGLT-2* inhibitors (SGLT-2is) have been shown to reduce the risk of hospitalization for HF (HHF) regardless of the presence or absence of diabetes.

Tristan Manalac, 18 Nov 2020
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