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The role of the size and number of index lesion in the diagnosis of clinically significant prostate cancer in patients with PI-RADS 4 lesions who underwent in-bore MRI-guided prostate biopsy

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Abstract

Purpose

To evaluate the contribution of the size and number of the sampled lesions to the diagnosis of clinically significant prostate cancer (CSPC) in patients who had PI-RADS 4 lesions.

Methods

In this retrospective study, a total of 159 patients who had PI-RADS 4 lesions and underwent In-bore MRI-Guided prostate biopsy were included. Patients with a lesion classified as Grade Group 2 and above were considered to have CSPC. Univariate and multivariate regression analyses were used to evaluate the factors affecting the diagnosis of prostate cancer (PCa) and CSPC.

Results

A great majority (86.8%) of the patients were biopsy-naïve. About three-fourths (71.7%) had PCa, and half (54.1%) had CSPC. When the patients were divided into three groups according to the index lesion size (< 5 mm, 5–10 mm, and > 10 mm), the prevalence of PCa was 64.3, 67.5, and 82.4% and the prevalence of CSPC was 42.9, 51.2, and 64.7%, respectively. In multivariate analysis, age, index lesion size, prostate volume (< 50 ml) and being biopsy-naïve were found significant for PCa, while age and prostate volume (< 50 ml) were significant for CSPC.

Conclusion

The number of lesions was found to be insignificant in predicting PCa and CSPC. While the size of PI-RADS 4 lesions was significant in predicting PCa, it had no significance in detecting CSPC.

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Data availability

The data that support the findings of this study are available on request from the corresponding author.

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Funding

This study did not receive any grant from any sector.

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Authors and Affiliations

  1. Department of Urology, VKF American Hospital, Güzelbahce Street No: 20, Teşvikiye, 34365, Istanbul, Turkey

    Mert Kilic & Serdar Madendere

  2. Department of Radiology, VKF American Hospital, Istanbul, Turkey

    Metin Vural

  3. Department of Urology, School of Medicine, Koç University, Istanbul, Turkey

    Ersin Koseoglu, Mevlana Derya Balbay & Tarik Esen

Authors
  1. Mert Kilic
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  2. Serdar Madendere
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  3. Metin Vural
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  4. Ersin Koseoglu
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  5. Mevlana Derya Balbay
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  6. Tarik Esen
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Contributions

MK: contributed to Manuscript writing, Data collection, Data analysis, SM: contributed to Data collection, MV: contributed to Data analysis, Manuscript editing, EK: contributed to Data collection, MDB: contributed to Data analysis, Supervision, TE contributed to Manuscript writing, Supervision, Project development.

Corresponding author

Correspondence to Mert Kilic.

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Conflict of interest

The authors declare to have no conflict of interest.

Ethical approval

Approval was obtained from the ethics committee of Koç University (Ethics approval number: 2022.264.IRB1.105.)

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The authors declare that informed consent was obtained from all participants in the study.

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Kilic, M., Madendere, S., Vural, M. et al. The role of the size and number of index lesion in the diagnosis of clinically significant prostate cancer in patients with PI-RADS 4 lesions who underwent in-bore MRI-guided prostate biopsy. World J Urol 41, 449–454 (2023). https://doi.org/10.1007/s00345-022-04274-y

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  • DOI: https://doi.org/10.1007/s00345-022-04274-y

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