Evidence map›Paper›PMID 33043575›Full record

ArticleBJU international2021

Multiparametric magnetic resonance imaging facilitates reclassification during active surveillance for prostate cancer.

Atsuko Fujihara, Tsuyoshi Iwata, Aliasger Shakir, Alessandro Tafuri, Giovanni E Cacciamani, Karanvir Gill, Akbar Ashrafi, Osamu Ukimura, Mihir Desai, Vinay Duddalwar and 5 more

Abstract read
PubMed Publisher
In one paragraph

Article in BJU international, 2021. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 10 papers.

0numbers the graph read from it
0cells of the map it votes in
10citing papers in PubMed
1.8field-weighted citation impact, top 12% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

10 citing papers in PubMed, 24 citations in OpenAlex.

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  10. A nomogram to predict the absence of clinically significant prostate cancer in males with negative MRIInternational braz j urol : official journal of the Brazilian Society of Urology
    Article
4 · The record

Corrections and comments

5 · Who and what money

Authors and funding

15 authors at 2 institutions in 3 countries.

Atsuko FujiharaUSC Institute of Urology and Catherine & Joseph Aresty Department of Urology, University of Southern California, Los Angeles, CA, USA.ORCID 0000-0001-5213-3831
Tsuyoshi IwataUSC Institute of Urology and Catherine & Joseph Aresty Department of Urology, University of Southern California, Los Angeles, CA, USA.ORCID 0000-0002-5306-1101
Aliasger ShakirUSC Institute of Urology and Catherine & Joseph Aresty Department of Urology, University of Southern California, Los Angeles, CA, USA.
Alessandro TafuriUSC Institute of Urology and Catherine & Joseph Aresty Department of Urology, University of Southern California, Los Angeles, CA, USA.ORCID 0000-0003-1404-2925
Giovanni E CacciamaniUSC Institute of Urology and Catherine & Joseph Aresty Department of Urology, University of Southern California, Los Angeles, CA, USA.
Karanvir GillUSC Institute of Urology and Catherine & Joseph Aresty Department of Urology, University of Southern California, Los Angeles, CA, USA.
Akbar AshrafiUSC Institute of Urology and Catherine & Joseph Aresty Department of Urology, University of Southern California, Los Angeles, CA, USA.
Osamu UkimuraDepartment of Urology, Graduate School of Medical Science, Kyoto Prefectural University of Medicine, Kyoto, Japan.ORCID 0000-0003-3443-3210
Mihir DesaiUSC Institute of Urology and Catherine & Joseph Aresty Department of Urology, University of Southern California, Los Angeles, CA, USA.ORCID 0000-0002-3744-8234
Vinay DuddalwarUSC Institute of Urology and Catherine & Joseph Aresty Department of Urology, University of Southern California, Los Angeles, CA, USA.
Mariana S SternUSC Institute of Urology and Catherine & Joseph Aresty Department of Urology, University of Southern California, Los Angeles, CA, USA.
Manju AronDepartment of Pathology, Keck School of Medicine, University of Southern California, Los Angeles, CA, USA.
Suzanne L PalmerDepartment of Radiology, Keck School of Medicine, University of Southern California, Los Angeles, CA, USA.
Inderbir S GillUSC Institute of Urology and Catherine & Joseph Aresty Department of Urology, University of Southern California, Los Angeles, CA, USA.
Andre Luis AbreuUSC Institute of Urology and Catherine & Joseph Aresty Department of Urology, University of Southern California, Los Angeles, CA, USA.
University of Southern California · USKyoto Prefectural University of Medicine · JP

Funding

Diagnosing clinically-significant prostate cancer in African American men: Systematic random versus MR-image-fusion guided biopsyR01CA205058 · NCI · UNIVERSITY OF SOUTHERN CALIFORNIA · PI GILL, INDERBIR, STERN, MARIANA C · 2016 to 2019
$2.1M
National Institutes of Health/National Cancer Institute CA205058-01
6 · The paper itself

Abstract

objectiveTo investigate the utility of multiparametric magnetic resonance imaging (mpMRI) in the reassessment and monitoring of patients on active surveillance (AS) for Grade Group (GG) 1 prostate cancer (PCa). PATIENTS AND

methodsWe identified, from our prospectively maintained institutional review board-approved database, 181 consecutive men enrolled on AS for GG 1 PCa who underwent at least one surveillance mpMRI followed by MRI/prostate biopsy (PBx). A subset analysis was performed among 68 patients who underwent serial (at least two) mpMRI/PBx during AS. Pathological progression (PP) was defined as upgrade to GG ≥2 on follow up biopsy.

resultsBaseline MRI was performed in 34 patients (19%). At a median follow-up of 2.2 years for the overall cohort, the PP was 12% (6/49) for Prostate Imaging Reporting and Data System (PI-RADS) 1-2 lesions and 37% (48/129) for the PI-RADS ≥3 lesions. The 2-year PP-free survival rate was 84%. Surveillance prostate-specific antigen density (P < 0.001) and surveillance PI-RADS ≥3 (P = 0.002) were independent predictors of PP on reassessment MRI/PBx. In the serial MRI cohort, the 2-year PP-free survival was 95% for the No-MRI-progression group vs 85% for the MRI-progression group (P = 0.02). MRI progression was significantly higher in the PP (62%) than in the No-PP (31%) group (P = 0.04). If serial MRI were used for PCa surveillance and biopsy were triggered based only on MRI progression, 63% of PBx might be postponed at the cost of missing 12% of GG ≥2 PCa in those with stable MRI. Conversely, this strategy would miss 38% of those with upgrading to GG ≥2 PCa on biopsy. Stable serial mpMRI correlates with no reclassification to GG ≥3 PCa during AS.

conclusionOn surveillance mpMRI, PI-RADS ≥3 was associated with increased risk of PCa reclassification. Surveillance biopsy based only on MRI progression may avoid a large number of biopsies at the cost of missing many PCa reclassifications.

Indexed as

Multiparametric Magnetic Resonance ImagingWatchful WaitingAgedHumansMaleMiddle AgedProstatic NeoplasmsRetrospective Studiesactive surveillancebiopsymultiparametric magnetic resonance imagingprostate cancer

Identifiers

PMID33043575
OpenAlexW3092454626

What OpenQuestion holds

Textmetadata
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Registered trials

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.