MP70-06 POST-TREATMENT MRI FOR ASSESSMENT OF FOCAL THERAPY TREATMENT RESPONSE

You have accessJournal of UrologyProstate Cancer: Localized: Ablative Therapy II (MP70)1 Apr 2020MP70-06 POST-TREATMENT MRI FOR ASSESSMENT OF FOCAL THERAPY TREATMENT RESPONSE Daniel Triner*, Jeffrey Montgomery, Simpa Salami, and Arvin George Daniel Triner*Daniel Triner* More articles by this author , Jeffrey MontgomeryJeffrey Montgomery More articles by this author , Simpa SalamiSimpa Salami More articles by this author , and Arvin GeorgeArvin George More articles by this author View All Author Informationhttps://doi.org/10.1097/JU.0000000000000950.06AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookLinked InTwitterEmail Abstract INTRODUCTION AND OBJECTIVE: Focal therapy may preserve quality of life while offering cancer control for appropriately selected men. The need for biopsy post-ablation is controversial and there is limited data regarding the performance of MRI in the post-treatment setting. We aim to assess the performance of multiparametric prostate MRI for treatment success/failure in men undergoing focal ablation for prostate cancer. METHODS: A retrospective review of men with clinically localized prostate cancer undergoing focal ablation (nanoparticle-direct focal laser ablation, high intensity focused ultrasound, or cryoablation from 9/2017 to 10/2019. All patients underwent preoperative prostate MRI with repeat imaging post ablation at 3-6 months with subsequent targeted mapping biopsy of the ablation zone. Delphi consensus criteria for success after focal therapy was defined at absence of at gleason pattern 4 and grade group 1 cancer core length ≤3mm. Persistent disease on MRI was defined as residual disease identified by restricted diffusion with persistent enhancement or a PIRADS 4/5 lesion within the focally treated volume of ablation. Sensitivity, specificity, positive predictive value and negative predictive value of MRI for any cancer at follow-up biopsy or by Delphi consensus criteria are reported. RESULTS: A total of 31 patients who underwent ablation, post-operative MRI, and post-operative biopsy were identified with a median age of 69 and median pre-operative PSA of 8.7. 32% of patients had persistent disease on post-operative biopsy and 81% were determined to be success by Delphi consensus criteria. The sensitivity and specificity of post-operative MRI for detecting any cancer were 63.6% and 80% and the positive predictive value and negative predictive value were 63.6% and 80%. The sensitivity and specificity of post-operative MRI according to Delphi consensus criteria were 85.7% and 79% and the positive predictive value and negative predictive value were 54.5% and 95%. CONCLUSIONS: Multiparametric prostate MRI has a high negative predictive value for residual clinically significant disease following focal ablation. Early re-biopsy may potentially be avoided in patients with MRI demonstrating complete treatment response. Source of Funding: None © 2020 by American Urological Association Education and Research, Inc.FiguresReferencesRelatedDetails Volume 203Issue Supplement 4April 2020Page: e1057-e1057 Advertisement Copyright & Permissions© 2020 by American Urological Association Education and Research, Inc.MetricsAuthor Information Daniel Triner* More articles by this author Jeffrey Montgomery More articles by this author Simpa Salami More articles by this author Arvin George More articles by this author Expand All Advertisement PDF downloadLoading ...