#0089
The Diagnostic value of MRI for Persistent Prostate Cancer following Irreversible Electroporation Focal Therapy: Results from a Randomized Controlled Trial
k. zhang1, J. TEOH2, . Laguna3, J. de la Rosette3
1beijing
united family hospital and clinics, urology, beijing, China
2The Chinese University of Hong Kong, urology, Hong Kong, Hong Kong,
China
3Istanbul Medipol University, urology, Istanbuk, Turkey
Introduction:
To investigate the diagnostic value of MRI for persistent prostate cancer after IRE therapy
Material and methods:
In this multi-center randomized trial, men with localized low-intermediate risk prostate cancer were randomized to receive either focal or extended IRE ablation. All the patients underwent repeat MRI scans at 6 and 12 months and transperineal template mapping biopsy (TMB) at 6 months post-IRE, Outcome measurements and statistical analysis: Sensitivity, specificity, positive predictive value (PPV), and negative predictive value (NPV) of MRI were calculated for infield and outfield lesions by 2×2 contingency tables with 95% confidence intervals (CIs) for clinically significant prostate cancer and any grade prostate cancer.
Results:
A total of 106 patients were recruited in this study, including 39 (36.8%) cases of clinically insignificant prostate cancer and 67 (63.2%) cases of clinically significant prostate cancer (ISUP≥2). 101 patients underwent repeat MRI scan and prostate biopsy at 6 months after IRE. The clinically significant prostate cancer detected by TMB infield and outfield was 9.9% (10/101) and 9.9% (10/101). In the treated area, the sensitivity, specificity, PPV, and NPV for MRI to detect clinically significant prostate cancer were 30.0% (95% CI: 6.7%-65.2%), 90.6% (95% CI: 82.3%-95.8%), 27.3% (95% CI: 6.0%-61.0%), 91.7% (95% CI: 83.6%-96.6%), respectively. In the untreated area, the sensitivity, specificity, PPV, and NPV of MRI were 20.0% (95% CI: 2.5%-55.6%), 90.6% (95% CI: 82.3%-95.8%), 20.0% (95% CI: 2.5%-55.6%), 90.6% (95% CI: 82.3%-95.8%) for clinically significant prostate cancer.