PhD Scientific Days 2024

Budapest, 9-10 July 2024

Health Sciences I.

Magnetic Resonance Imaging in Population-based Prostate Cancer Screening: A Meta-analysis

Előadó neve

Dr. Tamás, Fazekas

Neptun code

Q9ICSW

Előadó munkahelye

Department of Urology, Semmelweis University, Budapest, Hungary

Előadó telefonszáma

+36706118524

Előadó e-mail címe

fazekastamas192@gmail.com

Az előadás címe

Magnetic Resonance Imaging in Population-based Prostate Cancer Screening: A Meta-analysis

Szerző(k) neve és munkahelye

Tamás Fazekas1, Giuseppe Basile2, Sung Ryul Shim3, Michael Baboudjian4, Tamás Kói5, Guillaume Ploussard6, Veeru Kasivisvanathan7, Juan Gómez Rivas8, Girogio Gandaglia9, Tibor Szarvas1, Nyirády Péter1, Ivo G. Schoots10, Roderick C. N. van den Bergh11, Michael S. Leapman12, Shahrokh F. Shariat13, Pawel Rajwa14

1: Department of Urology, Semmelweis University, Budapest, Hungary
2: Unit of Urology, Division of Oncology, Urological Research Institute, IRCCS San Raffaele Scientific Institute, Vita-Salute San Raffaele University, Milan, Italy
3: Department of Biomedical Informatics, College of Medicine, Konyang University, Daejeon, Republic of Korea
4: Department of Urology, APHM, North Academic Hospital, Marseille, France
5: Department of Stochastics, Institute of Mathematics, Budapest University of Technology and Economics, Budapest, Hungary
6: Department of Urology, La Croix du Sud Hospital, Quint Fonsegrives, France
7: Division of Surgery and Interventional Science, University College London, UK
8: Department of Urology, Hospital Universitario La Paz, Madrid, Spain
9: Unit of Urology, Division of Oncology, Urologica Research Institute, IRCCS San Raffaele Scientific Institute, Vita-Salute San Raffaele University, Milan, Italy
10: Department of Radiology and Nuclear Medicine, Erasmus MC Cancer Institute, University Medical Centre, Rotterdam, The Netherlands
11: Department of Urology, Erasmus MC, Rotterdam, The Netherlands
12: Department of Urology, Yale School of Medicine, New Haven, Connecticut, USA
13: Department of Urology, Comprehensive Cancer Center, Medical University of Vienna, Vienna, Austria
14: Department of Urology, Medical University of Silesia, Zabrze, Poland

Bemutatás módja

Szóbeli

Szekció

Health Sciences I.

Language of the presentation

English

Preferred session

Pathological and Oncological Sciences

Összefoglaló szövege

Introduction: Prostate magnetic resonance imaging (MRI) is increasingly integrated within the prostate cancer (PCa) early detection pathway.
Aims: to evaluate the existing data regarding screening pathways incorporating MRI with targeted biopsy and assess their diagnostic value compared to prostate-specific antigen-based (PSA) screening with systematic biopsy strategies.
Methods: PubMed, Embase, Cochrane, Scopus, and Web of Science were queried through May 2023. We included only randomized clinical trials and prospective cohort studies. Number of screened individuals, biopsy indications, biopsies performed, clinically significant PCa (csPCa) defined as International Society of Urological Pathology (ISUP) grade≥2, and insignificant (ISUP1) PCa-s detected were extracted. The primary outcome was csPCa detection rate, secondary outcomes included clinically insignificant PCa detection rate, biopsy indication rates, and positive predictive value for the detection of csPCa. The generalized mixed-effect approach with pooled odds ratios (OR) and random-effect models was used to compare the MRI-based and PSA-only screening strategies. Separate analyses were performed based on the timing of MRI (primary/sequential after PSA test) and cut-off (Prostate Imaging Reporting and Data System (PI-RADS) ≥3 or ≥4) for biopsy indication.
Results: We synthesized data from 80,114 men from 12 studies. Compared to standard PSA-based screening, the MRI pathway (sequential screening, PI-RADS≥3 cut-off for biopsy) was associated with higher odds of csPCa when tests results were positive (OR: 4.15, 95%-CI: 2.93-5.88, p≤0.001), decreased odds of biopsies (OR: 0.28, 95%-CI: 0.22-0.36, p≤0.001) and insignificant cancers detected (OR: 0.34, 95%-CI: 0.23-0.49, p=0.002), without significant differences in the detection of csPCa (OR: 1.02, 95%-CI: 0.75-1.37, p=0.86). Implementing a PI-RADS≥4 threshold for biopsy selection led to a further reduction in the odds of detecting insignificant PCa (OR: 0.23, 95%-CI: 0.05-0.97, p=0.048), and biopsies performed (OR: 0.19, 95%-CI: 0.09-0.38, p=0.01), without differences in csPCa detection (OR: 0.85, 95%-CI: 0.49-1.45, p=0.22).
Conclusion: Integrating MRI in PCa screening pathways reduces the number of unnecessary biopsies and the overdiagnosis of insignificant PCa, while maintaining csPCa detection as compared with PSA-only screening.
Funding: none.

University

Semmelweis University

Other university, not listed above

Medical University of Vienna

Supervisor

Prof. Shahrokh F. Shariat

Publication of my abstract

I do not give consent to the publication of my abstract on the website of the congress.

Kind

Szabad

Status

elfogadva

Accepted presentation method

szóbeli

Előadás fájl jóváhagyás

nem rendelkezett róla

Előadó

6869

Start

11:00

End

11:15