The following is a summary of “Prostate Cancer Radiological Estimation of Change in Sequential Evaluation (PRECISE) Magnetic Resonance Imaging Scoring to Predict Clinical Outcomes in Active Surveillance for Grade Group 1 Prostate Cancer,” published in the OCTOBER 2023 issue of Urology by Bhanji, et al.
For a study, researchers sought to assess whether radiological changes observed on serial multiparametric magnetic resonance imaging (MRI), scored using the Prostate Cancer Radiological Estimation of Change in Sequential Evaluation (PRECISE) Scoring system, could predict grade reclassification (GR) at surveillance biopsy in men undergoing active surveillance (AS) with Grade Group 1 (GG1) prostate cancer (PCa).
A retrospective analysis was conducted on records of 255 men diagnosed with low-risk PCa on AS, who had undergone MRI-informed diagnostic and confirmatory biopsies. The study focused on a subset of 163 men who had surveillance biopsies within 6 months of an interval MRI.
Among the 255 men, 14% demonstrated radiological progression (PRECISE 4-5) on interval MRI within 24 months, while 34% showed progression when the interval exceeded 3 years (P = .002). Of the 163 men undergoing surveillance biopsy, 28% experienced GR to ≥ GG2 PCa. There was no significant increase in the rate of GR with rising PRECISE score (PRECISE 1-2: 24%, PRECISE 3: 23%, PRECISE 4-5: 38%; P = .11). However, a significant increase in GR rate was observed with higher PI-RADS scores (P < .05). Multivariable analysis revealed that a PI-RADS score of 4-5 was significantly associated with GR compared to men with a highest PI-RADS ≤3 (OR = 1.98 [95% CI: 1.45-3.09, P = .01]).
In a low-risk AS cohort with limited follow-up, the highest PI-RADS score on interval MRI, rather than the PRECISE score, was predictive of GR on surveillance biopsy.
Source: goldjournal.net/article/S0090-4295(23)00658-1/fulltext