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01-03-2018 | Original Article

Retrospective analysis of the development of PIRADS 3 lesions over time: when is a follow-up MRI reasonable?

Authors: Fabian Steinkohl, Leonhard Gruber, Jasmin Bektic, Udo Nagele, Friedrich Aigner, Thomas R. W. Herrmann, Michael Rieger, Daniel Junker

Published in: World Journal of Urology | Issue 3/2018

Abstract

Purpose

Often PIRADS 3 findings are usually followed up with further MRIs of the prostate. Current guidelines do not state an optimal interval between the initial MRI and the follow-up MRI. The aim of this study was to find out if PIRADS 3 lesions evolve over time and to determine how long the optimal interval between initial MRI and follow-ups should be.

Methods

In this retrospective study, 141 consecutive patients were included who underwent at least one follow-up MRI after an initial PIRADS 3 finding. Changes in PIRADS score and the interval between the first and the follow-up MRI were recorded. An optimal duration was calculated.

Results

Of all patients, 76.6% had a change from PIRADS 3 to either 2 or 4 in the first follow-up MRI. Reclassifications to PIRADS 4 happened earlier than reclassifications to PIRADS 2 (after 366.5 ± 217.9 days and after 534.2 ± 253.0 days, respectively). An optimal point of time for a follow-up to distinguish between changes to PIRADS 2 versus PIRADS 4 turned out to be 379 days (12.4 months, AUC 0.734, p = 0.0001). Of all patients with a PIRADS 3 lesion 14.8% harboured a prostate carcinoma.

Conclusion

Performing follow-up mpMRI rather than immediate biopsy may be beneficial for patients with PIRADS 3, as most lesions can be reclassified after a manageable period of time. Upgrades to PIRADS 4 seem to happen earlier and within fewer follow-ups than downgrades to PIRADS 2. The optimal interval for follow-up MRIs seems to be 12.4 months.

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Title: Retrospective analysis of the development of PIRADS 3 lesions over time: when is a follow-up MRI reasonable?
Authors: Fabian Steinkohl
Leonhard Gruber
Jasmin Bektic
Udo Nagele
Friedrich Aigner
Thomas R. W. Herrmann
Michael Rieger
Daniel Junker
Publication date: 01-03-2018
Publisher: Springer Berlin Heidelberg
Published in: World Journal of Urology / Issue 3/2018
Print ISSN: 0724-4983
Electronic ISSN: 1433-8726
DOI: https://doi.org/10.1007/s00345-017-2135-0

At a glance: The STEP trials

Springer Medicine

Retrospective analysis of the development of PIRADS 3 lesions over time: when is a follow-up MRI reasonable?

Abstract

Purpose

Methods

Results

Conclusion

At a glance: The STEP trials

Springer Medicine

Abstract

Purpose

Methods

Results

Conclusion

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