Abstract #2503

Characterising Indeterminate Lesions (Likert 3/5) in the Peripheral Zone of the Prostate on Multi-parametric MRI

Mrishta Brizmohun Appayya¹, Harbir Singh Sidhu^2,3, Nikolaos Dikaios², Edward William Johnston^2,3, Lucy Simmons⁴, Alex Freeman⁵, Alex Kirkham³, Hashim Uddin Ahmed⁴, and Shonit Punwani^2,3

¹Department of Radiology, Erasme Hospital, Universite Libre de Bruxelles, Brussels, Belgium, ²Centre for Medical Imaging, University College of London, London, United Kingdom, ³Department of Radiology, University College London Hospital, London, United Kingdom, ⁴Division of Surgery and Interventional Science, University College London Hospital, London, United Kingdom, ⁵Department of Pathology, University College London Hospital, London, United Kingdom

Despite the strong potential of multi-parametric MRI (mpMRI) in prostate cancer detection, 37% of prostate mp-MRI are Likert-scored 3/5, which are indeterminate for the presence of significant cancer. In this study, we assessed whether quantitative analysis of PSA, gland volume, volume-adjusted PSA density, PIRADS rescoring of Likert 3/5 lesions and qualitative prostate mpMRI descriptors could better characterise equivocal prostate lesions within the peripheral. We found that discontinuous signal changes on qualitative mpMRI were associated with clinically non-significant cancer; PIRADS rescoring did not appropriately categorise patients with clinically significant cancer. Conversely, PSA density was the most statistically significant discriminator (p=0.0040).

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