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Abstract #2503

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

Mrishta Brizmohun Appayya1, Harbir Singh Sidhu2,3, Nikolaos Dikaios2, Edward William Johnston2,3, Lucy Simmons4, Alex Freeman5, Alex Kirkham3, Hashim Uddin Ahmed4, and Shonit Punwani2,3

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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