Abstract #0267

Is MR-visible Gleason 6 prostate cancer clinically insignificant?

Alexandra Besser¹, Surbhi Raichandani¹, Tie Liang², Zachary Franks¹, Richard E Fan³, Geoffrey A Sonn³, and Pejman Ghanouni²

¹Body MRI, Stanford University, Stanford, CA, United States, ²Radiology, Stanford University, Stanford, CA, United States, ³Urology, Stanford University, Stanford, CA, United States

Synopsis

Keywords: Prostate, Prostate

Motivation: The clinical course of MR-visible Gleason 6 prostate cancer is unclear.

Goal(s): We studied patients with MR-visible prostate lesions scored as Gleason 6 after MR-guided and systematic biopsy.

Approach: We retrospectively analyzed the rate of Gleason grade upgrading in 95 men initially diagnosed with Gleason 6 prostate cancer in an MR-visible lesion who later underwent a second biopsy or prostatectomy.

Results: Over half of MR-visible Gleason 6 lesions were upgraded to Gleason 7 with a median time to upgrade of ~2 years. Neither PSA density nor ADC value predicted subsequent upgrade.

Impact: Gleason 6 prostate cancer that is MR-visible often harbors higher grade cancer. This argues for more aggressive monitoring or earlier intervention in these patients.

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