Identification of threshold prostate-specific antigen levels to optimize the detection of clinically-significant prostate cancer by MRI/US fusion guided biopsy

Abstract 68 69 Purpose 70 The sensitivity of prostate specific antigen (PSA) increases with lower threshold values but with 71 a corresponding decline in specificity. Magnetic resonance imaging/ultrasound (MR/US) 72 targeted biopsy has been shown to detect prostate cancer (PCa) more efficiently and of higher 73 grade than standard 12-core transrectal ultrasound (TRUS) biopsy, but the optimal population for 74 its use is not well defined. We aimed to evaluate the performance of MR/US targeted versus 12- 75 core biopsy across a PSA continuum. 76 77 Materials and Methods 78 A review of all patients enrolled in a prospective trial undergoing 12-core TRUS and MR/US- 79 targeted biopsies from August 2007 through February 2014 was performed. Patients were 80 stratified by each of four cutoffs by PSA. The greatest Gleason score from either biopsy method 81 was compared within and across groups as well as across the PSA range of the population. 82 Clinically-significant (CS) PCa was defined as Gleason ≥7 (4+3). Univariate and multivariable