Prevalence of Prostate Cancer Following an Initial Negative MRI-Fusion Biopsy of the Prostate from 2018-2022: A Single-Center Retrospective Descriptive Cohort

Abstract

Objectives: To determine the incidence of prostate cancer on follow up after an initial negative MRI- fusion biopsy of the prostate, and to determine the change in PSA and MRI results on follow-up.

Methods: MRI-fusion prostate biopsy registry from 2018 to 2022 was obtained then histopathology, MRI results, and PSA results were obtained. Repeat PSA and MRI results at extracted at <1 year, 1-2 years, 2-3 years, and >3 years. PSA mean, range, and change were then determined. MRI results were extracted to determine progression, regression, or persistence.

Results: A total of 670 prostate biopsies were done in the study period, of which 70 were included. PSA on biopsy 9.93 (3.35 – 55.0) with corresponding PIRADS lesions 3, 4, and 5 (n=55, n=19, and n=6). No patient was subsequently diagnosed with prostate cancer on follow-up. PSA mean 7.03, 6.44, 5.27, and 6.07 at <1year, 1-2years, 2-3years, and >3years interval from biopsy. Repeat prostate MRI showed persistence in 1 and regression in 6 patients.

Conclusion: After a negative MRI-fusion biopsy of the prostate no patient developed prostate cancer with a general decrease in trend in PSA and MRI on follow-up. These patients may have longer interval follow-up periods given the clinical scenario but would be best to test this method in prospective trials first.