Abstract
Objective
To assess the association between Prostate Imaging Reporting and Data System version
2 (PI-RADSv2) score, the Decipher score, and histologic grade of carcinoma in biopsy
tissue among low- to intermediate-risk prostate cancer patients.
Methods
MRI-ultrasound targeted biopsy of regions of interest and concurrent 12-core systematic
biopsy was performed on men with Gleason grade group (GG) 1 and 2. We compared Decipher
score with PI-RADS scores and biopsy Gleason GG. Subgroup analyses were performed
to evaluate patients who underwent radical prostatectomy (RP), and men with Decipher
testing from a targeted biopsy core.
Results
One hundred two patients with GG1 and GG2 had biopsy Decipher testing. There was no
significant difference in the median Decipher scores among the 3 multiparametric magnetic
resonance imaging categories. Patients with GG2 vs GG1 in the setting of PI-RADS 4-5
had higher genomic scores (P = .01), but no significant difference was noted in patients with PI-RADS ≤3. The
rate of genomic higher-risk disease on a targeted biopsy from PI-RADS5 was higher
in GG2 (75%) vs GG1 (11.1%; P = .01). On multivariable logistic regression analysis, the Decipher score ≥0.45,
(odds ratio (OR) 2.71; P = .02), and age (OR 1.11; P = .004) remained significant factors associated with Gleason GG2 on biopsy.
Conclusion
High-risk genomic classification can be seen across all combinations of PI-RADS categories
and Gleason GG1 and GG2, confirming a potential utility for Decipher testing in men
with low- to favorable intermediate-risk prostate cancer. The Decipher biopsy genomic
test related to Gleason GG independent of PI-RADSv2 score. Confirmatory genomic testing
for patients undergoing active surveillance appears more valuable than PI-RADSv2 score.
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Article info
Publication history
Published online: December 12, 2018
Accepted:
December 3,
2018
Received:
October 22,
2018
Footnotes
Darryl T. Martin and Kamyar Ghabili Contributed equally.
Financial Disclosure: The authors declare that they have no relevant financial interests.
Identification
Copyright
© 2018 Elsevier Inc. All rights reserved.
