Abstracts from the Mid-Atlantic Section of the AUA 2020

© The Canadian Journal of Urology TM : International Supplement, October 2020 MP1-02 Assessing the Deliverables of Template Biopsy on the Ipsilateral Side of the Target Lesion at the Time of Fusion Targeted Prostate Biopsy J. Ellis 1 ; D. Chen 2 ; J. Drevik 1 ;A. Srivastava 2 ; B. Ristau 3 ; R. Parsons 2 ; B. Milestone 2 ; L. Levin 2 ; R. Viterbo 2 ; R. Greenberg 2 ; M. Smaldone 2 ; R. Uzzo 2 ; J.Anaokar 2 ;A. Kutikov 2 1 Einstein Healthcare Network, Philadelphia, PA, USA; 2 Fox Chase Cancer Center, Philadelphia, PA, USA; 3 University of Connecticut, Farmington, CT, USA Introduction: TheActionable intelligencemetric (AIM) and Reductionmetric (ReM) were introduced to objectify fusion biopsy deliverables across patient cohorts. Here, we specifically assess deliverables of standard template biopsy on the ipsilateral side of the targeted lesion. Materials & Methods: Using a prospectively maintained database, we identified men who underwent targeted fusion prostate biopsy using the UroNav System (Invivo) at our tertiary care Cancer Center who also had a full 12-core template biopsy at the same time. AIM was defined as all patients with higher Gleason score (GS) on TB (minimum GS ≥ 3+4=7) relative to SB divided by total patients with GS ≥ 3+4=7 CaP (i.e. % patients for whom TB offered actionable information over SB). ReM was defined as 1 - [all patients with higher GS on SB relative to TB ÷ total patients undergoing biopsy] (i.e. % patients who could have foregone SB). Results: 747 fusion-targeted biopsies were performed at our institution between March 2014-July 2019 (median age: 65, median PSA 6.1). Targeted biopsies that were midline or that did not specify laterality were excluded. Astandard template biopsy on the ipsilateral side of a positive target achieves an AIM of 17.73% and ReM of 69%, while template biopsy on the contralateral side of the target achieves an AIM of 21.2% and ReM of 70% when compared the overall AIM of 26% and ReM of 82%. Data are summarized in Tables 1 and 2. Conclusions: Both fusion targeting and bilateral standard template biopsy should be performedwhen targetable lesion is seen onmpMRI. Standard template prostate biopsy should not be omitted either on the ipsilateral or on the contralateral side of the targeted lesions. Performance Characteristics of Urinary Cytology in a Population of Patients Presenting with Hematuria to an Academic Medical Center T. Pan; J. Raman Penn State College of Medicine, Hershey, PA, USA Introduction: To investigate the performance characteristics of urinary cytology in a population of patients presenting with gross (GH) and microscopic (MH) hematuria undergoing urologic evaluation. Materials &Methods: The charts of 400 patients undergoing a complete hematuria evaluation (cystoscopy with upper-tract imaging) who also had a urinary cytology performed were reviewed. The performance characteristics (PPV, NPV, sensitivity, specificity) of cytology for urothelial malignancy was determined. Subgroup analysis based on smoking history, type of hematuria, and gender was performed. For those with urothelial cancer, the predictive value of a positive cytology for high grade and high stage urothelial cancer was determined. Results: Overall, 29 of 400 patients (7.3%) were diagnosedwith urothelial carcinoma including 24 (9.2%) and 5 (3.4%) from the GH and MH populations, respectively. The performance characteristics of cytology for urothelial malignancy in the entire cohort included a sensitivity of 41%, specificity of 99%, PPV of 75%, NPV of 96%, and diagnostic accuracy of 95% (Table 1). No observed differences were notedwhen comparing gender (p = 0.55), type of hematuria (p = 0.37), or smoking history (p = 0.22). For those diagnosed with urothelial malignancy, a positive cytology was associated not associated with a greater likelihood of higher grade (p = 1.0) or higher stage tumors (p = 0.62). Conclusions: In this hematuria population, urine cytology had low sensitivity and PPV for urothelial carcinoma irrespective of smoker status, hematuria type, or gender. Cytology should not be routinely used in a hematuria screening population. MP1-01 14 Poster Session 1: Diagnostic Imaging and Risk Stratification in Cancer