ReviewTranslational andrology and urology2018
MRI in early prostate cancer detection: how to manage indeterminate or equivocal PI-RADS 3 lesions?
Review in Translational andrology and urology, 2018. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 101 papers, 4 of them syntheses that pooled it.
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Who cites it
101 citing papers in PubMed, 4 syntheses or guidelines pooled it.
- Clinical impact of MRI-based risk calculators for prostate cancer diagnosis: a systematic review and meta-analysis.Prostate cancer and prostatic diseases · 2026Pooled it
- Diagnostic Performance of Prostate-specific Antigen Density for Detecting Clinically Significant Prostate Cancer in the Era of Magnetic Resonance Imaging: A Systematic Review and Meta-analysis.European urology oncology · 2024Pooled it
- Impact of PI-RADS Category 3 lesions on the diagnostic accuracy of MRI for detecting prostate cancer and the prevalence of prostate cancer within each PI-RADS category: A systematic review and meta-analysis.The British journal of radiology · 2021Pooled it
- Prostate MRI, with or without MRI-targeted biopsy, and systematic biopsy for detecting prostate cancer.The Cochrane database of systematic reviews · 2019Pooled it
- Artificial intelligence-assisted reading of non-contrast prostate MRI: application and concordance with expert interpretation in a screening population within the PROSA trial.European radiology · 2026Trial
- Natural History of PI-RADS 3 Lesions on Serial Prostate mpMRI.The Prostate · 2026Article
- Prostate cancer screening with MRI: insights from the ESUR Prostate MRI Working Group.European radiology · 2026Review
- Multicentre evaluation of artificial intelligence risk classification for detection of clinically significant prostate cancer on biparametric MRI.European radiology · 2026Article
- Article
- Clinical significance of MRI PI-RADS 3 lesions upgraded by dynamic contrast enhancement: the "PI-RADS 3 + 1" subgroup.International urology and nephrology · 2026Article
- Reply to the Letter to the Editor: Artificial intelligence for prostate MRI screening-methodological considerations regarding reference standards and reader design.European radiology · 2026Article
- Precise zonal diagnosis: multi-b-value DWI model reveals differential predictors of clinically significant prostate cancer in peripheral and transition zones.Insights into imaging · 2026Article
- The evolving PI-RADS paradigm.Cancer imaging : the official publication of the International Cancer Imaging Society · 2026Review
- Clinically significant prostate cancer detection with deep learning in a multi-center magnetic resonance imaging study.Scientific reports · 2026Article
- Article
- Artificial Intelligence in Prostate MRI: Addressing Current Limitations Through Emerging Technologies.Journal of magnetic resonance imaging : JMRI · 2026Review
- Is targeted biopsy necessary for Prostate Imaging Reporting and Data System 3 lesions?Revista da Associacao Medica Brasileira (1992) · 2026Article
- Development and internal validation of a parsimonious logistic regression model integrating multiparametric clinical indicators for predicting prostate cancer in the PI-RADS 3 cohort.Frontiers in oncology · 2026Article
- Development and external validation of a simple pre-biopsy risk stratification model for clinically significant prostate cancer in men with PI-RADS 3 lesions: a multicenter transperineal biopsy study.Frontiers in oncology · 2026Article
- Using Artificial Intelligence as a Risk Prediction Model in Patients with Equivocal Multiparametric Prostate MRI Findings.Cancers · 2025Review
41 more citing papers are in PubMed but not listed here.
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Authors and funding
1 author.
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No grant is acknowledged in the PubMed record.
Abstract
This review focuses on indeterminate lesions on prostate magnetic resonance imaging (MRI), assigned as PI-RADS category 3. The prevalence of PI-RADS 3 index lesion in the diagnostic work-up is significant, varying between one in three (32%) to one in five (22%) men, depending on patient cohort of first biopsies, previously negative biopsies, and active surveillance biopsies. A management strategy must be developed for this group of men with an indeterminate suspicion of having clinically significant prostate cancer (csPCa). Currently available data show that the actual prevalence of csPCa after targeted biopsy in PI-RADS 3 lesions vary between patients groups from one in five (21%) to one in six (16%), depending on previous biopsy status. Although this prevalence is lower in comparison to PI-RADS 4 and PI-RADS 5 lesions, still a considerable proportion of men harbor significant disease. Men with such a PI-RADS 3 lesion should therefore be adequately managed. In general, the clinical approach of using a threshold of PI-RADS ≥4 instead of PI-RADS ≥3 to select MRI for targeted biopsies is not supported by data from our explorative literature search using current definitions of csPCa. A possible adaptation to the threshold of PI-RADS ≥4 in combination with other clinical markers could be considered within an active surveillance protocol, where the balance between the individual risk of missing csPCa and the constant process of repeating prostate biopsies is crucial. In the future, improvements in MR imaging and interpretation, combined with molecular biomarkers and multivariate risk models will all be employed in prostate cancer detection and monitoring. These combinations will aid decision-making in challenging circumstances, such as unclear and diagnostic equivocal results for csPCa at early detection.
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