ArticleProstate cancer and prostatic diseases2025
Detection of clinically significant prostate cancer following initial omission of biopsy in multiparametric MRI era.
Article in Prostate cancer and prostatic diseases, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 4 papers.
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4 citing papers in PubMed.
- PHI for adverse pathology and PHI density for upgrading: two complementary predictors in localized prostate cancer.Prostate cancer and prostatic diseases · 2026Article
- Prostate biopsy: evolving strategies and perspectives.Prostate cancer and prostatic diseases · 2026Article
- The evolving role of positron emission tomography in precision prostate cancer biopsy.European journal of clinical investigation · 2025Review
- Magnetic resonance imaging/ultrasound fusion-guided targeted biopsy and ultrasound-guided systematic biopsy for prior negative prostate biopsy: A meta-analysis.Indian journal of urology : IJU : journal of the Urological Society of IndiaArticle
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11 authors.
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Abstract
backgroundMultiparametric prostate MRI (mpMRI) is being increasingly adopted for work-up of prostate cancer. For patients selected to omit biopsy, we identified factors associated with repeat MRI, eventual prostate biopsy, and subsequent detection of clinically significant prostate cancer (csPCa, Grade Group ≥2).
methodsWe identified biopsy-naïve men presenting with PSA 2-20 ng/mL (March 2018-June 2021) undergoing initial mpMRI with PIRADS 1-3 lesions who were not selected for biopsy with ≥6 months follow-up. We examined factors associated with repeat mpMRI, progression to biopsy, and subsequent detection of csPCa with univariable and multivariable logistic regression.
resultsOf 1494 men, 31% (463/1494) did not pursue biopsy. PSA density (PSAD) ≤ 0.1, prostate health index (PHI) < 55, and PIRADS 1-2 were associated with omission of prostate biopsy. csPCa diagnosis-free survival was 97.6% (326/334) with median follow up of 23.1 months (IQR 15.1-34.6 months). Black race, PSA, PHI, PSA density, and PSA and PHI velocity were significant predictors of undergoing repeat mpMRI (15.6%, 52/334) and subsequent biopsy (8.4%, 28/334). 8 men were subsequently diagnosed with csPCa (N = 7 on prostate biopsy; N = 1 incidentally on holmium enucleation of prostate). All patients diagnosed with csPCa had PIRADS 4-5 on repeat mpMRI.
conclusionsThe subsequent detection rate of csPCa among patients not initially biopsied after mpMRI was low at 2.4%. Decisions to omit biopsy after initial reassuring PHI, PSAD, and mpMRI appear safe with subsequent reassuring serum biomarkers and for cause mpMRI during follow-up.
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