ArticleAnnals of medicine2025
Development and validation of risk-stratified biopsy decision pathways incorporating MRI and PSA-derived indicators.
Article in Annals of medicine, 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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Who cites it
4 citing papers in PubMed.
- Recent advances in discriminating prostate cancer from benign prostatic diseases in the pre-biopsy population.Medical oncology (Northwood, London, England) · 2026Review
- Development and Validation of a Novel Indicator for Differential Diagnosis of Clinically Significant Prostate Cancer Based on Comprehensive Hematological Testing.Diagnostics (Basel, Switzerland) · 2026Article
- Does prior TURP affect mpMRI findings or tumor grade in patients with prostate cancer?World journal of urology · 2026Article
- Deep learning model for predicting extraprostatic extension of prostate cancer based on H&E-stained biopsy digital images.Annals of medicine · 2025Article
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Authors and funding
7 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
objectivesDevelop risk-adapted conditional biopsy pathways utilizing MRI in combination with prostate-specific antigen (PSA) density (PSAD) and the ratio of free to total PSA (f/tPSA), respectively, to enhance the detection of clinically significant prostate cancer (csPCa) while minimizing 'negative' biopsies in low-risk patients.
methodsThe Prostate Imaging Reporting and Data System (PI-RADS) category, PSAD, f/tPSA and biopsy-pathology of 1018 patients were collected retrospectively. Subsequently, PSAD and f/tPSA were divided into four intervals, which were then combined with the MRI findings to construct two risk stratification matrix tables. Six biopsy decision pathways were established: three clinical pathways based solely on PSAD and f/tPSA, and three MRI-combined pathways incorporating both PI-RADS and PSA-derived indicators. The biopsy and clinically insignificant PCa (ciPCa) avoidance, csPCa detection rate, and 'negative' biopsies proportion were assessed. Decision curve analysis (DCA) was employed to evaluate the net benefit associated with each pathway.
resultsWhen reporting PI-RADS 1 - 2, PSAD ≥ 0.20 ng/ml/cm
conclusionsThe integration of MRI and PSA-derived indicators enables effective patient risk stratification, thereby providing valuable decision-making pathways to enhance the management of csPCa while minimizing 'negative' biopsies.
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