ArticleFrontiers in oncology2025
PI-RADSv2.1 combined with PSA density for optimizing prostate biopsy decisions: a retrospective analysis.
Article in Frontiers in oncology, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 6 papers.
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Who cites it
6 citing papers in PubMed.
- Value of PSA density in PI-RADS 3 lesions: a single-center retrospective observational study.International urology and nephrology · 2026Observational
- An Assessment of PI-RADS v2.1: Inter-Reader Agreement, Diagnostic Accuracy, and the Added Value of PSA Density in Prostate Cancer Prediction.Diagnostics (Basel, Switzerland) · 2026Article
- Location- and ADC-based stratification of transition zone PI-RADS 3 lesions to optimize biopsy indication.Abdominal radiology (New York) · 2026Article
- Beyond PSMA: The essential complementary role of MRI in staging prostate cancer with Low-PSMA expression phenotypes.European journal of nuclear medicine and molecular imaging · 2026Article
- Evolution of the prostate cancer diagnostic paradigm: integrated evidence and clinical pathways from targeted biopsy to biopsy-free strategy.Frontiers in oncology · 2026Review
- Preoperative Magnetic Resonance Imaging Findings of the Transition Zone Predict Incidental Prostate Cancer in HoLEP.Cancer diagnosis & prognosisArticle
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Authors and funding
9 authors.
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Abstract
Objective: This study aimed to explore the application value of the Prostate Imaging Reporting and Data System version 2.1 (PI-RADS v2.1) combined with prostate-specific antigen density (PSAD) for guiding prostate biopsy, with the goal of improving biopsy positivity rates and reducing unnecessary procedures. Methods: A retrospective analysis was conducted on data from 462 patients (44-89years) who underwent prostate biopsy. Univariate and multivariate logistic regression analyses were used to identify independent risk factors for clinically significant prostate cancer (csPCa). Independent risk factors were explored to establish a diagnostic model for csPCa and indications for prostate biopsy. The diagnostic performance was evaluated by receiver operating characteristic (ROC) curve analysis, assessing sensitivity, specificity, positive predictive value, negative predictive value, biopsy avoidance rate, and missed diagnosis rate. Results: Univariate and multivariate logistic regression analyses indicated that PI-RADS v2.1 score [ Conclusion: The use of the PI-RADS v2.1 score combined with PSAD is recommended as an indication for prostate biopsy: (1) For patients with PI-RADS scores of 1-2, biopsy can be avoided if PSAD is < 0.30 ng/(mL·cm³), whereas biopsy is recommended if PSAD is ≥ 0.30 ng/(mL·cm³). (2) For patients with a PI-RADS score of 3, biopsy can be avoided if PSAD is < 0.15 ng/(mL·cm³), but it is recommended if PSAD is ≥ 0.15 ng/(mL·cm³). (3) Patients with a PI-RADS score of 4 are recommended for biopsy in all cases. (4) For patients with a PI-RADS score of 5, biopsy is recommended if PSAD is < 2.00 ng/(mL·cm³), but empirical initiation of treatment without biopsy may be considered if PSAD ≥ 2.00 ng/(mL·cm³), subject to ethics committee approval. Using these criteria, 40% (186/462) of patients in this study could potentially avoid prostate biopsy.
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