ArticleDiagnostic and interventional radiology (Ankara, Turkey)2026
Diagnostic performance of magnetic resonance imaging-targeted biopsy for PI-RADS ≥3 peripheral zone lesions in multiparametric prostate magnetic resonance imaging: correlation with clinically significant prostate cancer.
Article in Diagnostic and interventional radiology (Ankara, Turkey), 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 1 paper.
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1 citing paper in PubMed.
- Beyond Total PSA: Clinical Significance of S2,3PSA% in Reducing Unnecessary Prostate Biopsies.International journal of urology : official journal of the Japanese Urological Association · 2026Review
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5 authors.
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Abstract
purposeTo evaluate magnetic resonance imaging (MRI)-targeted biopsy (MRI-TB) performance in detecting clinically significant prostate cancer (csPCa) with a Prostate Imaging Reporting and Data System (PI-RADS) score of ≥3 peripheral zone (PZ) lesions using multiparametric MRI (mpMRI)-histopathology correlation.
methodsThis retrospective study included 141 patients with 187 PZ lesions who underwent mpMRI followed by both MRI-TB and transrectal ultrasound-guided systematic biopsy (SB) between December 2021 and December 2024. All mpMRI scans were evaluated by a board-certified experienced radiologist in accordance with the PI-RADS version 2.1 criteria. The csPCa detection rates of SB, MRI-TB, and combined biopsy (CB) were compared. Statistical analyses included McNemar's test, Fisher's exact test, and the Mann-Whitney U test. A P value <0.05 was considered statistically significant.
resultsAmong the 141 patients (187 PI-RADS ≥3 PZ lesions), patients with csPCa exhibited significantly higher prostate-specific antigen (PSA) levels (15.3 vs. 8.2 ng/mL;
conclusionFor csPCa detection in PI-RADS ≥3 PZ lesions, particularly PI-RADS 4, MRI-TB outperforms SB. For PI-RADS 5, SB and MRI-TB showed equivalent efficacy. However, MRI-TB alone suffices for PI-RADS ≥4 lesions or PSAD >0.15 ng/mL/mL, whereas CB remains preferable for PI-RADS 3. The high CP prevalence underscores the need for adjunctive biomarkers to improve specificity. CLINICAL SIGNIFICANCE: MRI-TB optimizes csPCa detection for PI-RADS ≥4 PZ lesions, reducing reliance on SBs. A PSAD threshold >0.15 ng/mL/mL effectively stratifies biopsy necessity, and high CP prevalence (34% of benign cases) underscores the need for adjunct biomarkers to improve specificity in PI-RADS 3-4 lesions.
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