Evidence map›Paper›PMID 41691567›Full record

SynthesisWorld journal of urology2026

Association between baseline prostate MRI PI-RADS classification and risk of Gleason upgrade during active surveillance: a systematic review and meta-analysis.

Shayan Smani, Nishan Sohoni, Marcin Miszczyk, Tamás Fazekas, Pawel Rajwa, Alyssa A Grimshaw, Vinaik M Sundaresan, Soum D Lokeshwar, Jeffrey Weinreb, Preston C Sprenkle and 5 more

Abstract readSystematic ReviewMeta-Analysis
PubMed Publisher
In one paragraph

Synthesis in World journal of urology, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.

0numbers the graph read from it
0cells of the map it votes in
0citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

0 citing papers in PubMed.

No citing paper in PubMed yet.

4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

15 authors.

Shayan SmaniYale School of Medicine, New Haven, CT, USA.
Nishan SohoniYale School of Medicine, New Haven, CT, USA.
Marcin MiszczykMedical University of Vienna, Vienna, Austria.
Tamás FazekasMedical University of Vienna, Vienna, Austria.
Pawel RajwaSemmelweis University, Budapest, Hungary.
Alyssa A GrimshawYale School of Medicine, New Haven, CT, USA.
Vinaik M SundaresanYale School of Medicine, New Haven, CT, USA.
Soum D LokeshwarYale School of Medicine, New Haven, CT, USA.
Jeffrey WeinrebYale School of Medicine, New Haven, CT, USA.
Preston C SprenkleYale School of Medicine, New Haven, CT, USA.
Matthew R CooperbergUniversity of California, San Francisco School of Medicine, San Francisco, CA, USA.
Tyler M SeibertUniversity of California San Diego School of Medicine, La Jolla, CA, USA.
Shahrokh F ShariatMedical University of Vienna, Vienna, Austria.
William J CatalonaNorthwestern Feinberg School of Medicine, Chicago, IL, USA.
Michael S LeapmanYale School of Medicine, New Haven, CT, USA. Michael.leapman@yale.edu.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

purposeAlthough prostate magnetic resonance imaging (MRI) enhances the detection of high-grade prostate cancer (PCa), its predictive role in active surveillance (AS) of favorable risk PCa is unclear. We examined the association between baseline MRI Prostate Imaging-Reporting and Data System (PI-RADS) score and Gleason Grade Group (GG) upgrade risk among patients managed with AS.

methodsWe systematically searched eight databases to identify studies evaluating the association between baseline PI-RADS score and the risk of GG upgrade in patients managed with AS for PCa (PROSPERO: CRD42024567762). We pooled the hazard ratios (HR)using Hartung-Knapp random-effects meta-analysis models. We assessed the risk of bias using the ROBINS-I tool.

resultsWe included eleven studies (n = 6309) in the meta-analysis. The risk of bias was moderate, attributed to the retrospective and unblinded design of seven included studies. Among studies reporting baseline PI-RADS, 2,640 patients (52.1%) had PI-RADS 1-3 lesions, and 2,421 patients (47.9%) had PI-RADS 4-5 lesions. Baseline PI-RADS 4-5 was associated with an increased risk of upgrade compared to those with PI-RADS 1-3 lesions (HR:2.21, 95%CI: 1.66-2.93, p<.001). Compared to PI-RADS 1-2, the presence of PI-RADS 3 (HR:1.88, 95%CI: 1.29-2.74, p=.008), PI-RADS 4 (HR:2.73, 95%CI: 2.08-3.58, p<.001), or PI-RADS 5 (HR:3.69, 95%CI: 2.50-5.45, p<.001) lesions were associated with an increased risk of upgrade.

conclusionsBaseline prostate MRI finding as assessed with PI-RADS is highly prognostic for GG upgrading among patients with favorable risk PCa managed with AS. These findings support further study of tailored surveillance strategies based on initial MRI findings.

Indexed as

Magnetic Resonance ImagingProstatic NeoplasmsWatchful WaitingHumansMaleNeoplasm GradingRisk AssessmentImage-guided biopsyMagnetic resonance imagingProstate imaging reporting and data systemProstatic neoplasms

Identifiers

PMID41691567

What OpenQuestion holds

Textmetadata
Read underepoch 390

Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.