Observational studyInternational urology and nephrology2026
Value of PSA density in PI-RADS 3 lesions: a single-center retrospective observational study.
Observational study in International urology and nephrology, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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7 authors.
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Abstract
purposeThe aim of this study was to evaluate whether Prostate-specific antigen density (PSAD) improves risk stratification for clinically significant prostate cancer in patients with PI-RADS 3 lesions and to assess its potential role in reducing unnecessary biopsies.
methodsA single-center retrospective observational study was conducted at Hospital Universitario Clínico San Cecilio (Granada, Spain) between January 2022 and December 2025. A total of 203 patients with a PI-RADS 3 lesion who underwent systematic and targeted biopsy were included. Clinically significant prostate cancer was defined as ISUP ≥ 2. Univariate analysis, logistic regression (age and PSAD ≥ 0.15 ng/mL/cc), ROC curve analysis, and diagnostic performance metrics for PSAD ≥ 0.15 were performed.
resultsProstate cancer was detected in 73/203 patients (36%) and csPCa in 21/203 (10.3%). PSAD was higher in csPCa cases (0.17 vs 0.11; p = 0.001). PSAD ≥ 0.15 was independently associated with csPCa (OR 4.56; 95% CI 1.58-13.14; p = 0.005), as was age (OR 1.08 per year; p = 0.036). PSAD yielded an AUC of 0.722 and the combined age + PSAD model an AUC of 0.751. With PSAD ≥ 0.15, sensitivity was 76.2%, specificity 61.0%, and negative predictive value 95.7%.
conclusionIn conclusion, PSAD provides clinical value for risk stratification in PI-RADS 3 lesions and may support biopsy avoidance strategies in selected patients.
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