ArticleResearch and reports in urology2026
External Validation of the PROMOD Strategy, Combining PI-RADS Score and PSA Density, to Select Patients for Prostatic Biopsies.
Article in Research and reports in 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.
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11 authors.
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Abstract
Purpose: Combining MRI PI-RADS score (Prostate Imaging Reporting and Data System) with prostate-specific antigen density (PSAd) may optimize prostate biopsy (PBx) decisions. We aimed to externally validate the PROMOD strategy, combining PI-RADS with PSAd. Patients and Methods: We retrospectively included 972 men who underwent PBx, i.e. 12-core systematic, 2-4 targeted (MRI-FUSION) between 2013 and 2022, recorded in a prospectively maintained database. Patients with PSA > 20 ng/mL or prior prostate cancer (PCa) were excluded. We evaluated rates of avoided PBx, missed low-grade cancers, and csPCa (ISUP grade ≥2) according to 10 strategies. Decision curve analysis (DCA) assessed net benefit. Results: According to DCA, the highest net benefit in biopsy-naïve men was obtained by Strategies 8 (PI-RADS 4-5 or PI-RADS 3 with PSAd >0.15 ng/mL Conclusion: The PROMOD Strategy is an effective tool allowing a tailored decision to perform PBx based on degrees of risk that both patients and clinicians are willing to accept, in the context of shared decision-making.
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