Comparison of PSA density and lesion volume strategies for selecting men with equivocal PI-RADS 3 lesions on bpMRI for biopsies.

To compare two strategies: Prostate-specific antigen density (PSAd) and lesion volume measurement in ruling out significant prostate cancer (sPCa) in men with equivocal Prostate Imaging Reporting and Data System (PI-RADS) category 3 index lesions on biparametric magnetic resonance imaging.

In total, 130 men from our database had index lesions with PI-RADS scores of 3. Prostate volume was measured using the ellipsoid method, in accordance with PI-RADS version 2.1 criteria. Index lesion volumes were also measured using the ellipsoidal formula on the diffusion-weighted imaging sequence with the highest b-value and sagittal T2 sequences.

Among 130 men with PI-RADS category 3 index lesions, 23 (18%) had sPCa. In total, 6 of the 89 men with PSAd < 0.15 ng/mL2 (7%) had sPCa, whereas 8 of the 49 men with index lesion volumes < 0.5 mL (16%) had sPCa. The difference was statistically significant (McNemar, p < 0.0001).

The PSAd strategy performed better than the lesion volume strategy in ruling out sPCa in men with equivocal PI-RADS category 3 index lesions.

Abdominal radiology (New York). 2022 Nov 01 [Epub ahead of print]

Karen-Cecilie Kortenbach, Vibeke L√łgager, Henrik S Thomsen, Lars Boesen

Department of Radiology, Herlev Gentofte University Hospital, Borgmester Ib Juuls Vej 17, 2730, Herlev, Denmark. ., Department of Radiology, Herlev Gentofte University Hospital, Borgmester Ib Juuls Vej 17, 2730, Herlev, Denmark.

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