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Prospective evaluation of mpMRI-derived nomograms for detecting prostate cancer in PI-RADS v2.1 upgraded and non-upgraded lesions

  • 0Department of Radiology, First People's Hospital of Foshan, Foshan, China.
Frontiers in Oncology +

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June 19, 2025

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June 19, 2025

View abstract on PubMed

Summary

This summary is machine-generated.

Prostate Imaging Reporting and Data System (PI-RADS) v2.1 upgrading rules improve prostate cancer detection in the transition zone but may increase unnecessary biopsies in the peripheral zone. Multiparametric MRI features enhance diagnostic accuracy for clinically significant prostate cancer.

Area Of Science

  • Radiology
  • Urology
  • Oncology

Background

  • Limited data exist on the performance of Prostate Imaging Reporting and Data System (PI-RADS) v2.1 upgraded versus non-upgraded lesions for prostate cancer detection.
  • Multiparametric MRI (mpMRI) features may improve the diagnostic accuracy of PI-RADS v2.1 for prostate cancer (PCa).

Purpose Of The Study

  • To evaluate PCa and clinically significant PCa (csPCa) rates in PI-RADS v2.1 upgraded and non-upgraded lesions.
  • To identify mpMRI features that enhance PCa and csPCa detection accuracy.

Main Methods

  • Prospective evaluation of mpMRI scans in 94 men undergoing ultrasound-guided biopsy.
  • Extraction of mpMRI features including lesion size, volume, sphericity, SVR, T2WI SI, DWI SI, T1, T2, PD, ADC, and DCE-derived TIC.
  • Univariable and multivariable logistic regression analyses to identify features associated with PCa and csPCa in transition zone (TZ) and peripheral zone (PZ).

Main Results

  • Significant differences between upgraded and non-upgraded PI-RADS 4 lesions were found in the PZ (p < 0.05), but not in the TZ.
  • Risk factors for csPCa in TZ included lesion diameter, TIC type III, capsule, T1, and PD values.
  • Risk factors for csPCa in PZ included T1, SVR, DWI SI, and ADC values. ROC analysis showed high diagnostic accuracy (AUCs of 0.93 for TZ, 0.96 for PZ).

Conclusions

  • PI-RADS v2.1 upgrading rules enhance cancer detection in the TZ but may lead to unnecessary biopsies in the PZ.
  • MpMRI-based nomograms significantly improve the predictive accuracy for PCa and csPCa detection.

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