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Updated: Sep 12, 2025
A Cognitive Fusion-guided Prostate Biopsy Using Multiparametric Magnetic Resonance Imaging and Transrectal Ultrasound
Published on: March 21, 2025
[Diagnostic performance of PI-RADS v2.1 for clinically significant prostate cancer in the peripheral, transitional
Xiao-Jun Deng1, Hao-Cheng Zhang1, Jiong Zhang1
1Department of Urology, Hospital 411 of Shanghai University, Shanghai 200081, China.
Objective:
To evaluate the diagnostic performance of the Prostate Imaging Reporting and Data System version 2.1 (PI-RADS v2.1) for clinically significant prostate cancer (CSPCa) in the peripheral zone (PZ), transitional zone (TZ) and multiple zones (MZs).
Methods:
We retrospectively studied the clinical data on 108 patients undergoing multiparametric magnetic resonance imaging (mpMRI) and transperineal prostate biopsy in our hospital from January 2021 to January 2023. Using PI-RADS v2.1, we examined the MR images of the patients with suspected PCa, compared the PI-RADS v2.1 scores with the results of prostate biopsy, and analyzed the correlation of the PI-RADS v2.1 scores with CSPCa. We calculated the area under the receiver operating characteristic (ROC) curve (AUC), and described the diagnostic performance of PI-RADS v2.1 for CSPCa in the PZ, TZ and MZs.
Results:
Transperineal prostate puncture biopsy was successfully completed in all the patients, which revealed 66 (61.11%) cases of CSPCa with Gleason score (GS) 7-10. Suspected CSPCa was observed in 45 (95.74%) of the 47 PZ lesions, 8 (47.06%) of the 17 TZ lesions, and 40 (90.91%) of the 44 MZ lesions. The PZ, TZ and MZ lesions diagnosed by PI-RADS v2.1 were significantly correlated with CSPCa (r = 0.492, P < 0.001). The AUCs of PI-RADS v2.1 for PZ, TZ and MZs were 0.644, 0.732 and 0.811, with specificities of 66.8%, 57.6% and 62.1%, and sensitivities of 57.2%, 78.4% and 93.2%, respectively. The negative predictive values were 46.5%, 85.7% and 79.2%, and the positive predictive values 76.2%, 43.4% and 84.8%, respectively.
Conclusion:
The PI-RADS v2.1 score has a high diagnostic value for CSPCa in the PZ, TZ and MZs, with the best performance for that in the MZs.
