Related Experiment Video
Updated: Feb 5, 2026
09:11
Use of MRI-ultrasound Fusion to Achieve Targeted Prostate Biopsy
Published on: April 9, 2019
22.4K
Risk factors of negative prostate biopsies: A CHAID decision tree analysis.
Pierre Allainguillaume1, Coralie Uthe-Spencker1, Laura Larnaudie2
1Urology Department Cochin Hospital, APHP Paris France.
BJUI Compass
|February 4, 2026
Summary
Prostate cancer risk is predicted by PSA density and PIRADS score. Large prostate volume increases the risk of negative biopsies in men with low PIRADS scores, requiring careful MRI interpretation.
Area of Science:
- Urology
- Oncology
- Radiology
Background:
- Prostate cancer (PCa) diagnosis relies heavily on prostate biopsies.
- Accurate risk stratification for clinically significant prostate cancer (csPCa) is crucial for patient management.
Purpose of the Study:
- To analyze the risk of any prostate cancer (PCa) and clinically significant prostate cancer (csPCa) in a contemporary cohort undergoing prostate biopsies.
- To identify independent predictive factors for PCa and csPCa detection.
Main Methods:
- Retrospective analysis of 255 patients who underwent prostate biopsies (December 2020 - December 2022).
- Calculation of PCa and csPCa rates (ISUP grade ≥2).
- Univariate and multivariate regression, and CHAID decision tree analysis were employed.
Main Results:
- 69.8% of patients had positive biopsies for PCa, and 36.9% for csPCa.
- PSA density (PSAd) and PIRADS score were independent predictors of csPCa.
- For any PCa detection, patients with PIRADS score ≤4 and prostate volume >46 mL had doubled the risk of negative biopsies.
Conclusions:
- PSA density and PIRADS score are key predictors for csPCa.
- Large prostate volume is a significant predictor of negative biopsies in patients with PIRADS ≤4, irrespective of PSAd.
- Caution is advised in MRI interpretation and targeting for patients with PIRADS ≤4 and large prostates.
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