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Updated: Aug 8, 2026
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Use of MRI-ultrasound Fusion to Achieve Targeted Prostate Biopsy
Published on: April 9, 2019
Is targeted biopsy necessary for Prostate Imaging Reporting and Data System 3 lesions?
Diğdem Kuru Öz1, Sezer Nil Yılmazer Zorlu2, Nuray Haliloğlu1
1Ankara University, School of Medicine, Department of Radiology - Ankara, Turkey.
Revista Da Associacao Medica Brasileira (1992)
|August 6, 2026
Summary
Clinically significant prostate cancer is rare in Prostate Imaging Reporting and Data System (PI-RADS) 3 lesions. Biopsy decisions for PI-RADS 3 lesions should consider clinical factors, but targeted biopsies may be important for higher PI-RADS scores.
Area of Science:
- Urology
- Radiology
- Pathology
Background:
- Prostate Imaging Reporting and Data System (PI-RADS) version 2.1 categorizes lesions based on MRI findings.
- PI-RADS 3 lesions represent an intermediate probability of malignancy, necessitating careful diagnostic evaluation.
Purpose of the Study:
- To determine the histopathological outcomes of Prostate Imaging Reporting and Data System (PI-RADS) 3 lesions.
- To assess the necessity of targeted biopsy for PI-RADS 3 lesions.
Main Methods:
- Retrospective analysis of 127 patients with 176 PI-RADS 3 lesions.
- All patients underwent transrectal ultrasound-magnetic resonance imaging (TRUS-MRI) fusion biopsy.
Main Results:
- The prevalence of adenocarcinoma in PI-RADS 3 lesions was low (9% lesion-based).
- Clinically significant prostate cancer was detected in only 1.7% of lesions.
- No significant difference in PSA or PSA density was found between malignant and benign PI-RADS 3 lesions, though PSA density was higher in malignant cases with index lesions (p=0.046). Family history was also higher in malignant cases (p=0.028).
Conclusions:
- Clinically significant prostate cancer is infrequent in PI-RADS 3 lesions.
- Biopsy decisions for PI-RADS 3 lesions should incorporate clinical findings and risk factors.
- Targeting PI-RADS 3 areas may be relevant for higher PI-RADS score index lesions (4 and 5) to assess disease extent.
