PI-RADS score and risk stratification in prostate cancer: clinical, imaging, and histological correlations
DOI:
https://doi.org/10.52692/1857-0011.2025.2-82.01Keywords:
prostate cancer , PI-RADS , multiparametric MRI , PSA , prostate biopsyAbstract
Prostate cancer is one of the most common neoplasms diagnosed in men. PSA testing is an important step in early detection; however, multiparametric MRI assessment using the PI-RADS score provides a more accurate risk stratification and directly correlates with histological aggressiveness. The aim of this study was to evaluate the performance of the PI- RADS score in detecting clinically significant prostate cancer and to analyse its relationship with clinical and histological parameters.A retrospective analysis included 143 patients who underwent prostate biopsy and multiparametric MRI evaluation. Analysed parameters included age, PSA, prostate volume, PI-RADS score, and Gleason score. For PI-RADS ≥4, sensitivity was 90%, specificity 84%, and AUC 0.93. An inverse correlation was found between prostate volume and cancer probability, as well as a significant association between the PI-RADS score and Gleason grade. Combining PI- RADS with PSA density may improve risk stratification and reduce unnecessary biopsies.
References
Schafer EJ, Laversanne M, Sung H, et al. Recent Patterns and Trends in Global Prostate Cancer Incidence and Mortality: An Update. European Urology. 2025;87(3):302-313. doi:10.1016/J.EURURO.2024.11.013
Hugosson J, Godtman RA, Wallstrom J, et al. Results after Four Years of Screening for Prostate Cancer with PSA and MRI. New England Journal of Medicine. 2024;391(12):1083-1095. doi:10.1056/NEJMOA2406050
Schoots IG, Ahmed HU, Albers P, et al. Magnetic Resonance Imaging–based Biopsy Strategies in Prostate Cancer Screening: A Systematic Review. European Urology. Published online June 13, 2025. doi:10.1016/J.EURURO.2025.05.038
Wang S, Kozarek J, Russell R, et al. Diagnostic Performance of Prostate-specific Antigen Density for Detecting Clinically Significant Prostate Cancer in the Era of Magnetic Resonance Imaging: A Systematic Review and Meta-analysis. European Urology Oncology. 2024;7(2):189-203. doi:10.1016/J.EUO.2023.08.002
Ponsiglione A, Brembilla G, Cuocolo R, et al. ESR Essentials: using the right scoring system in prostate MRI—practice recommendations by ESUR. European Radiology. 2024;34(11):7481-7491. doi:10.1007/S00330-024-10792-7/FIGURES/9
Park KJ, Choi SH, Kim M hyun, Kim JK, Jeong IG. Performance of Prostate Imaging Reporting and Data System Version 2.1 for Diagnosis of Prostate Cancer: A Systematic Review and Meta-Analysis. Journal of Magnetic Resonance Imaging. 2021;54(1):103-112. doi:10.1002/JMRI.27546
Wen J, Liu W, Shen X, Hu W. PI-RADS v2.1 and PSAD for the prediction of clinically significant prostate cancer among patients with PSA levels of 4–10 ng/ ml. Scientific Reports. 2024;14(1):1-7. doi:10.1038/S41598-024-57337-Y
Li Y, Wang S, Wang J, et al. PI-RADSv2.1 combined with PSA density for optimizing prostate biopsy decisions: a retrospective analysis. Front Oncol. 2025;15:1602412. doi:10.3389/FONC.2025.1602412/BIBTEX
Distler FA, Radtke JP, Bonekamp D, et al. The Value of PSA Density in Combination with PI-RADSTM for the Accuracy of Prostate Cancer Prediction. Journal of Urology. 2017;198(3):575-582. doi:10.1016/J.JURO.2017.03.130/SUPPL_FILE/MMC3.PDF
Yamashiro JR, de Riese WTW. Any Correlation Between Prostate Volume and Incidence of Prostate Cancer: A Review of Reported Data for the Last Thirty Years. Res Rep Urol. 2021;13:749. doi:10.2147/RRU.S331506
Buie J, De Riese W, Sharma P. Smaller Prostate Volume is Associated with Adverse Pathological Features and Biochemical Recurrence after Radical Prostatectomy. Urol Sci. 2019;30(6):255-261. doi:10.4103/UROS.UROS_28_19
Banov P, Valache M, Galescu A, Ceban E. Cancerul de prostată și relațiile dintre antigenul specific prostatic, biopsia transrectală și interpretarea histologică. Arta Medica. 2023;2(87):96-99. doi:10.5281/zenodo.8213156.
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