PI-RADS 3+1 lesions show 29% clinically significant prostate cancer, supporting individualized biopsy

Single-center study of 55 men with PI-RADS 3+1 lesions (upgraded by DCE) found clinically significant prostate cancer (csPCa) in 29% (16/55). 71% of biopsies were negative for csPCa. Results support individualized decision-making rather than automatic PI-RADS 4 management. PSA d…

• Single-center retrospective study of 55 patients with PI-RADS 3+1 lesions undergoing biopsy (2023–2025).
• PSA density ≥0.15 threshold would avoid 49% of biopsies but miss 31% of csPCa; PSAd discrimination was modest (AUC 0.65).
• Limited by small sample, single-center design, and no external validation.

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