Combining PI-RADS and PSA density could cut prostate biopsies by up to 20%

A study in 972 men externally validated the PROMOD biopsy strategy. PI-RADS 4-5 or PI-RADS 3 with a PSA density >0.15 avoided 18-20% of biopsies while missing 5-8% of clinically significant cancers. A more conservative approach (PI-RADS 4-5 or PI-RADS 3 with PSA density >0.10) a…

• Decision curve analysis identified PI-RADS 4-5 or PI-RADS 3 with PSA density >0.15 ng/mL2 as the strategy with the highest net benefit in biopsy-naïve men, avoiding 18-20% of biopsies (95% CI 15.5-21.2 and 16.9-22.7) and missing 5-8% of clinically significant cancers (ISUP grade ≥2).
• A more conservative strategy (PI-RADS 4-5 or PI-RADS 3 with PSA density >0.10 ng/mL2) reduced biopsies by only 12% (95% CI 9.7-14.5) and missed 2% of clinically significant cancers (95% CI 0.9-3.8).

Automated summary

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