Standardized mpMRI, PI-QUAL v2, and PRECISE v2 strengthen prostate cancer active surveillance monitoring

In prostate cancer active surveillance, multiparametric MRI (mpMRI) progression has 59% sensitivity and 75% specificity, with 81-88% negative predictive value; standardized PI-RADS v2.1/PI-QUAL v2/PRECISE v2 reporting improves monitoring but does not replace scheduled biopsies.

• Baseline multiparametric MRI improves selection of candidates for active surveillance and reduces underestimation of clinically significant prostate cancer.
• Follow-up MRI progression has moderate positive predictive value, so scheduled biopsies remain essential despite high negative predictive value (81-88%).
• PRECISE v2 requires systematic comparison with prior exams and image quality assessment (PI-QUAL v2), improving reproducibility in multidisciplinary decision-making.

Automated summary

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