Most PI-RADS 3 Lesions on Prostate MRI Regress or Remain Stable, Supporting Surveillance

Over half of PI-RADS 3 prostate MRI lesions regressed on follow-up, and only 3% of biopsied lesions harbored clinically significant cancer — both cases in progressed lesions. Surveillance may be safe.

• 52% of PI-RADS 3 lesions regressed, 29% remained stable, and 19% progressed on follow-up mpMRI.
• Progression was more common in peripheral-zone lesions (25%) than transition-zone lesions (6%).
• Only 3% of biopsied lesions (2/64) had clinically significant prostate cancer (ISUP ≥2); both occurred in radiologically progressed lesions.

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