Follow-up MR imaging of PI-RADS 3 and PI-RADS 4 prostate lesions

Abstract

Objective: To determine the rate of malignancy after follow-up MR imaging of the prostate in PI-RADS 3 lesions without core biopsy and PI-RADS 4 lesions after negative initial core biopsy.

Materials and methods: We performed follow-up MRI in 46/72 (64%) patients with PI-RADS 3 lesions and 26/72 (36%) patients with PI-RADS 4 lesions in baseline MRI.

Results: The rate of malignancy in PI-RADS 3 lesions was 4% (2/46) and in PI-RADS 4 lesions 69% (18/26).

Conclusions: Follow-up MRI for PI-RADS 3 lesions should be performed. For PI-RADS 4 lesions with initial negative biopsy we recommend an instant repeat core biopsy.

Keywords: Biopsy; Diagnosis; Follow-up; MR imaging; Prostate cancer.