Analysis of false positive PI-RADS 4 lesions: experience from a single nonacademic center using cognitive fusion

Int Urol Nephrol. 2023 May;55(5):1081-1085. doi: 10.1007/s11255-023-03508-1. Epub 2023 Feb 18.

Abstract

Background: We evaluated pathological findings in targeted biopsies of PI-RADS4 and PI-RADS5 lesions, and clinical data that could predict those patients with benign findings.

Materials and methods: A retrospective study was conducted to summarize the experience from a single nonacademic center using cognitive fusion and a 1.5 or 3.0 Tesla scanner.

Results: We found a false positive rate of 29 and 3.7% for any cancer in PI-RADS 4 and 5 lesions, respectively. Diverse histologic patterns were observed among target biopsies. At multivariate analysis, size ≤ 6 mm and previous negative biopsy were independent predictors of false positive PI-RADS4 lesions. The small number of false PI-RADS5 lesions precluded further analyses.

Conclusion: Benign findings are common in PI-RADS4 lesions and most of them do not show obvious glandular or stromal hypercellularity as expected in hyperplastic nodules. Size ≤ 6 mm and previous negative biopsy predict a higher probability of false positive results in patients with PI-RADS 4 lesions.

Keywords: Biopsy; Diagnosis; Magnetic resonance imaging; Needle; Prostatic neoplasms.

MeSH terms

  • Cognition*
  • Humans
  • Image-Guided Biopsy* / methods
  • Magnetic Resonance Imaging / methods
  • Retrospective Studies