COMPARATIVE EVALUATION OF PI-RADS 3 VS PI-RADS 4 LESIONS: A RETROSPECTIVE COHORT STUDY

Abstract

Objective: To compare prostate cancer detection rates and predictors in PI-RADS 3 vs PI-RADS 4 lesions using our institutional data.
Methods: Retrospective data from two cohorts (n=520) were analyzed. PSA, PSA density, lesion location, and histopathology were compared.
Results: Clinically significant prostate cancer (csPCa) was found in 10.7% of PI-RADS 3 vs 35.5% of PI-RADS 4 lesions. A PSA density ≥0.15 ng/mL/cc predicted csPCa in both groups.
Conclusion: PI-RADS 4 carries a significantly higher risk for csPCa. PSA density enhances risk stratification for both categories.