PIRADS Score 3 of Multi-Parametric Magnetic Resonance Imaging in Patients with Suspicious Prostate Cancer, Is It Conclusive?

Abstract

Background Prostate cancer (Pca) is the second most common type of cancer in men worldwide. One of the new modalities for diagnosis is multiparametric magnetic resonance imaging (mp-MRI). To improve the interpretation of mp-MRI, Prostate Imaging Reporting and Data System (PI-RADS) scoring system was suggested by the European Society of Urogenital Radiology (ESUR). PI-RADS score 3 was found to be equivocal by many studies. Aim of our study is analysis of demographic, clinical, and histological data of patients with PI-RADS score 3 by mp-MRI. Methods Fifty patients were enrolled. Full history taking, digital rectal examination (DRE), PSA, mp-MRI followed by trans-rectal ultrasound (TRUS) guided prostate biopsy were performed for all patients. We analyzed data of the 34 patients who were proved to have prostate lesions with PI-RADS 3 score by mp-MRI. Results 62.5% of the PI-RADS 3 lesions proved to be benign by TRUS guided biopsy, and the rest (37.5%) was detected as prostate cancer in biopsy. No statistically significant correlations were found between age, total PSA and density, prostate volume, or DRE and detection of Pca in patients with PI-RADS 3 score. Conclusion Lesions with score of PI-RADS 3 by mp-MRI cannot prove or exclude Pca and needs further evaluation by prostate biopsy.