prevalence of biopsy-proven clinically significant prostate cancer in patients with pi-rads 3 on mri and factors associated with it

Background: to assess prevalence of prostate cancer and clinically significant prostate cancer in patients with pi-rads 3 on bpmri and factors associated with them.methods: patients suspicious for prostate cancer following serum prostate specific antigen (psa) screening, who had pi-rads 3 on bpmri, were included. all patients underwent systemic plus mri targeted biopsy of prostate. gleason score 3+3 was considered positive for prostate cancer but clinically non-significant one. higher scores were pertained to as clinically significant prostate cancer. the relationship between patient age, psa level, psa density, number of core biopsies, and number of pi-rads 3 lesions on bpmri with presence of prostate cancer per se and presence of clinically significant prostate cancer in our patients is assessed.results: 244 patients were enrolled. 101 patients had prostate cancer (41.4%). out of these 101 patients, 34 (13.9% of total) had clinically significant prostate cancer. among different factors, only psa density was associated with both prostate cancer (or=1.05, p=0.001) and clinically significant prostate cancer (or=1.03, p=0.001). according to receiver operating characteristic curve analysis, best cut off value of psa density which has highest association with clinically significant prostate cancer in pi-rads 3 patients would be 0.36; with a sensitivity of 0.38 and specificity of 0.93.conclusion: considering psa density with threshold of 0.36 for performing biopsy in patients with pi-rads 3 on bpmri might lower the rate of unnecessary biopsies.