Predicting the Need for Biopsy to Detect Clinically Significant Prostate Cancer in Patients with a Magnetic Resonance Imaging–detected Prostate Imaging Reporting and Data System/Likert ≥3 Lesion: Development and Multinational External Validation of the Imperial Rapid Access to Prostate Imaging and Diagnosis Risk Score

Abstract

<p><strong>Background</strong>: Although multiparametric magnetic resonance imaging (MRI) has high<br>sensitivity, its lower specificity leads to a high prevalence of false-positive lesions requir-<br>ing biopsy.<br><strong>Objective</strong>: To develop and externally validate a scoring system for MRI-detected Prostate<br>Imaging Reporting and Data System (PIRADS)/Likert 3 lesions containing clinically sig-<br>nificant prostate cancer (csPCa).<br><strong>Design, setting, and participants</strong>: The multicentre Rapid Access to Prostate Imaging and<br>Diagnosis (RAPID) pathway included 1189 patients referred to urology due to elevated<br>age-specific prostate-specific antigen (PSA) and/or abnormal digital rectal examination (DRE); April 27, 2017 to October 25, 2019.</p>