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

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