The predictive value of multiparametric magnetic resonance imaging in enhancing prostate-specific antigen assessment for prostate cancer: a cross-sectional study

Background: Prostate-specific antigen (PSA) testing and transrectal ultrasound (TRUS)-guided biopsy remain standard tools for diagnosing prostate cancer (PCa), but both have limitations in sensitivity and specificity, leading to overdiagnosis or missed detection of clinically significant cancers. Multiparametric magnetic resonance imaging (mp-MRI) has emerged as a valuable imaging modality for PCa detection and risk stratification, yet the optimal integration of mp-MRI findings with PSA levels for pre-biopsy assessment remains to be fully established. This study aims to evaluate the predictive value of mp-MRI in enhancing PSA-based assessment for clinically significant PCa. Methods: This cross-sectional study involved patients with clinically suspected PCa who underwent mp-MRI prior to systematic biopsy guided by TRUS. Results: A total of 192 patients with suspected PCa underwent mp-MRI before biopsy guided by TRUS. Grouping by Gleason score revealed that patients with a Gleason score of