The effects of prostate volume and PI-RADS category on optimal PSA-density thresholds for biopsy decision-making - Takeaways - MDSpire

The effects of prostate volume and PI-RADS category on optimal PSA-density thresholds for biopsy decision-making

  • By

  • Selahattin Durmaz

  • Shun-Chin Jim Wu

  • Kang-Lung Lee

  • Amreen Shakur

  • Iztok Caglic

  • Tristan Barrett

  • January 4, 2026

  • 0 min

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  • 1

    Multiparametric MRI (mpMRI) reduces unnecessary biopsies and improves detection of clinically significant prostate cancer (csPCa).

  • 2

    The positive predictive value (PPV) of mpMRI is low, with 55-65% of patients with positive findings diagnosed with clinically insignificant prostate cancer (cisPCa).

  • 3

    PSA-density (PSAd) is a promising biomarker for biopsy decision-making, but optimal PSAd thresholds for different PI-RADS categories remain unclear.

  • 4

    A PSAd threshold of 0.15 ng/mL² is suggested for guiding biopsies in patients with negative or equivocal MRI findings, but its validity needs further investigation.

  • 5

    The study evaluated csPCa risk across PSAd values and assessed the impact of prostate volume on PSAd's predictive performance for csPCa.

Original Source(s)

The effects of prostate volume and PI-RADS category on optimal PSA-density thresholds for biopsy decision-making

  • by Selahattin Durmaz, Shun-Chin Jim Wu, Kang-Lung Lee, Amreen Shakur, Iztok Caglic, Tristan Barrett

  • January 4, 2026

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