The relationship between preoperative PI-RADS version 2.1 and Gleason score change after radical prostatectomy

Motivation: If reliable preoperative risk factors to predict Gleason score (GS) upgrading after radical prostatectomy (RP) are identified, such could be helpful to reduce the risk of misclassification of PCa patients. Goal(s): To investigate the relationship between Prostate Imaging Reporting and Data System version 2.1 (PI-RADS v2.1) and GS change after RP. Approach: Multivariate analyses were performed to analyse the factors influencing GS change after RP. Results: Multivariate regression analysis showed positive biopsy cores of ≥ 4, biopsy Gleason score of <7 and PI-RADS v2.1 score of 4–5 were independent predictors of GS upgrading after RP (all P < 0.05). Impact: Combining the number of positive biopsy cores, biopsy Gleason score and PI-RADS v2.1 score could significantly improve the diagnostic efficiency for Gleason score upgrading after radical prostatectomy.