Clinically Significant Prostate Cancer Following Negative Biopsies for PIRADS 4 and 5 Lesions: A Multicenter Study

Motivation: To understand the risk of clinically significant prostate cancer (csPCa) in patients with negative biopsies for PIRADS categories 4 and 5 lesions, addressing a critical gap in clinical decision-making following discordant prostate MRI-biopsy findings. Goal(s): To determine the prevalence of csPCa among patients with negative biopsy for PIRADS 4 or 5 lesions. Approach: A multicenter retrospective study, utilizing Natural Language Processing (NLP) to analyze patient demographics, clinical, imaging and pathologic outcomes, followed by statistical analyses. Results: In 44% patients was found to have csPCa after initial discordant prostate MRI- biopsy. Impact: This study underscores the high risk of csPCa in patients with initial negative biopsies for PIRADS 4 or 5 lesions, potentially guiding clinicians in patient management and informing follow-up strategies.