Clinical Utility of the PI-RADSv2.1 Combined with PSA Parmeters for Prostate Biopsy Indication

Motivation: Prostate cancer diagnosis often relies on biopsies that carry risks, and traditional methods like PSA testing have limited accuracy. Goal(s): Combine PI-RADS v2.1 scoring with PSAD to reduce unnecessary procedures without missing clinically significant prostate cancer (csPCa). Approach: A retrospective analysis of 462 patients undergoing prostate biopsies; logistic regression identified independent risk factors; ROC curves evaluated diagnostic performance of the combined PI-RADS v2.1 score and PSAD. Results: PI-RADS v2.1 score and PSAD are independent risk factors for csPCa. Combining them improved diagnostic accuracy (AUC = 0.964), allowing safe avoidance of biopsies in certain cases. Impact: By integrating PI-RADS v2.1 scores with PSAD, this study offers a validated method to reduce unnecessary prostate biopsies by 40%, enhancing patient care and diagnostic precision for clinically significant prostate cancer.