{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,3,31]],"date-time":"2026-03-31T08:38:22Z","timestamp":1774946302178,"version":"3.50.1"},"reference-count":24,"publisher":"Wiley","issue":"13","license":[{"start":{"date-parts":[[2024,6,25]],"date-time":"2024-06-25T00:00:00Z","timestamp":1719273600000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["The Prostate"],"published-print":{"date-parts":[[2024,9]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Introduction<\/jats:title><jats:p>The follow\u2010up findings of patients who underwent prostate biopsy for prostate image reporting and data system (PIRADS) 4 or 5 multiparametric magnetic resonance imaging (mpMRI) findings and had benign histology were retrospectively reviewed.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>There were 190 biopsy\u2010naive patients. Patients with at least 12 months of follow\u2010up between 2012 and 2023 were evaluated. All MRIs were interpreted by two very experienced uroradiologists. Of the patients, 125 had either cognitive or software fusion MR\u2010targeted biopsies with 4\u2009+\u20098\/10 cores. The remaining 65 patients had in\u2010bore biopsies with 4\u20135 cores. Prostate\u2010specific antigen (PSA) levels below 4\u2009ng\/mL were defined as PSA regression following biopsy. PIRADS 1\u20133 lesions on new MRI images were classified as MRI regression.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Median patient age and PSA were 62 (39\u201382) years and six (0.4\u201333) ng\/mL, respectively, at the initial work\u2010up. During a median follow\u2010up period of 44 months, 37 (19.4%) patients were lost to follow\u2010up. Of the remaining 153 patients, 82 (53.6%) had persistently high PSA. Among them, 72 (87.8%) had repeat mpMRI within 6\u201324 months which showed regressive findings (PIRADS 1\u20133) in 53 patients (73.6%) and PIRADS 4\u20135 index lesion persistence in 19 cases (26.4%). The latter group was recommended to have rebiopsy. Of these 19 patients, 16 underwent MRI\u2010targeted rebiopsy. Prostate cancer was diagnosed in six (37.5%) patients and of these four (25%) were clinically significant (&gt;Grade Group 1). Totally, clinically significant prostate cancer was detected in 4\/153 (2.6%) patients followed up.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>Patients should be warned against the relative relaxing effect of a negative biopsy after identification of PIRADS 4\u20135 index lesion. While PSA decrease was observed in many patients during follow\u2010up, persistent MRI findings were present in nearly a quarter of patients with persistently high PSA. A rebiopsy is warranted in these patients, with significant prostate cancer diagnosed in a quarter of patients with rebiopsy.<\/jats:p><\/jats:sec>","DOI":"10.1002\/pros.24764","type":"journal-article","created":{"date-parts":[[2024,6,26]],"date-time":"2024-06-26T02:08:00Z","timestamp":1719367680000},"page":"1262-1267","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":3,"title":["Natural history of histologically benign PIRADS 4\u20135 lesions in multiparametric MRI: Real\u2010life experience in an academic center"],"prefix":"10.1002","volume":"84","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-7020-0276","authenticated-orcid":false,"given":"Serdar","family":"Madendere","sequence":"first","affiliation":[{"name":"Department of Urology VKV American Hospital Istanbul Turkey"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Mert","family":"Kilic","sequence":"additional","affiliation":[{"name":"Department of Urology VKV American Hospital Istanbul Turkey"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Hatice","family":"Zoroglu","sequence":"additional","affiliation":[{"name":"Department of Urology Gaziosmanpa\u015fa University School of Medicine Tokat Turkey"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Ahmet Furkan","family":"Sarikaya","sequence":"additional","affiliation":[{"name":"Department of Urology Ko\u00e7 University School of Medicine Istanbul Turkey"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Mert","family":"Veznikli","sequence":"additional","affiliation":[{"name":"Department of Biostatistics Ko\u00e7 University School of Medicine Istanbul Turkey"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Bilgen","family":"Coskun","sequence":"additional","affiliation":[{"name":"Department of Radiology VKV American Hospital Istanbul Turkey"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Ayse","family":"Armutlu","sequence":"additional","affiliation":[{"name":"Department of Pathology Ko\u00e7 University School of Medicine Istanbul Turkey"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Ibrahim","family":"Kulac","sequence":"additional","affiliation":[{"name":"Department of Pathology Ko\u00e7 University School of Medicine Istanbul Turkey"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Bengi","family":"G\u00fcrses","sequence":"additional","affiliation":[{"name":"Department of Radiology Ko\u00e7 University School of Medicine Istanbul Turkey"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Murat Can","family":"Kiremit","sequence":"additional","affiliation":[{"name":"Department of Urology Ko\u00e7 University School of Medicine Istanbul Turkey"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Dilek Ertoy","family":"Baydar","sequence":"additional","affiliation":[{"name":"Department of Pathology Ko\u00e7 University School of Medicine Istanbul Turkey"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Abdullah Erdem","family":"Canda","sequence":"additional","affiliation":[{"name":"Department of Urology Ko\u00e7 University School of Medicine Istanbul Turkey"},{"name":"RMK AIMES Rahmi M. 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