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The Prostate Imaging Quality Score (PI-QUAL) is a novel tool for the qualitative assessment of mpMRI. Aim of this study was to evaluate the impact of PI-QUAL on consistency of radiological to pathological T-stage.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>\n                      Patients undergoing MRI-TRUS fusion biopsy and radical prostatectomy (RP) from 01\/2016 to 03\/2024 were retrospectively included. PI-QUAL was determined by two expert radiologists and categorised: inadequate (1\u20132), sufficient (3) and optimal (4\u20135). Primary endpoint was upstaging from locally confined disease in mpMRI (mrT\u2009\u2264\u20092) to advanced in RP-specimen (pT\u2009\u2265\u20093a). Variables were compared using analysis of variance and \u03c7\n                      <jats:sup>2<\/jats:sup>\n                      or Fisher\u2019s exact test. Uni- and multivariate binary regression identified independent predictors.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      Of 349 patients included, 18 had PI-QUAL 1\u20132, 44 PI-QUAL 3 and 287 PI-QUAL 4\u20135. Patient characteristics, PI-RADS scores and biopsy counts were balanced between these groups. Upstaging from mrT\u2009\u2264\u20092 to pT\u2009\u2265\u20093a was significantly more frequent in PI-QUAL 1\u20132 (22.4%) and PI-QUAL 3 (22.7%) compared to PI-QUAL 4\u20135 (10.8%) (\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.031). Suboptimal mpMRI harbours an increased risk of upstaging (HR 2.22; 95% CI 1.05\u20134.71;\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.037). Optimal mpMRI quality independently predicts higher PI-RADS grading (PI-RADS\u2009\u2265\u20094) (HR 2.27; 95% CI 1.02-5.00;\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.043).\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>PI-QUAL (\u2264\u20093) significantly influences PI-RADS grading and predicts for upstaging from radiological to pathological staging. In case of suboptimal image quality, repetition of mpMRI should be considered.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1007\/s00345-025-05755-6","type":"journal-article","created":{"date-parts":[[2025,6,30]],"date-time":"2025-06-30T04:54:12Z","timestamp":1751259252000},"update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":3,"title":["Impact of the PI-QUAL MRI quality score on histopathological up-staging from MRI fusion biopsy to final prostatectomy specimen"],"prefix":"10.1007","volume":"43","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-0957-2219","authenticated-orcid":false,"given":"Maximilian","family":"Haack","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mohamad","family":"Turkman","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Tobias","family":"Jorg","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Lukas","family":"M\u00fcller","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Gregor","family":"Duwe","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Lisa Johanna","family":"Frey","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Maximilian Peter","family":"Brandt","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Axel","family":"Haferkamp","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hendrik","family":"Borgmann","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Robert","family":"Dotzauer","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"297","published-online":{"date-parts":[[2025,6,30]]},"reference":[{"key":"5755_CR1","unstructured":"EAU Guidelines on Prostate Cancer - DIAGNOSTIC EVALUATION - Uroweb [Internet] Uroweb - European Association of Urology. 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