{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,3,8]],"date-time":"2026-03-08T22:16:58Z","timestamp":1773008218003,"version":"3.50.1"},"reference-count":25,"publisher":"Wiley","issue":"1","license":[{"start":{"date-parts":[[2025,4,25]],"date-time":"2025-04-25T00:00:00Z","timestamp":1745539200000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"},{"start":{"date-parts":[[2025,4,25]],"date-time":"2025-04-25T00:00:00Z","timestamp":1745539200000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"funder":[{"DOI":"10.13039\/100021763","name":"American Urological Association","doi-asserted-by":"publisher","id":[{"id":"10.13039\/100021763","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["bjui-journals.onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["BJU International"],"published-print":{"date-parts":[[2025,7]]},"abstract":"<jats:sec>\n                    <jats:title>Objectives<\/jats:title>\n                    <jats:p>To determine the incidence of isolated high grade prostatic epithelial neoplasia (iHGPIN) following magnetic resonance imaging (MRI)\u2013ultrasonography co\u2010registration fusion targeted biopsy (MRFTB) coupled with systematic biopsy (SB) and to assess the detection rates of clinically significant prostate cancer (csPCa).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Patients and Methods<\/jats:title>\n                    <jats:p>Beginning in June 2012, most patients at our institution underwent multiparametric MRI (mpMRI) before prostate biopsy. Biopsies were performed between June 2012 and October 2021. The surveillance protocol for iHGPIN included prostate\u2010specific antigen assessment every 6 months, digital rectal examinations annually, and multiparametric MRI (mpMRI) at 3\u2009years. Repeat biopsies were recommended primarily for suspicious mpMRI, defined as a new Prostate Imaging\u2010Reporting and Data System (PI\u2010RADS) score &gt;2 region of interest (ROI) or an increase in size of the pre\u2010existing ROI.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>Of the 628 biopsies, 230 (33.7%), 48 (7.0%), 404 (59.2%) were interpreted as benign, iHGPIN, or prostate cancer (PCa), respectively. Of these cancers 140 (34.7%) and 264 (65.3%) were low\u2010risk PCa and csPCa, respectively. iHGPIN was detected in MRRFTB only, SB only, and both MRFRB + SB in six (12.5%) 36 (75%), and six patients (12.5%), respectively. Of the 32 MRI scans performed at 3\u2009years, a new PI\u2010RADS score &gt;2 ROI or an increase in the size or PI\u2010RADS score of a pre\u2010existing ROI was observed in four and eight patients, respectively. Nine of these underwent biopsy. Three additional biopsies were performed on non\u2010suspicious mpMRI. csPCa was detected in two patients, both with an enlarging ROI.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>To our knowledge, this is the first study examining the incidence, natural history, and subsequent csPCa detection rates for iHGPIN in the era of mpMRI and MRI targeted biopsy. The lower prevalence of iHGPIN is attributed to the selection of biopsy candidates based on mpMRI and an increased likelihood of detecting pre\u2010existing csPCa. Our findings provide compelling evidence that biopsy strategies limited to MRI targets will almost eliminate iHGPIN detection while decreasing detection of csPCa. A 3\u2010year biopsy should be performed only in men with suspicious mpMRI.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1111\/bju.16748","type":"journal-article","created":{"date-parts":[[2025,4,25]],"date-time":"2025-04-25T03:43:43Z","timestamp":1745552623000},"page":"159-164","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Incidence, surveillance and natural history of high\u2010grade prostatic epithelial neoplasia in the era of multiparametric MRI and targeted biopsy"],"prefix":"10.1111","volume":"136","author":[{"ORCID":"https:\/\/orcid.org\/0009-0005-3264-4083","authenticated-orcid":false,"given":"Nathalie","family":"Eid","sequence":"first","affiliation":[{"name":"Department of Urology New York University Grossman School of Medicine  New York New York USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Herbert","family":"Lepor","sequence":"additional","affiliation":[{"name":"Department of Urology New York University Grossman School of Medicine  New York New York USA"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"311","published-online":{"date-parts":[[2025,4,25]]},"reference":[{"key":"e_1_2_8_2_1","doi-asserted-by":"publisher","DOI":"10.1038\/modpathol.2017.138"},{"key":"e_1_2_8_3_1","first-page":"39","article-title":"High\u2010grade prostatic intraepithelial neoplasia: the most likely precursor of prostate cancer\u2014morphologic, molecular, and clinical insights","volume":"44","author":"Bostwick DG","year":"2004","journal-title":"Histopathology"},{"key":"e_1_2_8_4_1","first-page":"124","article-title":"Is repeat biopsy for isolated high\u2010grade prostatic intraepithelial neoplasia necessary?","volume":"9","author":"Chin AI","year":"2007","journal-title":"Rev Urol"},{"key":"e_1_2_8_5_1","doi-asserted-by":"publisher","DOI":"10.1016\/S0022-5347(05)00337-X"},{"key":"e_1_2_8_6_1","doi-asserted-by":"publisher","DOI":"10.1016\/S0022-5347(05)64463-1"},{"key":"e_1_2_8_7_1","unstructured":"National Comprehensive Cancer Network.NCCN clinical guidelines in oncology: prostate cancer early detection. 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