{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,5,9]],"date-time":"2026-05-09T01:43:19Z","timestamp":1778290999269,"version":"3.51.4"},"reference-count":27,"publisher":"Springer Science and Business Media LLC","issue":"1","license":[{"start":{"date-parts":[[2026,3,2]],"date-time":"2026-03-02T00:00:00Z","timestamp":1772409600000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"},{"start":{"date-parts":[[2026,3,2]],"date-time":"2026-03-02T00:00:00Z","timestamp":1772409600000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"}],"content-domain":{"domain":["link.springer.com"],"crossmark-restriction":false},"short-container-title":["Insights Imaging"],"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Objectives<\/jats:title>\n                    <jats:p>To determine the value of MRI in men with highly elevated PSA values for the exclusion of clinically significant prostate cancer (csPC).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Materials and methods<\/jats:title>\n                    <jats:p>In this retrospective bicenter cohort study, consecutive men with PSA values\u2009\u2265\u200915\u2009ng\/mL and multiparametric (mp) MRI were included. We excluded patients with acute prostatitis and patients without histopathology or follow-up. Examinations were evaluated regarding MRI quality, PSAD, and PI-RADS classification. For all patients with subsequent biopsy, PC and csPC detection rates were determined. In a subgroup analysis, patients with and without the presence of csPC were compared regarding clinical and MRI parameters.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      Finally, 376 patients (median PSA 20\u2009ng\/mL) were included. MRI quality was excellent (median PI-QUAL 3). 26% of the patients revealed an MRI with a PI-RADS category 2, 16% were classified as category 3, 12% PI-RADS 4, and 46% showed a PI-RADS 5. A total of 280 patients underwent systematic screening with or without targeted prostate biopsy. Among these, 42% with PSA values ranging from 15 to 116\u2009ng\/mL (median 19.5\u2009ng\/mL) showed no presence of PC. Overall, csPC detection rates were 94% for PI-RADS 5 and 51% for PI-RADS 4. No csPC were identified in PI-RADS 2, and 8% in PI-RADS 3. Comparative analysis between patients with and without csPC revealed significant differences in age, PSA, PSAD, and PI-RADS (\n                      <jats:italic>p<\/jats:italic>\n                      \u2009\u2264\u20090.05).\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>mpMRI demonstrated excellent performance in the detection of csPC in this high-risk cohort with PSA levels\u2009\u2265\u200915\u2009ng\/mL. High-quality MRI helps to exclude csPC in cases with significantly elevated PSA levels to avoid unnecessary prostate biopsies.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Critical relevance statement<\/jats:title>\n                    <jats:p>mpMRI demonstrated a high diagnostic accuracy for csPCs in men with PSA\u2009\u2265\u200915\u2009ng\/mL, and in cases of non-suspicious MRI findings, it can avoid unnecessary biopsies in these patients at risk.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Key Points<\/jats:title>\n                    <jats:p>\n                      <jats:list list-type=\"bullet\">\n                        <jats:list-item>\n                          <jats:p>MpMRI demonstrated high diagnostic accuracy in men with PSA values of \u2265\u200915\u2009ng\/mL.<\/jats:p>\n                        <\/jats:list-item>\n                        <jats:list-item>\n                          <jats:p>MpMRI enables the reliable exclusion of csPC in cases with non-suspicious MRI findings in these patients.<\/jats:p>\n                        <\/jats:list-item>\n                        <jats:list-item>\n                          <jats:p>In patients with significantly elevated PSA levels, mpMRI provides an effective risk stratification to avoid unnecessary biopsies.<\/jats:p>\n                        <\/jats:list-item>\n                      <\/jats:list>\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Graphical Abstract<\/jats:title>\n                  <\/jats:sec>","DOI":"10.1186\/s13244-026-02235-2","type":"journal-article","created":{"date-parts":[[2026,3,2]],"date-time":"2026-03-02T13:28:25Z","timestamp":1772458105000},"update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":2,"title":["Diagnostic value of prostate magnetic resonance imaging in men with prostate-specific antigen levels \u2265 15 ng\/mL for biopsy decision-making"],"prefix":"10.1186","volume":"17","author":[{"given":"Samuel","family":"Trappe","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-7476-292X","authenticated-orcid":false,"given":"Lars","family":"Schimm\u00f6ller","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Patrick","family":"Althoff","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Karla Johanna","family":"Schero","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Sebastian","family":"Berg","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Jan Philipp","family":"Radtke","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Irene","family":"Esposito","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Florian","family":"Roghmann","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Peter","family":"Albers","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Gerald","family":"Antoch","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Rouvier","family":"Al-Monajjed","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Matthias","family":"Boschheidgen","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"297","published-online":{"date-parts":[[2026,3,2]]},"reference":[{"key":"2235_CR1","unstructured":"EAU Guidelines (2025) Edn. presented at the EAU Annual Congress Madrid 2025. 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