{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,16]],"date-time":"2026-09-16T05:02:27Z","timestamp":1789534947587,"version":"build-2803163510"},"reference-count":25,"publisher":"MDPI AG","issue":"9","license":[{"start":{"date-parts":[[2026,9,11]],"date-time":"2026-09-11T00:00:00Z","timestamp":1789084800000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Curr. Oncol.","Current Oncology"],"abstract":"<jats:p>The incremental value of PI-RADS for predicting adverse pathology at radical prostatectomy in men diagnosed through systematic biopsy remains uncertain. We assessed whether PI-RADS improves discrimination beyond age, MRI-derived prostate-specificantigen density (PSAD), biopsy Grade Group, and quantitative biopsy tumour burden. This retrospective study included 284 men undergoing 1.5-T mpMRI, systematic biopsy, and radical prostatectomy between January 2020 and January 2026. Adverse pathology comprised prostatectomy Grade Group \u2265 3 and\/or stage \u2265 pT3a. Three logistic models were compared: age\/PSAD\/biopsy grade\/tumour burden; age\/PSAD\/PI-RADS; and their combination. Internal validation used 2000 bootstrap samples. Adverse pathology occurred in 143 patients (50.4%). Apparent AUCs were 0.790 (95% CI 0.737\u20130.843), 0.713 (0.653\u20130.773), and 0.799 (0.747\u20130.851); optimism-corrected AUCs were 0.781, 0.703, and 0.787. Adding PI-RADS \u2265 4 yielded an adjusted OR of 1.996 (95% CI 1.150\u20133.465) and an apparent AUC difference of 0.009 (95% CI \u22120.015 to 0.033; descriptive DeLong p = 0.469). The combined model had a corrected calibration slope of 0.915 and Brier score of 0.187. PI-RADS from routine 1.5-T mpMRI was independently associated with adverse pathology, but its incremental discrimination beyond clinical and systematicbiopsy variables was small and uncertain. These findings concern a surgery-selected systematicbiopsy pathway, do not estimate the overall value of MRI, and require external validation.<\/jats:p>","DOI":"10.3390\/curroncol33090554","type":"journal-article","created":{"date-parts":[[2026,9,11]],"date-time":"2026-09-11T14:39:24Z","timestamp":1789137564000},"page":"554","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Incremental Value of PI-RADS v2.1 for Adverse Pathology at Radical Prostatectomy: A Retrospective 1.5-T MRI Cohort"],"prefix":"10.3390","volume":"33","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-7836-0490","authenticated-orcid":false,"given":"Yunus","family":"Kayali","sequence":"first","affiliation":[{"name":"Department of Urology, University of Health Sciences, Istanbul Kartal Dr. Lutfi Kirdar City Hospital, 34865 Istanbul, Turkey"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-7080-8601","authenticated-orcid":false,"given":"Onur","family":"Erdemoglu","sequence":"additional","affiliation":[{"name":"Department of Urology, University of Health Sciences, Istanbul Kartal Dr. Lutfi Kirdar City Hospital, 34865 Istanbul, Turkey"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-3647-2603","authenticated-orcid":false,"given":"Yigit Kudret","family":"Akyol","sequence":"additional","affiliation":[{"name":"Department of Urology, University of Health Sciences, Istanbul Kartal Dr. Lutfi Kirdar City Hospital, 34865 Istanbul, Turkey"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0008-0880-2346","authenticated-orcid":false,"given":"Melih","family":"Colak","sequence":"additional","affiliation":[{"name":"Department of Urology, University of Health Sciences, Istanbul Kartal Dr. Lutfi Kirdar City Hospital, 34865 Istanbul, Turkey"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0009-9496-8867","authenticated-orcid":false,"given":"Alpcan","family":"Torun","sequence":"additional","affiliation":[{"name":"Department of Urology, University of Health Sciences, Istanbul Kartal Dr. Lutfi Kirdar City Hospital, 34865 Istanbul, Turkey"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-7175-713X","authenticated-orcid":false,"given":"Fatih","family":"Bicaklioglu","sequence":"additional","affiliation":[{"name":"Department of Urology, University of Health Sciences, Istanbul Kartal Dr. Lutfi Kirdar City Hospital, 34865 Istanbul, Turkey"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-2213-3985","authenticated-orcid":false,"given":"Bilal","family":"Eryildirim","sequence":"additional","affiliation":[{"name":"Department of Urology, University of Health Sciences, Istanbul Kartal Dr. Lutfi Kirdar City Hospital, 34865 Istanbul, Turkey"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2026,9,11]]},"reference":[{"key":"ref_1","first-page":"e70043","article-title":"Cancer statistics, 2026","volume":"76","author":"Siegel","year":"2026","journal-title":"CA A Cancer J. 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