{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,5,13]],"date-time":"2026-05-13T14:15:54Z","timestamp":1778681754537,"version":"3.51.4"},"reference-count":0,"publisher":"AVES YAYINCILIK A.\u015e.","license":[{"start":{"date-parts":[[2026,5,13]],"date-time":"2026-05-13T00:00:00Z","timestamp":1778630400000},"content-version":"unspecified","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["URP"],"abstract":"<jats:p>Objective: Combining Prostate Imaging-Reporting and Data System (PI-RADS) with prostate-specific antigen density (PSAD) may improve the detection of clinically significant prostate cancer (csPCa) while reducing unnecessary biopsies. This study aimed to evaluate csPCa detection rates using PI-RADS and PSAD, identify optimal PSAD cutoffs, and assess biopsy strategies to optimize csPCa detection and reduce unnecessary procedures within a South Korean cohort.\r\nMethods: This multicenter retrospective study included 3117 biopsy-na\u00efve patients from 2 tertiary hospitals in South Korea (2020-2025) who underwent magnetic resonance imaging\u2013based transperineal prostate biopsy. Patients were stratified into PI-RADS groups (1-2, 3, 4-5) and PSAD categories (&lt;0.10, 0.10-0.15, 0.15-0.20, and \u22650.20). Receiver-operating characteristic (ROC) curve analyses validated PSAD cut-offs, and biopsy strategies were compared for csPCa detection and biopsy avoidance.\r\nResults: The overall csPCa detection rate was 47.1%. PI-RADS 4-5 patients had high detection rates across all PSAD levels (20.1%-76.5%), while PI-RADS 1-2 and 3 patients with PSAD \u2265 0.15 showed elevated rates (15.2%-16.9% and 25.0%-35.7%, respectively). ROC curve analyses identified optimal PSAD cut-offs of 0.155 (area under the ROC curve (AUC), 0.708) for PI-RADS 1-2 and 0.145 (AUC, 0.749) for PI-RADS 3. The proposed strategy (PI-RADS \u2265 4 or PI-RADS 1-2 or 3 with PSAD \u2265 0.15) outperformed other strategies, avoiding 448 (14.4%) biopsies, missing 28 (1.9%) csPCa cases, and achieving a negative predictive value of 93.8%.\r\nConclusion: Integrating PI-RADS with PSAD enhances risk stratification for csPCa, maintaining high diagnostic accuracy while reducing unnecessary procedures.\r\nCite this article as: Lee SJ, Shin DH, Kim HY. Multicenter study on integrating prostate magnetic resonance imaging with prostate-specific antigen density for risk-adapted biopsy strategy in a South Korean cohort. Urol Res Pract. 2026, 52, 0014, doi: 10.5152\/tud.2026.26014.<\/jats:p>","DOI":"10.5152\/tud.2026.26014","type":"journal-article","created":{"date-parts":[[2026,5,13]],"date-time":"2026-05-13T13:32:12Z","timestamp":1778679132000},"page":"1-6","source":"Crossref","is-referenced-by-count":0,"title":["Multicenter Study on Integrating Prostate Magnetic Resonance Imaging with Prostate-Specific Antigen Density for Risk-Adapted Biopsy Strategy in a South Korean Cohort"],"prefix":"10.5152","volume":"52","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-0072-8010","authenticated-orcid":false,"given":"Seung-Ju","family":"Lee","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-8496-8825","authenticated-orcid":false,"given":"Dong Ho","family":"Shin","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-4149-5479","authenticated-orcid":false,"given":"Hee Youn","family":"Kim","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"3111","published-online":{"date-parts":[[2026,5,13]]},"container-title":["Urology Research and Practice"],"original-title":[],"link":[{"URL":"https:\/\/urologyresearchandpractice.org\/index.php\/pub\/article\/download\/3709\/3694","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/urologyresearchandpractice.org\/index.php\/pub\/article\/download\/3709\/3694","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,5,13]],"date-time":"2026-05-13T13:32:12Z","timestamp":1778679132000},"score":1,"resource":{"primary":{"URL":"https:\/\/urologyresearchandpractice.org\/index.php\/pub\/article\/view\/3709"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,5,13]]},"references-count":0,"URL":"https:\/\/doi.org\/10.5152\/tud.2026.26014","relation":{},"ISSN":["2980-1478"],"issn-type":[{"value":"2980-1478","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,5,13]]}}}