The Use of Multiparametric Magnetic Resonance Imaging for Follow-up of Patients Included in Active Surveillance Protocol. Can PSA Density Discriminate Patients at Different Risk of Reclassification?

We tested the ability of Prostate Imaging Reporting and Data System (PI-RADS) score and prostate-specific antigen density (PSAD) in predicting the risk of reclassification during active surveillance. Three hundred eighty-nine patients underwent multiparametric magnetic resonance imaging and subsequent confirmatory or follow-up biopsy. PSAD ≥ 0.20 ng/mL2 may improve predictive accuracy of multiparametric magnetic resonance imaging results for reclassification of patients in active surveillance, whereas PSAD < 0.10 ng/mL2 may help selection of patients at lower risk of harboring clinically significant prostate cancer.