Association between changes in suspicious prostate lesions on serial MRI examinations and follow-up biopsy results ★

We assessed changes in prostate lesions on serial magnetic resonance imaging (MRI) examinations in predicting biopsy results. Fifty-five men undergoing two prostate MRI examinations ≥ 6 months apart, followed by targeted biopsy, were included. Two radiologists assessed dominant lesions for an increase in size or suspicion score. Progression on MRI had lower sensitivity (23.5%–35.3%) and higher specificity (76.2%–90.5%) than prostate-specific antigen (PSA) velocity (sensitivity 70.6%, specificity 52.4%) for predicting positive biopsy. Highest accuracy was achieved by PSA velocity (63.6%) for positive biopsy, and by MRI (65.5%-72.7%) for Gleason > 6 tumor. Findings support lesion progression on MRI serving as a basis for performing subsequent targeted biopsy.