01/11/2025
Evaluation of PI-RADS version 2.1 vs. 2.0 for detecting clinically significant prostate cancer in biopsy-naïve men
Kathryn E Fink et al. Urol Oncol. 2025.
Results: Of 1,427 patients, 1,144 (80.2%) underwent mpMRI evaluated under v2.1 and 283 (19.8%) under v2.0. Compared to v2.0, the v2.1 group had more PI-RADS 5 lesions (21% vs. 16%) and fewer PI-RADS 1 to 2 lesions (8% vs. 14%) (P = 0.004). csPCa detection per patient was higher in the v2.1 group (50% vs. 43%, P = 0.04), driven by improved detection in the TZ (55.1% vs. 39.3%, P = 0.04). No significant difference was seen in the peripheral zone (PZ). Multivariable analysis showed higher csPCa detection for TZ lesions with v2.1 (OR: 1.34, 95% CI: 1.02-1.76, P = 0.03).
Conclusions: PI-RADS v2.1 was associated with csPCa detection in TZ lesions compared to v2.0.