Predictive impact of PI-RADS 3 lesion volume/total prostate volume ratio in prostate cancer diagnosis in biopsy-naïve patients

Sep 30, 2026

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The study evaluates whether the ratio of PI-RADS 3 lesion volume to total prostate volume can predict biopsy outcomes in patients with PI-RADS 3 findings on multiparametric prostate MRI. Among 749 men scanned between 2014 and 2023, 308 met inclusion criteria. Benign and malignant cases were compared using age, PSA, prostate volume, mpMRI results, PI-RADS 3 lesion volume, and biopsy pathology. The PI-RADS 3 ratio differed significantly between groups, with ROC analysis showing moderate discrimination and a weak positive correlation with dPSA. Results support using the ratio as an auxiliary parameter to refine biopsy candidate selection.

LanguageEnglish

CategoryHealthcare

FormatPDF

Pages9

Reading Time23 min

AccessFree to download

Background/aim

Materials and methods

Results

Conclusion

Introduction

Turkish Journal of Medical Sciences | Volume 55 Number 6 | Article 12 | | --- | --- | | 12-12-2025
Predictive impact of PI-RADS 3 lesion volume/total prostate volume ratio in prostate cancer diagnosis in biopsy-naïve patients EMRAH ÖZSOY
MUSAB ALİ KUTLUHAN
EMRE TOKUÇ RIDVAN KAYARSAMET DEMİR
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Follow this and additional works at: [https://journals.tubitak.gov.tr/medical](https://journals.tubitak.gov.tr/medical)
Part of the Medical Sciences Commons | | Recommended Citation ÖZSOY, E, KUTLUHAN, M. A, TOKUÇ, E, KAYAR, R, DEMİR, S, MERİÇ, K, & ÖZTÜRK, M. İ (2025) . Predictive impact of PI-RADS 3 lesion volume/total prostate volume ratio in prostate cancer diagnosis in biopsynaïve patients. Turkish Journal of Medical Sciences 55 (6): 1459-1465 . [https://doi.org/10.55730/](https://doi.org/10.55730/)[ ](https://doi.org/10.55730/)1300-0144.6103 This work is licensed under a Creative Commons Attribution 4.0 International License. This Research Article is brought to you for free and open access by TÜBİTAK Academic Journals. It has been accepted for inclusion in Turkish Journal of Medical Sciences by an authorized editor of TÜBİTAK Academic Journals. For more information, please contact [academic.publications@tubitak.gov.tr](academic.publications@tubitak.gov.tr) Predictive impact of PI-RADS 3 lesion volume/total prostate volume ratio in prostate cancer diagnosis in biopsy-naïve patients Authors EMRAH ÖZSOY, MUSAB ALİ KUTLUHAN, EMRE TOKUÇ, RIDVAN KAYAR, SAMET DEMİR, KAAN MERİÇ, and METİN İSHAK ÖZTÜRK This research article is available in Turkish Journal of Medical Sciences: [https://journals.tubitak.gov.tr/medical/](https://journals.tubitak.gov.tr/medical/)[ ](https://journals.tubitak.gov.tr/medical/)vol55/iss6/12 |
| Turkish Journal of Medical Sciences [http://journals.tubitak.gov.tr/medical/](http://journals.tubitak.gov.tr/medical/)

Research Article | Turk J Med Sci
(2025) 55: 1459-1465 © TÜBİTAK
doi:10.55730/1300-0144.6103 | | --- | --- | --- | Predictive impact of PI-RADS 3 lesion volume/total prostate volume ratio in prostate cancer diagnosis in biopsy-naïve patients Emrah ÖZSOY1,*􀁋, MusabAli KUTLUHAN2􀁋, Emre TOKUÇ3􀁋, Rıdvan KAYAR4􀁋, Samet DEMİR3􀁋, Kaan MERİÇ5􀁋, Metin İshak ÖZTÜRK3􀁋 1Department of Urology, Ünye Çakırtepe Hospital, Ordu, Turkiye 2 Department of Urology, Faculty of Medicine, Ankara Yıldırım Beyazıt University, Ankara, Turkiye 3Department of Urology, Haydarpaşa Numune Training and Research Hospital, Health Sciences University, İstanbul, Turkiye 4 Department of Urology, Van Training and Research Hospital, Health Sciences University, Van, Turkiye 5Department of Radiology, Medistate Hospital, Beykoz University, İstanbul, Turkiye Received: 30.09.2024 Accepted/Published Online: 05.10.2025 Final Version: 12.12.2025 Background/aim: To assess the potential of the ratio between PI-RADS 3 lesion volume and total prostate volume as a predictive parameter for guiding the decision to perform a biopsy in patients presenting with PI-RADS 3 lesions on multiparametric prostate magnetic resonance imaging (mpMRI) . Materials and methods: A total of 749 patients who underwent mpMRI due to suspected prostate cancer between January 2014 and August 2023 were scanned. Based on predefined inclusion and exclusion criteria, 308 patients were included. Age, total prostate-specific antigen (PSA) value, prostate volume measured in mpMRI, mpMRI result, PI-RADS 3 lesion volume, and biopsy results were collected. The PI-RADS 3 ratio was calculated as PI-RADS 3 lesion volume/total prostate volume. PSA density (dPSA) was calculated. The patients were categorized according to their biopsy results as benign or malignant (subclassified by Gleason group grade), and the two groups were compared. Results: The average PI-RADS 3 ratio was 0.032 ± 0.002. There were 230 (74.7%) patients in the benign group and 78 (25.3%) patients in the malignant g

FAQs

What is the main objective of this study?

To assess whether the PI-RADS 3 lesion volume to total prostate volume ratio can serve as a predictive parameter for biopsy decisions in patients with PI-RADS 3 lesions on mpMRI.

How were patients selected and what variables were collected?

mpMRI scans were performed in biopsy-naïve patients with suspected prostate cancer (749 initially); 308 were included after predefined criteria. Collected variables included age, PSA, prostate volume, mpMRI results, PI-RADS 3 lesion volume, PSA density (dPSA), and biopsy results.

What were the key findings regarding diagnostic performance?

The PI-RADS 3 ratio showed a statistically significant difference between benign and malignant groups. ROC analysis produced an area under the curve of 0.643 ± 0.037, with an optimal cut-off of 0.026 (sensitivity 58.97%, specificity 66.96%).

How should the PI-RADS 3 ratio be used in clinical practice according to the conclusion?

It may be used as an auxiliary clinical parameter alongside age, dPSA, and lesion volume to help identify more refined candidates for biopsy and support patient care individualization.

Sep 30, 2026

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