Objective: We evaluate the performance and relevance of MRI to detect csPC in men with normal PSA. Methods: Out of our database of patients referred for prostate MRI, we selected men with PSA Results: A total of 148 men were included, with PSA ranging from 0.42 to 3.99 ng/mL (median 2.95, IQR 1.68-3.50) and age ranging from 36 to 84 years (median 58, IQR 52-66). A total of 74 men (50.0%) had a PSA level Conclusions: Performing prostate MRI in men with normal PSA (<4 ng/mL) seems useful if there are other reasons that increase the clinical suspicion of csPC. In about one-fifth of these patients, csPC is present and MRI has high sensitivity for its detection. Prostate MRI has, however, low positive predictive value in this patient group, and clinicians should be aware of the risk of false-positive MRI. Below a PSA level of 2 ng/mL, no csPC was found and prostate MRI generated only false positives, suggesting limited value in this subgroup.
Visschere et al. (Wed,) studied this question.