What question did this study set out to answer?

The study aims to assess how MRI imaging parameters relate to Gleason Scores from prostate biopsies.

March 14, 2026

Association of Prostate Multiparametric MRI Parameters with Gleason Score: A Fusion Biopsy-Based Correlation

Key Points

The study aims to assess how MRI imaging parameters relate to Gleason Scores from prostate biopsies.
Included 120 patients undergoing MP-MRI and MRI/US fusion-guided biopsy
Recorded anatomical location, PSA, prostate volume, PD, ADC values, and PI-RADS scores
Statistically compared Gleason Scores with imaging and clinical parameters using Pearson’s correlation and ROC analysis.
68.3% of MRI-targeted lesions were benign, 17.3% low-grade, and 14.4% high-grade malignancy
ADC values negatively correlated with age, PSA, PD, and PI-RADS scores
ADC values showed high sensitivity and specificity for distinguishing low-grade and high-grade malignancies.

Abstract

Introduction: This study aimed to investigate the relationship between imaging parameters obtained from Multiparametric Magnetic Resonance İmaging (MPMRI) and Gleason Scores (GS) derived from targeted prostate biopsies performed using MRI/Ultrasound (US) fusion guidance. Materials and Methods: A total of 120 consecutive patients who underwent 1.5T MP-MRI followed by MRI/US fusion-guided prostate biopsy were included. In total, 202 MRI-identified targets were sampled. For each lesion, anatomical location, Prostate-Specific Antigen (PSA), prostate volume, Prostate Density (PD), apparent diffusion Coefficient (ADC) values, neurovascular bundle invasion, and PI-RADS v2.1 score were recorded. GS results were statistically compared with imaging and clinical parameters. Pearson’s correlation was calculated to investigate the associations, and the diagnostic ability of ADC values was evaluated by Receiver Operating Characteristic (ROC) analysis. Results: Of the 202 targets, 138 (68.3%) were benign, 35 (17.3%) had GS 3+4 (low-grade), and 29 (14.4%) had GS ≥4+3 (high-grade) malignancy. ADC values were negatively correlated with age, PSA, PD, and PI-RADS score. Most lesions were located in the peripheral zone, particularly in the mid-gland and apical regions. Malignant lesions were frequently found in the peripheral zone and right mid-gland. ADC values showed strong diagnostic performance, with cut-offs of 0.78 ×10−3 mm2/s for low-grade (sensitivity: 79.69%, specificity: 86.21%) and 0.70 ×10−3mm2/s for highgrade malignancies (sensitivity: 92.03%, specificity: 92.49%). Discussion: This echoes previous reports indicating that ADC value negatively correlated with GS, supporting the application of MP-MRI-derived parameters in the assessment of prostate cancer. Conclusion: Correlation of MP-MRI-derived imaging parameters with histopathology results allows meaningful exploitation in clinical decision-making in prostate cancer diagnosis. Both the PI-RADS score and the ADC value were validated as reliable predictors of tumor aggressiveness. Although MRI-targeted fusion biopsies have gained more and more popularity in clinical practice, based on our data, no conclusion can be drawn as to their effect in decreasing the number of unnecessary prostate biopsies.

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