Original Article| Volume 43, P64-68, May 2017

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Follow-up MR imaging of PI-RADS 3 and PI-RADS 4 prostate lesions


      • The rate of malignancy after follow-up MRI of the prostate in PI-RADS 3 lesions was 4% (1/23).
      • In follow-up MRI maximal diameter of PI-RADS 3 lesions was significantly smaller and ADC-average was significantly higher than in baseline MRI.
      • The NPV of mp-MRI for malignancy in PI-RADS 3 lesions was 96%.
      • The rate of malignancy after follow-up MRI of the prostate in PI-RADS 4 lesions with negative initial core biopsy was 69% (9/13).
      For PI-RADS 4 lesions with initial negative biopsy an instant repeat biopsy should be performed.



      To determine the rate of malignancy after follow-up MR imaging of the prostate in PI-RADS 3 lesions without core biopsy and PI-RADS 4 lesions after negative initial core biopsy.

      Materials and methods

      We performed follow-up MRI in 46/72 (64%) patients with PI-RADS 3 lesions and 26/72 (36%) patients with PI-RADS 4 lesions in baseline MRI.


      The rate of malignancy in PI-RADS 3 lesions was 4% (2/46) and in PI-RADS 4 lesions 69% (18/26).


      Follow-up MRI for PI-RADS 3 lesions should be performed. For PI-RADS 4 lesions with initial negative biopsy we recommend an instant repeat core biopsy.


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