2024-11-1020230724-498310.1007/s00345-022-04274-y2-s2.0-85145500873http://dx.doi.org/10.1007/s00345-022-04274-yhttps://hdl.handle.net/20.500.14288/15840Purpose To evaluate the contribution of the size and number of the sampled lesions to the diagnosis of clinically significant prostate cancer (CSPC) in patients who had PI-RADS 4 lesions. Methods In this retrospective study, a total of 159 patients who had PI-RADS 4 lesions and underwent In-bore MRI-Guided prostate biopsy were included. Patients with a lesion classified as Grade Group 2 and above were considered to have CSPC. Univariate and multivariate regression analyses were used to evaluate the factors affecting the diagnosis of prostate cancer (PCa) and CSPC. Results A great majority (86.8%) of the patients were biopsy-naive. About three-fourths (71.7%) had PCa, and half (54.1%) had CSPC. When the patients were divided into three groups according to the index lesion size (< 5 mm, 5-10 mm, and > 10 mm), the prevalence of PCa was 64.3, 67.5, and 82.4% and the prevalence of CSPC was 42.9, 51.2, and 64.7%, respectively. In multivariate analysis, age, index lesion size, prostate volume (< 50 ml) and being biopsy-naive were found significant for PCa, while age and prostate volume (< 50 ml) were significant for CSPC. Conclusion The number of lesions was found to be insignificant in predicting PCa and CSPC. While the size of PI-RADS 4 lesions was significant in predicting PCa, it had no significance in detecting CSPC.UrologyNephrologyJournal Article1433-8726907097900002Q24955