The role of multiparametric magnetic resonance in active surveillance of a low‐risk prostate cancer cohort from clinical practice

Introduction Active surveillance (AS) is considered a suitable management practice for those patients with low‐risk prostate cancer (PCa). At present, however, the role of multiparametric magnetic resonance imaging (mpMRI) in AS protocols has not yet been clearly established. Outcomes To determine the role of mpMRI and its ability to detect significant prostate cancer (SigPCa) in PCa patients enrolled in AS protocols. Materials and Methods There were 229 patients enrolled in an AS protocol between 2011 and 2020 at Reina Sofía University Hospital. MRI interpretation was based on PIRADS v.1 or v.2/2.1 classification. Demographics, clinical, and analytical data were collected and analyzed. Sensitivity, specificity, positive predictive value (PPV), and negative predictive value (NPV) were calculated for mpMRI in different scenarios. We defined SigPCa and reclassification/progression as a Gleason score (GS) ≥ 3 + 4, a clinical stage ≥T2b, or an increase in PCa volume. Kaplan–Meier and log‐rank tests were used to estimate progression‐free survival time. Results Median age was 69.02 (±7.73) at diagnosis, with a 0.15 (±0.08) PSA density (PSAD). Eighty‐six patients were reclassified after confirmatory biopsy, with a suspicious mpMRI an indication for a clear reclassification and risk‐predictor factor in disease progression (p