INTRODUCTION
Prostate cancer(PCa) is the most commonly observed cancer in men in the world and the 3rd most common cause of cancer-related deaths1. An autopsy study of 1056 men, who died from causes other than prostate cancer, found 68-77% of men aged 60-79 years had not received a diagnosis but had asymptomatic PCa identified. This result shows the prevalence of this silent disease2,3. However, the mortality and morbidity of advanced stage PCa are very high. Recent studies have focused on distinguishing lesions expressed as “silent disease” with almost no fatality potential, such as tumors with a Gleason score(GS) of 6, and high-grade cancers4. Due to limited sensitivity and specificity of serum PSA screening, digital prostate examination, and TRUS-bx, advanced imaging methods are required to reduce biopsy numbers and to perform target-specific biopsies5. With advanced imaging methods, diagnosis and treatment of prostate cancer can be chosen specifically to the person or active surveillance may be performed. To ensure standardization and reduce differences emerging in the selection of parameters and interpretation of images on prostate MRI, the ESUR published a guideline in 20125,6. Rapid developments in this field and limitations encountered during the use of the PI-RADSv1 led to an update of the PI-RADS system and PI-RADSv2 was published in 2015 by a committee7. In 2019, PI-RADSv2.1 was published including changes ensuring more accurate and reproducible interpretations can be made8,9.
The aim of this prospective study is; to investigate the correlation of the PIRADSv2.1 score with the histopathological result and the ISUP score in patients with suspected prostate cancer in MpMRI examinations guided PI-RADSv2.1 and diagnosed with TRUS-guided cognitive fusion biopsy(TRUS-guided CF-Bx) and to assess the compatibility between different experience levels of the radiologists.