Clinically Significant ISUP Upgrading in the Multiparametric MRI Era: Biopsy Tumor Burden Outperforms Complex Machine Learning Models in a Single-Center Exploratory Cohort.

22% for positive margins, respectively), although these differences did not reach statistical significance in the present cohort.

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In our cohort, the patients who underwent additional mpMRI-targeted cognitive fusion lesion sampling had a nonsignificant trend toward lower upgrading rates (34.6% vs. 41.1% with systematic biopsy alone, Δ6.5%), consistent with the modest reductions in under-grading risk reported with MRI-targeted approaches [ 50 ].

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The presence of variant histologic patterns on biopsy showed a trend toward higher upgrading risk but did not reach statistical significance when considered in isolation.

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