Prostate-Specific Antigen Density to Select Magnetic Resonance Imaging–Targeted vs Combined Biopsy for Prostate Cancer Diagnosis: A Secondary Analysis of the Trio Study

Given an approximate doubling in grade group ≥ 3 cancer detection on combined biopsy with rising PSAD intervals, clinicians may consider PSAD in risk stratifying men at high risk of clinically significant prostate cancer. Clinicians may consider omitting systematic biopsy for targeted biopsy of MRI-visible lesions in patients with PSAD ≥ 0.2 ng/mL/cm³, as systematic biopsy results in low rates of additional clinically significant cancer detection.