doi:10.3390/cancers14071828engMorote, JuanBorque-Fernando, AngelTriquell, MarinaCelma, AnnaRegis, LucasMast, Richardde Torres, Inés M.Semidey, María E.Santamaría, AnnaPlanas, JacquesEsteban, Luis M.Trilla, EnriqueMultiparametric Magnetic Resonance Imaging Grades the Aggressiveness of Prostate CancerART-2022-128327We sought to find further evidence showing the increase in PCa aggressiveness as PI-RADS score increases from four surrogates of PCa aggressiveness: i. prostate biopsy GG (≤3 vs. >3), ii. type of pathology in surgical specimens (favourable vs. unfavourable), iii. clinical stage (localised vs. advanced), and risk of recurrence of localised PCa after primary treatment (low-intermediate vs. high). A group of 692 PCa patients were diagnosed after 3-T multiparametric MRI (mpMRI) and guided and/or systematic biopsies, showing csPCa (GG ≥ 2) in 547 patients (79%) and insignificant PCa (iPCa) in 145 (21%). The csPCa rate increased from 32.4% in PI-RADS < 3 to 95.5% in PI-RADS 5 (p < 0.001). GG ≥ 3 was observed in 7.6% of PCa with PI-RADS < 3 and 32.6% in those with PI-RADS > 3 (p < 0.001). Unfavourable pathology was observed in 38.9% of PCa with PI-RAD < 3 and 68.3% in those with PI-RADS > 3 (p = 0.030). Advanced disease was not observed in PCa with PI-RADS ≤ 3, while it existed in 12.7% of those with PI-RADS > 3 (p < 0.001). High-risk recurrence localised PCa was observed in 9.5% of PCa with PI-RADS < 3 and 35% in those with PI-RADS > 3 (p = 0.001). The PI-RADS score was an independent predictor of all surrogates of PCa aggressiveness as PSA density. We confirmed that mpMRI grades PCa aggressiveness.2022http://zaguan.unizar.es/record/11218810.3390/cancers14071828http://zaguan.unizar.es/record/112188oai:zaguan.unizar.es:112188info:eu-repo/grantAgreement/ES/ISCIII/PI20/01666Cancers 14, 7 (2022), 1828 [9 p.]byhttp://creativecommons.org/licenses/by/3.0/es/info:eu-repo/semantics/openAccess