Comparison of Chitosan-Based Liquid Scaffold and Hyaluronic Acid–Based Soft Scaffold for Treatment of Talus Osteochondral Lesions

2020 ◽  
Vol 41 (10) ◽  
pp. 1240-1248
Author(s):  
Ramazan Akmeşe ◽  
Mehmet Batu Ertan ◽  
Hakan Kocaoğlu
Keyword(s):  
Magnetic Resonance ◽  
Osteochondral Lesions ◽  
Resonance Imaging ◽  
Analog Scale ◽  
Level Of Evidence ◽  
Time Period ◽  
Significant Difference ◽  
Vas Scores ◽  
American Orthopaedic ◽  
Retrospective Comparative Study

Background: The aim of this study was to evaluate the clinical and radiologic results of 2 different scaffolds with hyaluronan or chitosan-based structure used in the treatment of talus osteochondral lesions. Methods: Eighty-one patients who underwent chondral lesion repair with hyaluronan (n = 42) or chitosan-based (n = 39) scaffold were included. American Orthopaedic Foot & Ankle Society (AOFAS) and visual analog scale (VAS) scores were evaluated within and between groups preoperatively and at the 3rd, 12th, and 24th month postoperatively. In all patients, magnetic resonance imaging was performed between the 12 and 18th month postoperatively and compared with magnetic resonance observation of cartilage repair tissue (MOCART) scoring. Results: Within-group evaluations revealed significant improvements in AOFAS and VAS scores at postoperative 3 and 12 months. The postoperative 24th-month results of AOFAS scores in any group did not differ significantly from the 12th-month results. There was no significant difference between the groups in comparison of AOFAS, VAS, and MOCART scores at any time period. Conclusion: Both scaffolds were found to be effective in cartilage healing but had no clinical or radiologic superiority to each other. This is the first study to compare the use of different cell-free scaffold types in osteochondral defects of the talus. Level of Evidence: Level III, retrospective comparative study.

Comparison of All Arthroscopic Implantation of Chitosan-Based Liquid Scaffold and Hyaluronan-Based Soft Scaffold in the Treatment of Condylar Osteochondral Lesions in the Knee

2021 ◽  
Author(s):  
Ramazan Akmeşe ◽  
Emre Anıl Özbek ◽  
Hakan Kocaoğlu ◽  
Mehmet Batu Ertan ◽  
İrem İnanç ◽  
...  
Keyword(s):  
Magnetic Resonance ◽  
Osteochondral Lesion ◽  
Cartilage Regeneration ◽  
International Knee Documentation Committee ◽  
Osteochondral Lesions ◽  
Time Period ◽  
Significant Difference ◽  
Vas Scores ◽  
Retrospective Comparative Study ◽  
Clinical And Radiological Results

AbstractCell-free scaffolds used in cartilage regeneration are produced from different materials. The aim of this study is to compare the clinical and radiological results of two different scaffolds with hyaluronan- or chitosan-based structure used in the treatment of symptomatic condylar osteochondral lesions. The study comprises 69 patients who were operated for osteochondral lesion repair with hyaluronan- (n = 37) or chitosan-based (n = 32) scaffold. The International Knee Documentation Committee (IKDC), Lysholm Knee Scoring Scale and Visual Analog Scale (VAS) scores were collected for both groups at the preoperative and postoperative 3rd, 12th, and 24th months. Magnetic resonance imaging was performed between the 12th and 15th months postoperatively and this with magnetic resonance observation of cartilage repair tissue (MOCART) scoring were compared. Within group assessments demonstrate significant improvement in IKDC, Lysholm, and VAS scores at postoperative 3rd and 12th months. However, in both groups, IKDC, Lysholm and, VAS scores at the postoperative 24th month indicate no significant further improvement, compared with the 12th month results. There was no significant difference between the groups in terms of IKDC, Lysholm, VAS, and MOCART scores at any time period. This study shows that both scaffolds are useful in cartilage regeneration but have no clinical or radiological superiority to each other. Surgeons should select the method with which they feel comfortable. This is a level III, retrospective comparative study.

Clinical and Magnetic Resonance Imaging Outcomes of Microfracture Plus Chitosan/Blood Implant vs Microfracture for Osteochondral Lesions of the Talus

2020 ◽  
Vol 41 (11) ◽  
pp. 1368-1375
Author(s):  
Yalkin Camurcu ◽  
Hanifi Ucpunar ◽  
Furkan Yapici ◽  
Resit Karakose ◽  
Seckin Ozcan ◽  
...  
Keyword(s):  
Magnetic Resonance Imaging ◽  
Magnetic Resonance ◽  
Osteochondral Lesions ◽  
Resonance Imaging ◽  
Glycerol Phosphate ◽  
Level Of Evidence ◽  
Repair Tissue ◽  
Significant Difference ◽  
The Mean ◽  
Group 1

Background: The aim of this study was to compare the clinical and magnetic resonance imaging (MRI) outcomes of arthroscopic microfracture (MF) plus chitosan-glycerol phosphate/blood implant and MF alone for the treatment of the osteochondral lesions of the talus (OCLTs). Methods: Patients who underwent either MF plus chitosan (group 1, n = 32) or MF alone (group 2, n = 31) between 2015 and 2019 in 2 separate time periods were retrospectively analyzed. Visual analog scale (VAS) score and American Orthopaedic Foot & Ankle Society (AOFAS) score were used for clinical evaluation. The magnetic resonance observation of cartilage repair tissue (MOCART) system was used for MRI evaluation. The mean follow-up time was 32 ± 13 months (range, 12-61 months). Results: Postoperatively, we detected significant improvements in both groups in terms of VAS and AOFAS scores. However, we observed no statistically significant difference between groups in terms of clinical scores, except the mean VAS function score, which was significantly higher in group 1 ( P = .022). According to MOCART scale, complete repair with the filling of the chondral defect and intactness of the surface of the repair tissue were more common in group 1. However, these parameters did not significantly differ between groups ( P = .257 and .242, respectively). Conclusion: Arthroscopic MF plus chitosan glycerol phosphate/blood implant did not result in better clinical and MRI outcomes compared with MF alone in the treatment of OCLTs. Level of Evidence: Level III, retrospective comparative study.

Distal Metatarsal Segmental Shortening for the Treatment of Chronic Metatarsophalangeal Dislocation of Lesser Toes

2020 ◽  
pp. 107110072096108
Author(s):  
Tzu-Cheng Yang ◽  
Yun-Hsuan Tzeng ◽  
Chien-Shun Wang ◽  
Ming-Chau Chang ◽  
Chao-Ching Chiang
Keyword(s):  
Demographic Data ◽  
Level Of Evidence ◽  
Radiographic Measurements ◽  
Group I ◽  
Significant Difference ◽  
Scale Scores ◽  
Group Ii ◽  
American Orthopaedic ◽  
Retrospective Comparative Study ◽  
Mtp Joints

Background: This retrospective study aimed to describe the techniques and results of distal metatarsal segmental shortening (DMSS) for the treatment of chronic irreducible metatarsophalangeal (MTP) dislocation of lesser toes. Methods: We retrospectively reviewed patients who underwent DMSS for chronic dislocation of MTP joints of lesser toes between January 2010 and December 2017 with follow-up of at least 24 months. Demographic data, radiographic measurements, functional outcomes, and complications were analyzed. Furthermore, the results of patients with short segment of shortening (group I, <10 mm) were compared to those with long segment of shortening (group II, ≥10 mm). A total of 43 MTP joints of 30 patients with an average age of 70.4 years were included. Results: Union was observed in 42 metatarsals (97.7%). Mean American Orthopaedic Foot & Ankle Society scale scores improved significantly from 42.2 (range, 15-65) preoperatively to 79.1 (range, 52-90) ( P < .001). Mean visual analog scale pain score improved significantly from 5.0 (range, 1-9) preoperatively to 1.8 (range, 0-6) ( P < .001). Complications included 1 nonunion, 1 osteonecrosis, 3 metatarsal angulation, 4 recurrent instability, 4 symptomatic osteoarthritis, 3 transfer metatarsalgia, and 1 floating toe. Group I included 23 MTP joints and group II included 20 MTP joints. There was no significant difference in clinical outcomes and complications between the 2 groups. Conclusion: DMSS was a reliable procedure for the treatment of chronic irreducible dislocated MTP joint of lesser toes. It provided satisfactory surgical outcomes and a low rate of postoperative complications, regardless of length of metatarsal shortening. Level of Evidence: Level III, retrospective comparative study.

Treatment of Bone Marrow Edema of the Talus with Pulsed Electromagnetic Fields

2015 ◽  
Vol 105 (1) ◽  
pp. 27-32 ◽  
Author(s):  
Nicolò Martinelli ◽  
Alberto Bianchi ◽  
Elena Sartorelli ◽  
Alessandra Dondi ◽  
Carlo Bonifacini ◽  
...  
Keyword(s):  
Magnetic Resonance Imaging ◽  
Magnetic Resonance ◽  
Bone Marrow Edema ◽  
Foot And Ankle ◽  
Resonance Imaging ◽  
Analog Scale ◽  
Pulsed Electromagnetic ◽  
American Orthopaedic ◽  
Marrow Edema

Background Bone marrow edema (BME) of the talus is a rare, mostly self-limiting cause of foot and ankle pain. We sought to investigate in patients with idiopathic BME of the talus the effectiveness of pulsed electromagnetic fields and to determine the effect of this therapy on magnetic resonance imaging findings. Methods Six patients with BME of the talus confirmed by magnetic resonance imaging were enrolled. Pain was quantified with a visual analog scale from 0 (no pain) to 10 (the worst pain imaginable). The clinical outcome was assessed using the American Orthopaedic Foot and Ankle Society scoring system. Treatment consisted of pulsed electromagnetic field stimulation 8 h/d for 30 days. The device used generated pulses 1.3 milliseconds in duration, with a frequency of 75 Hz and a mean ± SD induced electric field of 3.5 ± 0.5 mV. Results The mean American Orthopaedic Foot and Ankle Society score improved from 59.4 (range, 40–66) before treatment to 94 (range, 80–100) at the last follow-up. The visual analog scale score decreased significantly from 5.6 (range, 4–7) before treatment to 1 (range, 0–2) at the last follow-up. Magnetic resonance imaging showed that BME improved after 1 month of treatment and resolved completely within 3 months in 5 patients, with normal signal intensity and no signs of progression to avascular necrosis. Conclusions A significant reduction in BME area was associated with a significant decrease in pain within 3 months of beginning treatment.

Outcomes of Autologous Osteochondral Transplantation With and Without Extracellular Matrix Cartilage Allograft Augmentation for Osteochondral Lesions of the Talus

2021 ◽  
pp. 036354652110571
Author(s):  
Nathaniel P. Mercer ◽  
Alan P. Samsonov ◽  
John F. Dankert ◽  
John G. Kennedy
Keyword(s):  
Magnetic Resonance ◽  
Cyst Formation ◽  
Osteochondral Lesions ◽  
Foot And Ankle ◽  
Osteochondral Transplantation ◽  
Resonance Imaging ◽  
Autologous Osteochondral Transplantation ◽  
Additional Surgery ◽  
Significant Difference ◽  
Graft Interface

Background: Autologous osteochondral transplantation (AOT) using a cylindrical graft in the treatment of osteochondral lesions of the talus (OLTs) is typically indicated for patients with larger lesions. However, with lesions that are irregular in shape, the AOT graft may not completely replace the lesion. For these lesions, we utilize extracellular matrix cartilage allograft (EMCA) augmentation in AOT to act as a physiologic grout at the host-graft interface. Purpose: To determine if the combination of EMCA with concentrated bone marrow aspirate (CBMA) would improve integration of the host-graft interface and subsequently reduce postoperative cyst formation after AOT. It was also hypothesized that EMCA in conjunction with CBMA would demonstrate improved MOCART (magnetic resonance observation of cartilage repair tissue) scores and functional outcome scores at a minimum 2 years after surgery. Study Design: Cohort study; Level of evidence, 3. Methods: A retrospective analysis was performed comparing patients treated with AOT/CBMA alone and AOT with CBMA/EMCA. Clinical outcomes were evaluated with the Foot and Ankle Outcome Score. Magnetic resonance imaging appearance was evaluated with the use of the MOCART (magnetic resonance observation of cartilage repair tissue) score. Cyst formation was also evaluated on postoperative magnetic resonance imaging. Results: A total of 26 patients were included in the AOT + CBMA/EMCA group (10 male, 16 female), and 34 patients were included in the AOT/CBMA group (17 male, 17 female). The mean Foot and Ankle Outcome Score significantly improved in both groups ( P < .001) across all subscales (symptoms, pain, activities of daily living, sports activities, and quality of life), but there was no significant difference between groups at final follow-up. There was no significant difference in mean MOCART scores between the groups ( P = .118). In the AOT/CBMA group, 3 patients (8.8%) complained of knee pain, and 1 (2.9%) required additional surgery (hardware removal). In the AOT + CBMA/EMCA group, 2 patients (7.7%) complained of knee pain, and 6 patients (23%) required additional surgery (3 hardware removals and 3 arthroscopic debridements of scar tissue in the ankle). Conclusion: We found that while EMCA with CBMA has benefit in regeneration and repair of OLT treated with bone marrow stimulation, there appears to be little benefit of EMCA over CBMA alone as a physiologic grout at the graft-host interface in OLT treated with AOT.

The Impact of Weight on Arthroscopic Osteochondral Talar Reconstruction

2017 ◽  
Vol 38 (6) ◽  
pp. 612-620 ◽  
Author(s):  
Federico Giuseppe Usuelli ◽  
Camilla Maccario ◽  
Chiara Ursino ◽  
Nicola Serra ◽  
Riccardo D’Ambrosi
Keyword(s):  
Repeated Measures ◽  
Short Form ◽  
Osteochondral Lesions ◽  
Healthy Weight ◽  
Level Of Evidence ◽  
Significant Difference ◽  
Overweight Group ◽  
American Orthopaedic ◽  
The Impact

Background: The purpose of the study was to assess the functional and radiologic outcomes after AT-AMIC (arthroscopic talus autologous matrix–induced chondrogenesis) in 2 weight groups of patients with osteochondral lesions of the talus (OLTs): patients with BMI <25 (Healthy Weight Group [HG]) and with BMI ≥25 (Overweight Group [OG]). Methods: Thirty-seven patients were evaluated. HG was composed of 21 patients (BMI = 21.90 ± 1.94), whereas OG consisted of 16 patients (BMI = 27.41 ± 1.98). All patients were treated with AT-AMIC repair for OLTs. Magnetic resonance imaging (MRI), computed tomography (CT), Visual Analgoue Scale (VAS) for pain, American Orthopaedic Foot & Ankle Society (AOFAS) Ankle and Hindfoot score and Short-Form Health Survey (SF-12) were administered preoperatively (T0) and at 6 (T1), 12 (T2), and 24 (T3) months postoperatively. Results: In both groups, we found a significant difference for clinical and radiologic parameters with analysis of variance for repeated measures through 4 time points ( P < .001). In HG, AOFAS increased at every follow-up ( P < .05), whereas in OG, AOFAS improved only between T2 and T3 ( P = .0104). In OG we found a significant difference comparing CT and MRI at each follow-up; in HG this difference was found only at T0 ( P < .0001) and T1 ( P = .0492). Finally, OG presented a significantly larger lesion measured with MRI at T0 ( P = .033). Conclusions: OLTs in overweight patients were characterized by a larger preoperative size. At final follow-up, both groups showed a significant clinical improvement. AT-AMIC can be considered a safe and reliable procedure, regardless of weight, with a significant improvement also in quality of life. Level of Evidence: Level III, comparative study.

Magnetic Resonance Imaging Appearance of a Repaired Capsulolabral Complex after Arthroscopic Bankart Repair

2008 ◽  
Vol 36 (12) ◽  
pp. 2310-2316 ◽  
Author(s):  
Jae Chul Yoo ◽  
Yong Seuk Lee ◽  
Suk Kee Tae ◽  
Jung Ho Park ◽  
Jong Woong Park ◽  
...  
Keyword(s):  
Magnetic Resonance Imaging ◽  
Magnetic Resonance ◽  
Full Range ◽  
Bankart Repair ◽  
Preoperative Period ◽  
Resonance Imaging ◽  
Recurrent Instability ◽  
Level Of Evidence ◽  
Glenohumeral Ligament ◽  
Significant Difference

Background Revision Bankart operations frequently show capsulolabral buttress loss and recurrent soft tissue Bankart lesion. Capsulolabral augmentation is designed to increase glenohumeral stability by 2 separate mechanisms: deepening the glenoid concavity and reducing capsular laxity. This is accomplished by shifting the capsule to buttress the glenoid labrum. Hypothesis A retained capsulolabral buttress may show loss of height and slope at a certain period after surgery, regardless of stability. Thus, the authors wanted to confirm the importance of an intraoperative establishment of capsulolabral buttress in terms of stability. Study Design Case-control study; Level of evidence, 3. Methods Arthroscopically repaired Bankart lesions in 21 consecutive shoulders that showed no frank dislocation were evaluated using axial and oblique coronal T2-weighted magnetic resonance imaging at 3 timepoints (preoperative period, average postoperative week 6 and a nearly full range of motion recovery, and postoperative month 6 with a return to daily activity). The authors measured 2 parameters (height and slope) on axial (mainly capsulolabral containment) and oblique coronal images (mainly inferior glenohumeral ligament) at the anteroinferior portion of the glenoid (5 mm above the most inferior anchor). In addition, they compared the above-mentioned parameters at postoperative month 6 by magnetic resonance imaging in 21 controls and in 21 patients whose instability recurred after surgery (not included in the prospective study). Results There was a significant increase between the preoperative period and postoperative week 6 in all 4 parameters ( P < .0001). There was also a significant increase between the preoperative period and postoperative month 6 in all 4 parameters ( P < .0001). However, no statistically significant difference was observed between postoperative week 6 and postoperative month 6 in all 4 parameters ( P > .1). Furthermore, significant differences were observed between normal controls and patients with recurrent instability ( P < .001) and between the authors’ cases and patients with recurrent instability not in the study (P < .001). However, no difference was observed between their cases and normal shoulders ( P > .1). Conclusion After suture anchor Bankart repair, initial capsulolabral buttress property was maintained at 6 months postoperatively. Furthermore, the buttress was more prominent in stable and normal shoulders than in recurrent instability shoulders. Therefore, the authors believe that the establishment of a capsulolabral buttress is meaningful during Bankart repair.

scholarly journals Treatment of osteochondral lesions of the talus with autologous collagen-induced chondrogenesis: clinical and magnetic resonance evaluation at one-year follow-up

Joints ◽  
2016 ◽  
Vol 04 (02) ◽  
pp. 080-086 ◽  
Author(s):  
Federico Usuelli ◽  
Miriam Grassi ◽  
Luigi Manzi ◽  
Vincenzo Guarrella ◽  
Michele Boga ◽  
...  
Keyword(s):  
Magnetic Resonance ◽  
Case Series ◽  
Clinical Results ◽  
Lesion Size ◽  
Osteochondral Lesions ◽  
Level Of Evidence ◽  
Imaging Results ◽  
American Orthopaedic ◽  
One Year

Purpose: the aim of this study is to report the clinical and imaging results recorded by a series of patients in whom osteochondral lesions of the talus (OLTs) were repaired using the autologous collagen-induced chondrogenesis (ACIC) technique with a completely arthroscopic approach. Methods: nine patients (mean age 37.4±10 years) affected by OLTs (lesion size 2.1±0.9 cm2) were treated with the ACIC technique. The patients were evaluated clinically both preoperatively and at 12 months after surgery using the American Orthopaedic Foot and Ankle Society Ankle-Hindfoot Scale (AOFAS) and a visual analog scale (VAS). For morphological evaluation, the magnetic resonance observation of cartilage repair tissue (MOCART) score was used. Results: the AOFAS score improved from 51.4±11.6 preoperatively to 71.8±20.6 postoperatively, while the VAS value decreased from 6.9±1.8 to 3.2±1.9. The mean MOCART score was 51.7±16.6 at 12 months of follow-up; these scores did not directly correlate with the clinical results. Conclusions: use of the ACIC technique for arthroscopic repair of OLTs allowed satisfactory clinical results to be obtained in most of the patients as soon as one year after surgery, with no major complications or delayed revision surgery. ACIC is a valid and lowinvasive surgical technique for the treatment of chondral and osteochondral defects of the talus. Level of evidence: therapeutic case series, level IV.

scholarly journals Operational experience of the Dutch helicopter emergency medical services (HEMS) during the initial phase of the COVID-19 pandemic: jeopardy on the prehospital care system?

2021 ◽  
Author(s):  
Quinten G. H. Rikken ◽  
Sarah Mikdad ◽  
Mathijs T. Carvalho Mota ◽  
Marcel A. De Leeuw ◽  
Patrick Schober ◽  
...  
Keyword(s):  
The Netherlands ◽  
Initial Phase ◽  
Prehospital Care ◽  
Operational Experience ◽  
Level Of Evidence ◽  
Historical Cohort ◽  
Significant Difference ◽  
One Year ◽  
Retrospective Comparative Study ◽  
Global And Local

Abstract Purpose The SARS-CoV-2 virus has disrupted global and local medical supply chains. To combat the spread of the virus and prevent an uncontrolled outbreak with limited resources, national lockdown protocols have taken effect in the Netherlands since March 13th, 2020. The aim of this study was to describe the incidence, type and characteristics of HEMS and HEMS-ambulance ‘Lifeliner 1’ dispatches during the initial phase of the COVID-19 pandemic compared to the same period one year prior. Methods A retrospective review of all HEMS and HEMS-ambulance ‘Lifeliner 1’ dispatches was performed from the start of Dutch nationwide lockdown orders from March 13th until May 13th, 2020 and the corresponding period one year prior. Dispatch-, operational-, patient-, injury-, and on-site treatment characteristics were extracted for analysis. In addition, the rate of COVID-19 positively tested HEMS personnel and the time physicians were unable to take call was described. Results During the initial phase of the COVID-19 pandemic, the HEMS and HEMS-ambulance was requested in 528 cases. One year prior, a total of 620 requests were received. The HEMS (helicopter and ambulance) was cancelled after deployment in 56.4% of the COVID-19 cohort and 50.7% of the historical cohort (P = 0.05). Incident location type did not differ between the two cohorts, specifically, there was no significant difference in the number of injuries that occurred at home in pandemic versus non-pandemic circumstances. Besides a decrease in the number of falls, the distribution of mechanisms of injury remained similar during the COVID-19 study period. There was no difference in self-inflicted injuries observed. Prehospital interventions remained similar during the COVID-19 pandemic compared to one year prior. Specifically, prehospital intubation did not differ between the two cohorts. The rate of COVID-19 positively tested HEMS personnel was 23.1%. Physicians who tested positive were unable to take call for a mean of 25 days (range 8–53). Conclusion A decrease in the number of deployments and increase in the number of cancelled missions was observed during the COVID-19 study period. No major differences in operational- and injury characteristics were found for HEMS and HEMS-ambulance dispatches between the initial phase of the COVID-19 pandemic in the Netherlands and the same period one year prior. These findings highlight the importance of continued operability of the HEMS, even during pandemic circumstances. Level of evidence III, retrospective comparative study.

One-year experience of government-funded magnetic resonance imaging prior to prostate biopsy: A case for omitting biopsy in men with a negative magnetic resonance imaging

2021 ◽  
pp. 205141582110043
Author(s):  
Hanna J El-Khoury ◽  
Niranjan J Sathianathen ◽  
Yuxin Jiao ◽  
Reza Farzan ◽  
Dennis Gyomber ◽  
...  
Keyword(s):  
Magnetic Resonance Imaging ◽  
Prostate Cancer ◽  
Magnetic Resonance ◽  
Prostate Biopsy ◽  
Multivariable Analysis ◽  
Transrectal Ultrasound ◽  
Resonance Imaging ◽  
Retrospective Case ◽  
Level Of Evidence ◽  
Clinically Significant

Objectives: This study aimed to characterise the accuracy of multiparametric magnetic resonance imaging (mpMRI) as an adjunct to prostate biopsy, and to assess the effect of the new Australian Medicare rebate on practice at a metropolitan public hospital. Patients and methods: We identified patients who underwent transrectal ultrasound (TRUS)-guided prostate biopsy at a single institution over a two-year period. Patients were placed into two groups, depending upon whether their consent was obtained before or after the introduction of the Australian Medicare rebate for mpMRI. We extracted data on mpMRI results and TRUS-guided biopsy histopathology. Descriptive statistics were used to demonstrate baseline patient characteristics as well as MRI and histopathology results. Results: A total of 252 patients were included for analysis, of whom 128 underwent biopsy following the introduction of the Medicare rebate for mpMRI. There was a significant association between Prostate Imaging Reporting and Data System v2 (PI-RADS) classification and the diagnosis of clinically significant prostate cancer ( p<0.01). Only one man with PI-RADS ⩽2 was found to have clinically significant prostate cancer. Four men with a PI-RADS 3 lesion were found to have clinically significant cancer. A PI-RADS 4 or 5 lesion was significantly associated with the diagnosis of clinically significant cancer on multivariable analysis. Conclusion: mpMRI is an important adjunct to biopsy in the diagnosis of clinically significant prostate cancer. Our findings support the safety of omitting/delaying prostate biopsy in men with negative mpMRI. Level of evidence: Level 3 retrospective case-control study.

Sign in / Sign up

Export Citation Format

Share Document