Dynacad software

MRI was performed using 3‐Tesla MRI (Siemens Magnetom Triop and Verio). In rare instances, 1.5‐Tesla MRI (GE Optima MR450W) was employed when use of 3‐T coil was contraindicated. An endorectal coil was used for cases prior to 2019, after which it was routinely omitted for most patients. Postimage processing used DynaCAD software (Philips Healthcare, Best, Netherlands). MRI images were graded by experienced but nondedicated faculty using PI‐RADS version 2.0 or 2.1.
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All MRI‐TRUS fusion biopsies were performed transrectally by experienced urologists using the UroNav system (Invivo, Philips Healthcare). Transperineal biopsy was introduced after the study period. Standard template biopsies included two biopsy cores taken from each sextet region. Targeted biopsies were obtained at the discretion of the urologist; PI‐RADS 3‐5 lesions were routinely biopsied with two cores, while PI‐RADS 2 lesions were rarely sampled.

The majority of mpMRIs were performed at 3‐Tesla with an endorectal coil using the technical standards set forth by PI‐RADS v2. All mpMRI, including the few not performed at our institution, were interpreted by two diagnostic radiologists (BF, FC) with extensive mpMRI experience using PI‐RADS v2 criteria. Prostate and ROI contouring was performed using Dynacad software (Invivo, Philips, Best, Netherlands).