前列腺病变在磁共振成像诱导活检（MRI-TB）结果为阴性后的放射学随访仍需优化。本研究的目的是展示活检阴性病变中等期的放射学和临床随访。回顾了2017年9月至2020年3月间前往UCLH一站式诊所接受多参数MRI的男性病历（n = 1199）。选取Likert 4或5的病变（n = 495），并筛选出后续MRI-TB结果为阴性的患者，成为最终的研究对象（n = 91）。从报告中提取基线和随访期MRI和活检数据（包括前列腺特异性抗原[PSA]、前列腺体积、放射学评分和非癌症病理的存在）。最后一个随访日期为最后一次检测或回顾临床的日期。中位随访时间为1.8年（656天，四分位数[IQR] 359-1008）。基线时，中位年龄为65.4岁（IQR 60.7-70.0），中位PSA为7.1 ng/ml（IQR 4.7-10.0），中位前列腺体积为54 ml（IQR 39.5-75.0），中位PSA密度（PSAD）为0.13 ng/ml2（IQR 0.09-0.18）。86名男性（95%）有Likert 4病变，其余5名男性（5%）有Likert 5病变。只有21名男性（23%）只有一个病变，大多数人有至少两个病变。萎缩在MRI-TB中是最普遍的病理改变，64名男性（74%）有此病理，其次为急性炎症（42人，46%）、前列腺内皮瘤样增生（33人，36%）、慢性炎症（18人，20%）、非典型增生（13人，14%）和肉芽肿性炎症（3人，3%）。58名男性进行了第二次MRI评估（中位数376天，IQR 361-412）。第二次MRI时，中位PSAD下降至0.11 ng/ml2（IQR 0.08-0.18）。只有5名男性（9%）的病变持续为Likert 4或5评分；40名男性（69%）的评分是Likert 3，其余13名男性（22%）的评分是Likert 2（无病变）。在具有Likert ≥3评分的45名男性中，多数只有一处病变（28人；62%）。在研究期间进行重复MRI-TB的6名男性中，其中2人随后被诊断为前列腺癌，两者的Likert 4评分持续存在（在基线和至少一次随访MRI中均如此）。前列腺检查中磁共振成像（MRI）扫描检测到的阴性癌症病变通常会消失。重复MRI可以指示需要二次活检的持续病变。大多数前列腺活检阴性的MRI病变会随着时间的推移而消失，但任何持续存在的病变应密切进行随访。版权所有 © 2023作者。Elsevier B.V.保留所有权利。

The optimal radiological follow-up of prostate lesions negative on magnetic resonance imaging (MRI)-targeted biopsy (MRI-TB) is yet to be optimised.To present medium-term radiological and clinical follow-up of biopsy-negative lesions.The records for men who underwent multiparametric MRI at the UCLH one-stop clinic for suspected prostate cancer between September 2017 and March 2020 were reviewed (n = 1199). Patients with Likert 4 or 5 lesions were considered (n = 495), and those with a subsequent negative MRI-TB comprised the final study population (n = 91).Baseline and follow-up MRI and biopsy data (including prostate-specific antigen [PSA], prostate volume, radiological scores, and presence of any noncancerous pathology) were extracted from reports. The last follow-up date was the date of the last test or review in clinic.Median follow-up was 1.8 yr (656 d, interquartile range [IQR] 359-1008). At baseline, the median age was 65.4 yr (IQR 60.7-70.0), median PSA was 7.1 ng/ml (IQR 4.7-10.0), median prostate volume was 54 ml (IQR 39.5-75.0), and median PSA density (PSAD) was 0.13 ng/ml2 (IQR 0.09-0.18). Eighty-six men (95%) had Likert 4 lesions, while the remaining five (5%) had Likert 5 lesions. Only 21 men (23%) had a single lesion; most had at least two. Atrophy was the most prevalent pathology on MRI-TB, present in 64 men (74%), and followed by acute inflammation in 42 (46%), prostatic intraepithelial neoplasia in 33 (36%), chronic inflammation in 18 (20%), atypia in 13 (14%), and granulomatous inflammation in three (3%). Fifty-eight men had a second MRI study (median 376 d, IQR 361-412). At the second MRI, median PSAD decreased to 0.11 ng/ml2 (IQR 0.08-0.18). A Likert 4 or 5 score persisted only in five men (9%); 40 men (69%) were scored Likert 3, while the remaining 13 (22%) were scored Likert 2 (no lesion). Of 45 men with a Likert ≥3 score, most only had one lesion at the second MRI (28 men; 62%). Of six men with repeat MRI-TB during the study period, two were subsequently diagnosed with prostate cancer and both had persistent Likert 4 scores (at baseline and at least one follow-up MRI).Most biopsy-negative MRI lesions in the prostate resolve over time, but any persistent lesions should be closely monitored.Lesions in the prostate detected via magnetic resonance imaging (MRI) scans that are negative for cancer on biopsy usually resolve. Repeat MRI can indicate persistent lesions that might need a second biopsy.Copyright © 2023 The Author(s). Published by Elsevier B.V. All rights reserved.