biostudies-literatureEng SEUnited States Department of Defense | United States Army | Army Medical Command | Congressionally Directed Medical Research ProgramsU.S. Department of Health &amp; Human Services | NIH | National Cancer InstituteNCI NIH HHSDivision of Cancer Prevention, National Cancer InstituteSPORE Career Enhancement Program65-72https://www.ebi.ac.uk/biostudies/studies/S-EPMC12356097biostudies-literatureUnknown27(1)<h4>Background</h4>Protocol-based active surveillance (AS) biopsies have led to poor compliance. To move to risk-based protocols, more accurate imaging biomarkers are needed to predict upgrading on AS prostate biopsy. We compared restriction spectrum imaging (RSI-MRI) generated signal maps as a biomarker to other available non-invasive biomarkers to predict upgrading or reclassification on an AS biopsy.<h4>Methods</h4>We prospectively enrolled men on prostate cancer AS undergoing repeat biopsy from January 2016 to June 2019 to obtain an MRI and biomarkers to predict upgrading. Subjects underwent a prostate multiparametric MRI and a short duration, diffusion-weighted enhanced MRI called RSI to generate a restricted signal map along with evaluation of 30 biomarkers (14 clinico-epidemiologic Prostate cancer and prostatic diseasesProspective comparison of restriction spectrum imaging and non-invasive biomarkers to predict upgrading on active surveillance prostate biopsy.PMC12356097P30CA016042U01 CA214194U01CA214194P50 CA186786P30 CA054174U01CA214170U01 CA214170U24 CA115102U24CA115102U24 CA248265P30 CA016042U24 CA086368U24CA086368W81XWH-15-1-0441P30CA054174Thompson IMChan DWTroyer DASokoll LJLam ABasasie BEng SEChinnaiyan AMSunnapwar AGJohn Semmes OClarke GDTosoian JJBoutros PCLiss MAJohnson-Pais TLLeach RJSiddiqui JfalseProspective comparison of restriction spectrum imaging and non-invasive biomarkers to predict upgrading on active surveillance prostate biopsy.<h4>Background</h4>Protocol-based active surveillance (AS) biopsies have led to poor compliance. To move to risk-based protocols, more accurate imaging biomarkers are needed to predict upgrading on AS prostate biopsy. We compared restriction spectrum imaging (RSI-MRI) generated signal maps as a biomarker to other available non-invasive biomarkers to predict upgrading or reclassification on an AS biopsy.<h4>Methods</h4>We prospectively enrolled men on prostate cancer AS undergoing repeat biopsy from January 2016 to June 2019 to obtain an MRI and biomarkers to predict upgrading. Subjects underwent a prostate multiparametric MRI and a short duration, diffusion-weighted enhanced MRI called RSI to generate a restricted signal map along with evaluation of 30 biomarkers (14 clinico-epidemiologic 2024-01-01T00:00:00Z2024 Mar2026-04-16T15:08:22.43Z2026-04-07T14:12:17.59ZS-EPMC123560973609716810.1038/s41391-022-00591-w