AI risk scores could spare about one in five PI-RADS 3 biopsies while keeping sensitivity near 98%

The edition in brief

Four items for radiologists and those who act on imaging. In 787 men with histologically verified prostate MRI at several centres, a commercial AI risk classification had non-inferior patient-level sensitivity to PI-RADS for clinically significant cancer (97.6% vs 92.6%) but lower lesion-level sensitivity (78.8% vs 88.8%); applied to PI-RADS 3 cases it would have avoided 18.9% of biopsies while keeping 98.4% sensitivity. An ERS guideline recommends screening all adults with common variable immunodeficiency for granulomatous-lymphocytic interstitial lung disease, preferably with HRCT, with multidisciplinary review, exclusion of infection and bronchoalveolar lavage; most recommendations are conditional. In 66 patients restaged after neoadjuvant chemotherapy for oesophagogastric adenocarcinoma, FDG PET-CT predicted pathological response better than contrast CT (AUC 0.72 vs 0.51) and found all 8 metastases against CT's 4. In 1,037 German men without prostate disease, the 95th percentile of PSA density was 0.071 and age-adjusted values never exceeded 0.11. The pearl covers reporting PSA density with every prostate MRI.