• Mefail Aksu, Ural Oğuz, Serdar Aslan, Erhan Demirelli, Özay Demiray, Birgül Tok, Doğan Sabri Tok, and Ercan Öğreden.
• Mefail Aksu, Giresun University, Faculty of Medicine, Department of Urology, Nizamiye, Mumcular Sk., 28200 Giresun, Turkey, mefailaksu@gmail.com.
• Croat. Med. J. 2024 Oct 31; 65 (5): 417423417-423.

AimTo evaluate the effect of 5 alpha-reductase inhibitor (5-ARI) treatment on prostate cancer detection by multiparametric magnetic resonance imaging (mpMRI).MethodsWe retrospectively collected data on 429 patients who underwent mpMRI before prostate biopsy in the Urology Department of Giresun University Training and Research Hospital between March 2018 and December 2021. The patients were categorized as those who had never been treated with 5-ARI (n=359) and those who were treated with 5-ARI for more than six months (n=70). The two groups were compared in terms of age, mpMRI findings, and pathology results.ResultsThe number of patients with Prostate Imaging-Reporting and Data System (PIRADS) 3 score was significantly higher in the 5-ARI group (37.1% vs 20.6%; P=0.009). The groups did not differ in terms of malignant pathological findings (48.5% in the non-5-ARI vs 47.1% in the 5-ARI group; P=0.505). The detection rates of malignant pathological findings in PIRADS 3 and PIRADS 5 patients were similar between the 5-ARI and non-5-ARI group. However, malignancy detection rate in PIRADS 4 patients was significantly higher in the non-5-ARI group (P=0.031). In the non-5-ARI group, the sensitivity was 56.4% and the specificity was 79.7%. In the 5-ARI group, the sensitivity was 84.9% and the specificity was 56.8%.ConclusionIn patients with suspected prostate cancer, 5-ARI intake may alter lesion mpMRI characteristics and PIRADS distribution on mpMRI. 5-ARI intake should be reported to the radiologist.

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