🔷 Prostate Nodule Smart Manager · Assessment, Follow-up & Treatment Decision
UseUse to decide biopsy versus follow-up (1–2 mostly follow-up, 3 by PSAD, 4–5 biopsy) and, once ISUP/stage are …
SourceNational Comprehensive Cancer Network. NCCN Clinical Practice Guidelines: Prostate Cancer.
This-shift next steps
After scoring: open the scene pack, peer scores, and the matching pathway. Local reference — no HIS write.
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Methodology · worked example, guidelines & full notes
PSAD < 0.15 with a negative DRE supports deferring biopsy at PI-RADS 1–3.
When to use
Use to decide biopsy versus follow-up (1–2 mostly follow-up, 3 by PSAD, 4–5 biopsy) and, once ISUP/stage are known, to name the risk group; treatment follows the current version of the cited guidelines.
How it works
PI-RADS + PSAD (threshold 0.15) → biopsy decision. ISUP grade + PSA band + cT → NCCN risk group (low/favorable-int/unfavorable-int/high/very-high).
Key points
- PSAD < 0.15 with a negative DRE supports deferring biopsy at PI-RADS 1–3.
- Diagnosis relies on biopsy pathology, and the simplified risk stratification must integrate core involvement, PSAD, and genomics.
- After diagnosis, treat by NCCN risk group per the current version of the cited guidelines (pending update).
References
Worked calculation
The values below come from this tool's own example placeholders and are computed server-side with the formula shown on this page, so the arithmetic can be checked quickly. It demonstrates how to substitute values only — it is not clinical advice and not a real case.
| PI-RADS v2.1 category (mpMRI) | 3 |
|---|---|
| Serum PSA | 6.5 ng/mL |
| Prostate volume (for PSAD) | 50 mL |
| Digital rectal exam DRE | No nodule palpated |
| ISUP/grade group (if biopsied) | 2 (3+4) |
| Clinical stage cT (if diagnosed) | T2b |
→ConclusionPI-RADS 3 · diagnosed · risk group
- (1) Assessment & biopsy decision：PI-RADS 3 (equivocal). (PSAD ≈ 0.130 ng/mL/cc) PSAD < may follow up and defer biopsy.
- (2) Risk stratification：ISUP grade 2 / PSA < 10 / clinical stage t2b → NCCN unfavorable intermediate.
- (3) Post-diagnosis treatment (pending update)：Post-diagnosis treatment content is pending update to the current guidelines and is not shown; treat by risk group per the current version of the cited guidelines, with MDT decision.
| PI-RADS v2.1 category (mpMRI) | 1 |
|---|---|
| Serum PSA | 6.5 ng/mL |
| Prostate volume (for PSAD) | 50 mL |
| Digital rectal exam DRE | No nodule palpated |
| ISUP/grade group (if biopsied) | Not biopsied/unknown |
| Clinical stage cT (if diagnosed) | Unknown |
→ConclusionPI-RADS 1 · follow-up
- (1) Assessment & biopsy decision：PI-RADS 1: low probability of clinically significant cancer (csPCa). (PSAD ≈ 0.130 ng/mL/cc) PSAD < 0.15 and DRE negative → may defer biopsy, follow with PSA/MRI.
- Note：If biopsy-confirmed, entering ISUP grade, PSA, and clinical stage gives the NCCN risk-group name.
- Basis：PI-RADS v2.1 (ACR/ESUR 2019) + PSAD 0.15 consensus; NCCN prostate cancer Version 1.2027; EAU guideline; CSCO prostate cancer guideline.
Verification & sources · governance
FAQ
Frequently asked questions
- What are the limits and cautions when using Prostate Nodule Smart Manager · Assessment, Follow-up & Treatment Decision?
- For licensed clinicians and clinical researchers. Interpret results with history, investigations and local protocols; not a diagnosis or prescription, and not a substitute for multidisciplinary decision-making or local guidelines.
- Does Prostate Nodule Smart Manager · Assessment, Follow-up & Treatment Decision upload patient data? Where is it calculated?
- Calculation runs locally in the browser; inputs and results are not uploaded. For licensed clinicians only; interpret with history, investigations and local protocols — not a diagnosis or prescription.
- How is Prostate Nodule Smart Manager · Assessment, Follow-up & Treatment Decision calculated in practice? Can you show a worked example?
- Inputs: PI-RADS v2.1 category (mpMRI) 3, Serum PSA 6.5 ng/mL, Prostate volume (for PSAD) 50 mL, Digital rectal exam DRE No nodule palpated, ISUP/grade group (if biopsied) 2 (3+4), Clinical stage cT (if diagnosed) T2b → Result: Conclusion PI-RADS 3 · diagnosed · risk group（(1) Assessment & biopsy decision: PI-RADS 3 (equivocal). (PSAD ≈ 0.130 ng/mL/cc) PSAD < may follow up and defer biopsy., (2) Risk stratification: ISUP grade 2 / PSA < 10 / clinical stage t2b → NCCN unfavorable intermediate., (3) Post-diagnosis treatment (pending update): Post-diagnosis treatment content is pending update to the current guidelines and is not shown; treat by risk group per the current version of the cited guidelines, with MDT decision.） Inputs: PI-RADS v2.1 category (mpMRI) 1, Serum PSA 6.5 ng/mL, Prostate volume (for PSAD) 50 mL, Digital rectal exam DRE No nodule palpated, ISUP/grade group (if biopsied) Not biopsied/unknown, Clinical stage cT (if diagnosed) Unknown → Result: Conclusion PI-RADS 1 · follow-up（(1) Assessment & biopsy decision: PI-RADS 1: low probability of clinically significant cancer (csPCa). (PSAD ≈ 0.130 ng/mL/cc) PSAD < 0.15 and DRE negative → may defer biopsy, follow with PSA/MRI., Note: If biopsy-confirmed, entering ISUP grade, PSA, and clinical stage gives the NCCN risk-group name., Basis: PI-RADS v2.1 (ACR/ESUR 2019) + PSAD 0.15 consensus; NCCN prostate cancer Version 1.2027; EAU guideline; CSCO prostate cancer guideline.）