Performance of MRI-based Prostate Cancer Risk Calculators and decision strategies in two large European medical centres.

Even in this high-risk cohort, biopsy decision support tools would avoid many prostate biopsies, while missing very few csPCa cases. The Van Leeuwen model had the highest clinical utility, followed by the RPCRC. These multivariable MRI-RCs outperformed and should be favoured over decision strategies based only on MRI and PSAD.