The best MRI scans grade each lesion identified on the 1-5 PIRADS scale, where, basically,
lesions graded 3 or higher should be investigated by biopsy. See this article (and its Table 1 showing the scale), which discusses the percentages assigned to PIRADS scores 1-5 and the descript
ive language for each score:
Potential miscommunication of risk in American College of Radiology Prostate Imaging and Data System (PIRADS) scores (2024)
As discussed, a distinction is made between "prostate cancer" (Gleason scores 6-10) and "clinically significant prostate cancer" (Gleason scores 7-10). This can lead to confusion.
Also:
Analysis of false-positive biopsy results of PIRADS 4 lesions in multiparametric magnetic resonance imaging of the prostate: Experience from a single nonacademic center using cognitive fusion. (2023; Full Text can be downloaded)
Remember, currently only a biopsy can diagnose prostate cancer; PIRAD scores only assign probabilities.