Sheridan AD, et al. - The goal herein was to evaluate the imaging and clinical features related to Prostate Imaging Reporting and Data System (PI-RADS) category 5 lesions detected prospectively at multiparametric MRI (mpMRI) that were found benign at MRI-ultrasound fusion targeted biopsy. A connection was demonstrated between PI-RADS 5 lesions identified during routine clinical interpretation with a high risk of clinically significant prostate cancer. Findings displayed that a benign pathologic result was prominently linked with lower prostate-specific antigen density and apex or base location and most commonly due to a benign prostatic hyperplasia nodule. An improvement could be achieved in the interpretation of high-risk lesions identified with mpMRI through the integration of these clinical features.