Press BH, Khajir G, Ghabili K, et al. - Experts aspired to explore whether PSA density (PSAD), can sub-stratify the risk of biopsy upgrade among men on active surveillance (AS) with normal baseline MRI. From February 2013 to December 2017, a cohort of patients with low and favorable intermediate-risk prostate cancer on AS at two large academic centers were identified. Ninety-eight patients on AS with negative baseline or surveillance mpMRI were identified. Data reported that median PSA at diagnosis was 5.8 ng/mL and median PSAD was 0.08 ng/mL/mL. PSAD accurately predicted the risk of Gleason upgrade at confirmatory biopsy in men with low-grade prostate cancer who had a negative MRI. PSAD could be used in the clinical setting to reduce the intensity of surveillance for a subset of patients.