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Key Points Question What are the diagnostic accuracy and negative predictive value of novel biparametric magnetic resonance imaging (MRI) in biopsy-naive men in detecting and ruling out significant prostate cancer? Findings In this cohort study of 1020 men who underwent both biparametric targeted and standard transrectal ultrasound-guided biopsies, low-suspicion biparametric MRI had a high negative predictive value (97%) in ruling out significant prostate cancer on confirmatory biopsies. Meaning The biparametric MRI used as a triage test in this study was associated with improved prostate cancer risk stratification and may be used to exclude aggressive disease and avoid unnecessary biopsies in 30% of men with clinical suspicion of prostate cancer, although further studies are needed to fully explore this new diagnostic approach.

Highlights d Novel methods for isolating human M-ILFs, SM-ILFs, and GALT-free intestinal LP d Human M-ILFs and SM-ILFs are highly organized sites of adaptive immune induction d An adaptive immune roadmap of human GALT and GALTfree LP d Human ILFs contribute to regionalized adaptive immune responses

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