This study demonstrates the feasibility of using quantitative Riesz texture analysis to predict whether a suspicious lesion on mpMRI (PI-RADS ≥3) is cancerous. Particularly notable is the 85% correct prediction for PI-RADS 4 lesions, given the tremendous variability of biopsy results for PI-RADS 4 lesions among different radiologists. Validation of this approach in a larger dataset is ongoing. In the future, we expect that quantitative image analysis will be incorporated into grading systems to refine prostate mpMRI image interpretation, enable greater reproducibility across radiologists, and improve patient counselling and decision making about prostate biopsy.