A prospective study of the prostate health index density and multiparametric magnetic resonance imaging in diagnosing clinically significant prostate cancer
Purpose: To evaluate the predictive performance of the prostate health index (PHI) and PHI density (PHID), for clinically significant prostate cancer (csPCa) in patients with a PI-RADS score ≤3. Materials and Methods: Patients tested for total prostate-specific antigen (tPSA, ≤100 ng/mL), free PSA...
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| Format: | Article |
| Language: | English |
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Korean Urological Association
2023-07-01
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| Series: | Investigative and Clinical Urology |
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| Online Access: | https://www.icurology.org/pdf/10.4111/icu.20230060 |
| _version_ | 1797782602178887680 |
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| author | Yuanchong Chen Dong Xu Mingjian Ruan Haixia Li Guiting Lin Gang Song |
| author_facet | Yuanchong Chen Dong Xu Mingjian Ruan Haixia Li Guiting Lin Gang Song |
| author_sort | Yuanchong Chen |
| collection | DOAJ |
| description | Purpose: To evaluate the predictive performance of the prostate health index (PHI) and PHI density (PHID), for clinically significant prostate cancer (csPCa) in patients with a PI-RADS score ≤3.
Materials and Methods: Patients tested for total prostate-specific antigen (tPSA, ≤100 ng/mL), free PSA (fPSA), and p2PSA at Peking University First Hospital were prospectively enrolled. Possible predictive factors of csPCa were analyzed using the receiver operating characteristic (ROC) curve. Results were expressed as area under the curve (AUC) with 95% confidence intervals (CI). The cutoff values of PHI and PHID were determined.
Results: We enrolled 222 patients in this study. The prevalence of csPCa in the PI-RADS ≤3 subgroup (n=89) was 22.47% (20/89). Age, tPSA, F/T, prostate volume, PSA density, PHI, PHID, and PI-RADS score were significantly associated with csPCa. PHID (AUC: 0.829 [95% CI: 0.717–0.941]) was the best predictor of csPCa. PHID >0.956 was set as the threshold of suspicious csPCa with a sensitivity of 85.00% and a specificity of 73.91%, avoiding 94.44% of unnecessary biopsies but missing 15.00% csPCa. A threshold of PHI ≥52.83 showed the same sensitivity but a rather lower specificity of 65.22% that avoided 93.75% of unnecessary biopsies.
Conclusions: PHI and PHID have the best predictive performance of csPCa in patients with PI-RADS score ≤3. A threshold value of PHID ≥0.956 may be used as the criterion for biopsy in these patients. |
| first_indexed | 2024-03-13T00:13:15Z |
| format | Article |
| id | doaj.art-1d0e0d683f844b03b1a68a0b4dc0ced6 |
| institution | Directory Open Access Journal |
| issn | 2466-0493 2466-054X |
| language | English |
| last_indexed | 2024-03-13T00:13:15Z |
| publishDate | 2023-07-01 |
| publisher | Korean Urological Association |
| record_format | Article |
| series | Investigative and Clinical Urology |
| spelling | doaj.art-1d0e0d683f844b03b1a68a0b4dc0ced62023-07-12T07:31:01ZengKorean Urological AssociationInvestigative and Clinical Urology2466-04932466-054X2023-07-0164436337210.4111/icu.20230060A prospective study of the prostate health index density and multiparametric magnetic resonance imaging in diagnosing clinically significant prostate cancerYuanchong Chen 0https://orcid.org/0000-0002-2562-7286Dong Xu1https://orcid.org/0009-0006-9280-9924Mingjian Ruan2https://orcid.org/0009-0002-3051-526XHaixia Li3https://orcid.org/0000-0003-0024-0971Guiting Lin4https://orcid.org/0000-0001-7518-0788Gang Song5https://orcid.org/0000-0003-2176-5419Department of Urology, Peking University First Hospital, Beijing, China.Department of Clinical Laboratory, Peking University First Hospital, Beijing, China.Department of Urology, Peking University First Hospital, Beijing, China.Department of Clinical Laboratory, Peking University First Hospital, Beijing, China.Department of Urology, School of Medicine, University of California San Francisco, San Francisco, CA, USA.Department of Urology, Peking University First Hospital, Beijing, China.Purpose: To evaluate the predictive performance of the prostate health index (PHI) and PHI density (PHID), for clinically significant prostate cancer (csPCa) in patients with a PI-RADS score ≤3. Materials and Methods: Patients tested for total prostate-specific antigen (tPSA, ≤100 ng/mL), free PSA (fPSA), and p2PSA at Peking University First Hospital were prospectively enrolled. Possible predictive factors of csPCa were analyzed using the receiver operating characteristic (ROC) curve. Results were expressed as area under the curve (AUC) with 95% confidence intervals (CI). The cutoff values of PHI and PHID were determined. Results: We enrolled 222 patients in this study. The prevalence of csPCa in the PI-RADS ≤3 subgroup (n=89) was 22.47% (20/89). Age, tPSA, F/T, prostate volume, PSA density, PHI, PHID, and PI-RADS score were significantly associated with csPCa. PHID (AUC: 0.829 [95% CI: 0.717–0.941]) was the best predictor of csPCa. PHID >0.956 was set as the threshold of suspicious csPCa with a sensitivity of 85.00% and a specificity of 73.91%, avoiding 94.44% of unnecessary biopsies but missing 15.00% csPCa. A threshold of PHI ≥52.83 showed the same sensitivity but a rather lower specificity of 65.22% that avoided 93.75% of unnecessary biopsies. Conclusions: PHI and PHID have the best predictive performance of csPCa in patients with PI-RADS score ≤3. A threshold value of PHID ≥0.956 may be used as the criterion for biopsy in these patients.https://www.icurology.org/pdf/10.4111/icu.20230060biomarkerclinical laboratory techniquesdiagnostic imagingmultiparametric magnetic resonance imagingprostate cancer |
| spellingShingle | Yuanchong Chen Dong Xu Mingjian Ruan Haixia Li Guiting Lin Gang Song A prospective study of the prostate health index density and multiparametric magnetic resonance imaging in diagnosing clinically significant prostate cancer Investigative and Clinical Urology biomarker clinical laboratory techniques diagnostic imaging multiparametric magnetic resonance imaging prostate cancer |
| title | A prospective study of the prostate health index density and multiparametric magnetic resonance imaging in diagnosing clinically significant prostate cancer |
| title_full | A prospective study of the prostate health index density and multiparametric magnetic resonance imaging in diagnosing clinically significant prostate cancer |
| title_fullStr | A prospective study of the prostate health index density and multiparametric magnetic resonance imaging in diagnosing clinically significant prostate cancer |
| title_full_unstemmed | A prospective study of the prostate health index density and multiparametric magnetic resonance imaging in diagnosing clinically significant prostate cancer |
| title_short | A prospective study of the prostate health index density and multiparametric magnetic resonance imaging in diagnosing clinically significant prostate cancer |
| title_sort | prospective study of the prostate health index density and multiparametric magnetic resonance imaging in diagnosing clinically significant prostate cancer |
| topic | biomarker clinical laboratory techniques diagnostic imaging multiparametric magnetic resonance imaging prostate cancer |
| url | https://www.icurology.org/pdf/10.4111/icu.20230060 |
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