New model of PIRADS and adjusted prostatespecific antigen density of peripheral zone improves the detection rate of initial prostate biopsy: a diagnostic study
This study explored a new model of Prostate Imaging Reporting and Data System (PIRADS) and adjusted prostate-specific antigen density of peripheral zone (aPSADPZ) for predicting the occurrence of prostate cancer (PCa) and clinically significant prostate cancer (csPCa). The demographic and clinical c...
| Main Authors: | , , , , , , , , , , |
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| Format: | Article |
| Language: | English |
| Published: |
Wolters Kluwer Medknow Publications
2023-01-01
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| Series: | Asian Journal of Andrology |
| Subjects: | |
| Online Access: | http://www.ajandrology.com/article.asp?issn=1008-682X;year=2023;volume=25;issue=1;spage=126;epage=131;aulast=Huang |
| _version_ | 1797905005830733824 |
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| author | Chen Huang Zong-Qiang Cai Feng Qiu Jin-Xian Pu Qi-Lin Xi Xue-Dong Wei Xi-Ming Wang Xiao-Jun Zhao Lin-Chuan Guo Jian-Quan Hou Yu-Hua Huang |
| author_facet | Chen Huang Zong-Qiang Cai Feng Qiu Jin-Xian Pu Qi-Lin Xi Xue-Dong Wei Xi-Ming Wang Xiao-Jun Zhao Lin-Chuan Guo Jian-Quan Hou Yu-Hua Huang |
| author_sort | Chen Huang |
| collection | DOAJ |
| description | This study explored a new model of Prostate Imaging Reporting and Data System (PIRADS) and adjusted prostate-specific antigen density of peripheral zone (aPSADPZ) for predicting the occurrence of prostate cancer (PCa) and clinically significant prostate cancer (csPCa). The demographic and clinical characteristics of 853 patients were recorded. Prostate-specific antigen (PSA), PSA density (PSAD), PSAD of peripheral zone (PSADPZ), aPSADPZ, and peripheral zone volume ratio (PZ-ratio) were calculated and subjected to receiver operating characteristic (ROC) curve analysis. The calibration and discrimination abilities of new nomograms were verified with the calibration curve and area under the ROC curve (AUC). The clinical benefits of these models were evaluated by decision curve analysis and clinical impact curves. The AUCs of PSA, PSAD, PSADPZ, aPSADPZ, and PZ-ratio were 0.669, 0.762, 0.659, 0.812, and 0.748 for PCa diagnosis, while 0.713, 0.788, 0.694, 0.828, and 0.735 for csPCa diagnosis, respectively. All nomograms displayed higher net benefit and better overall calibration than the scenarios for predicting the occurrence of PCa or csPCa. The new model significantly improved the diagnostic accuracy of PCa (0.945 vs 0.830, P < 0.01) and csPCa (0.937 vs 0.845, P < 0.01) compared with the base model. In addition, the number of patients with PCa and csPCa predicted by the new model was in good agreement with the actual number of patients with PCa and csPCa in high-risk threshold. This study demonstrates that aPSADPZ has a higher predictive accuracy for PCa diagnosis than the conventional indicators. Combining aPSADPZ with PIRADS can improve PCa diagnosis and avoid unnecessary biopsies. |
| first_indexed | 2024-04-10T09:58:07Z |
| format | Article |
| id | doaj.art-c8fac34cdfdf4b1487e4eacfa33830ce |
| institution | Directory Open Access Journal |
| issn | 1008-682X 1745-7262 |
| language | English |
| last_indexed | 2024-04-10T09:58:07Z |
| publishDate | 2023-01-01 |
| publisher | Wolters Kluwer Medknow Publications |
| record_format | Article |
| series | Asian Journal of Andrology |
| spelling | doaj.art-c8fac34cdfdf4b1487e4eacfa33830ce2023-02-16T12:09:20ZengWolters Kluwer Medknow PublicationsAsian Journal of Andrology1008-682X1745-72622023-01-0125112613110.4103/aja202218New model of PIRADS and adjusted prostatespecific antigen density of peripheral zone improves the detection rate of initial prostate biopsy: a diagnostic studyChen HuangZong-Qiang CaiFeng QiuJin-Xian PuQi-Lin XiXue-Dong WeiXi-Ming WangXiao-Jun ZhaoLin-Chuan GuoJian-Quan HouYu-Hua HuangThis study explored a new model of Prostate Imaging Reporting and Data System (PIRADS) and adjusted prostate-specific antigen density of peripheral zone (aPSADPZ) for predicting the occurrence of prostate cancer (PCa) and clinically significant prostate cancer (csPCa). The demographic and clinical characteristics of 853 patients were recorded. Prostate-specific antigen (PSA), PSA density (PSAD), PSAD of peripheral zone (PSADPZ), aPSADPZ, and peripheral zone volume ratio (PZ-ratio) were calculated and subjected to receiver operating characteristic (ROC) curve analysis. The calibration and discrimination abilities of new nomograms were verified with the calibration curve and area under the ROC curve (AUC). The clinical benefits of these models were evaluated by decision curve analysis and clinical impact curves. The AUCs of PSA, PSAD, PSADPZ, aPSADPZ, and PZ-ratio were 0.669, 0.762, 0.659, 0.812, and 0.748 for PCa diagnosis, while 0.713, 0.788, 0.694, 0.828, and 0.735 for csPCa diagnosis, respectively. All nomograms displayed higher net benefit and better overall calibration than the scenarios for predicting the occurrence of PCa or csPCa. The new model significantly improved the diagnostic accuracy of PCa (0.945 vs 0.830, P < 0.01) and csPCa (0.937 vs 0.845, P < 0.01) compared with the base model. In addition, the number of patients with PCa and csPCa predicted by the new model was in good agreement with the actual number of patients with PCa and csPCa in high-risk threshold. This study demonstrates that aPSADPZ has a higher predictive accuracy for PCa diagnosis than the conventional indicators. Combining aPSADPZ with PIRADS can improve PCa diagnosis and avoid unnecessary biopsies.http://www.ajandrology.com/article.asp?issn=1008-682X;year=2023;volume=25;issue=1;spage=126;epage=131;aulast=Huangadjusted prostate-specific antigen density of peripheral zone; biopsy; diagnosis; prostate imaging reporting and data system; prostate cancer |
| spellingShingle | Chen Huang Zong-Qiang Cai Feng Qiu Jin-Xian Pu Qi-Lin Xi Xue-Dong Wei Xi-Ming Wang Xiao-Jun Zhao Lin-Chuan Guo Jian-Quan Hou Yu-Hua Huang New model of PIRADS and adjusted prostatespecific antigen density of peripheral zone improves the detection rate of initial prostate biopsy: a diagnostic study Asian Journal of Andrology adjusted prostate-specific antigen density of peripheral zone; biopsy; diagnosis; prostate imaging reporting and data system; prostate cancer |
| title | New model of PIRADS and adjusted prostatespecific antigen density of peripheral zone improves the detection rate of initial prostate biopsy: a diagnostic study |
| title_full | New model of PIRADS and adjusted prostatespecific antigen density of peripheral zone improves the detection rate of initial prostate biopsy: a diagnostic study |
| title_fullStr | New model of PIRADS and adjusted prostatespecific antigen density of peripheral zone improves the detection rate of initial prostate biopsy: a diagnostic study |
| title_full_unstemmed | New model of PIRADS and adjusted prostatespecific antigen density of peripheral zone improves the detection rate of initial prostate biopsy: a diagnostic study |
| title_short | New model of PIRADS and adjusted prostatespecific antigen density of peripheral zone improves the detection rate of initial prostate biopsy: a diagnostic study |
| title_sort | new model of pirads and adjusted prostatespecific antigen density of peripheral zone improves the detection rate of initial prostate biopsy a diagnostic study |
| topic | adjusted prostate-specific antigen density of peripheral zone; biopsy; diagnosis; prostate imaging reporting and data system; prostate cancer |
| url | http://www.ajandrology.com/article.asp?issn=1008-682X;year=2023;volume=25;issue=1;spage=126;epage=131;aulast=Huang |
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