Combining prostate health index and multiparametric magnetic resonance imaging in the diagnosis of clinically significant prostate cancer in an Asian population

Objective To evaluate the practicability of combining prostate health index (PHI) and multiparametric magnetic resonance imaging (mpMRI) for the detection of clinically significant prostate cancer (csPC) in an Asian population. Patients and methods We prospectively enrolled patients who underwent pr...

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Veröffentlicht in:World journal of urology Jg. 38; H. 5; S. 1207 - 1214
Hauptverfasser: Hsieh, Po-Fan, Li, Wei-Juan, Lin, Wei-Ching, Chang, Han, Chang, Chao-Hsiang, Huang, Chi-Ping, Yang, Chi-Rei, Chen, Wen-Chi, Chang, Yi-Huei, Wu, Hsi-Chin
Format: Journal Article
Sprache:Englisch
Veröffentlicht: Berlin/Heidelberg Springer Berlin Heidelberg 01.05.2020
Springer Nature B.V
Schlagworte:
Aged
Asian Continental Ancestry Group
Biopsy
Clinical significance
Feasibility Studies
Humans
Kallikreins - blood
Magnetic resonance imaging
Male
Medicine
Medicine & Public Health
Middle Aged
Multiparametric Magnetic Resonance Imaging
Nephrology
NMR
Nuclear magnetic resonance
Oncology
Original
Original Article
Predictive Value of Tests
Prospective Studies
Prostate - diagnostic imaging
Prostate cancer
Prostate-specific antigen
Prostate-Specific Antigen - blood
Prostatic Neoplasms - blood
Prostatic Neoplasms - diagnosis
Prostatic Neoplasms - diagnostic imaging
Rectum
Sensitivity and Specificity
Urology
Prostate health index
Prostate cancer detection
mpMRI
PI-RADS
ISSN:0724-4983, 1433-8726, 1433-8726
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Zusammenfassung:Objective To evaluate the practicability of combining prostate health index (PHI) and multiparametric magnetic resonance imaging (mpMRI) for the detection of clinically significant prostate cancer (csPC) in an Asian population. Patients and methods We prospectively enrolled patients who underwent prostate biopsy due to elevated serum prostate-specific antigen (PSA > 4 ng/mL) and/or abnormal digital rectal examination in a tertiary referral center. Before prostate biopsy, the serum samples were tested for PSA, free PSA, and p2PSA to calculate PHI. Besides, mpMRI was performed using a 3-T scanner and reported in the Prostate Imaging Reporting and Data System version 2 (PI-RADS v2). The diagnostic performance of PHI, mpMRI, and combination of both was assessed. Result Among 102 subjects, 39 (38.2%) were diagnosed with PC, including 24 (23.5%) with csPC (Gleason ≥ 7). By the threshold of PI-RADS ≥ 3, the sensitivity, specificity, positive predictive value (PPV), and negative predictive value (NPV) to predict csPC were 100%, 44.9%, 35.8%, and 100%, respectively. By the threshold of PHI ≥ 30, the sensitivity, specificity, PPV, and NPV to predict csPC were 91.7%, 43.6%, 33.3%, and 94.4%, respectively. The area under the receiver operator characteristic curve of combining PHI and mpMRI was greater than that of PHI alone (0.873 vs. 0.735, p  = 0.002) and mpMRI alone (0.873 vs. 0.830, p  = 0.035). If biopsy was restricted to patients with PI-RADS 5 as well as PI-RADS 3 or 4 and PHI ≥ 30, 50% of biopsy could be avoided with one csPC patient being missed. Conclusion The combination of PHI and mpMRI had higher accuracy for detection of csPC compared with PHI or mpMRI alone in an Asian population.
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SourceType-Scholarly Journals-1
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ISSN:0724-4983
1433-8726
1433-8726
DOI:10.1007/s00345-019-02889-2