Journal of Shandong University (Health Sciences) ›› 2022, Vol. 60 ›› Issue (6): 46-50.doi: 10.6040/j.issn.1671-7554.0.2021.1496

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Multiparametric magnetic resonance imaging combined with prostate health index in the diagnosis of prostate cancer in 142 patients within PSA grey zone

SUN Haoyu, JIANG Xin, CHEN Shouzhen, QU Sifeng, SHI Benkang   

  1. Department of Urology, Qilu Hospital of Shandong University, Jinan 250012, Shandong, China
  • Published:2022-06-17

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Abstract: Objective To evaluate the value of multiparametric magnetic resonance imaging(mpMRI), prostate imaging reporting and data system(PIRADS)v2.1 and prostate health index(phi)in the diagnosis of clinically significant prostate cancer(CSPCa)within the prostate specific antigen(PSA)grey zone, and to establish a prediction model for CSPCa based on PIRADS score combined with phi. Methods A total of 142 patients who underwent prostate biopsy were enrolled. Binary Logistic regression was used to analyze the correlation between the variables with CSPCa. Logit(P)was established. Receiver operating characteristic(ROC)curve was drawn to evaluate the diagnostic efficacy of each variable. The optimal cut-off value and the diagnostic efficiency of each variable was calculated, and McNemar test was used to compare the differences in diagnostic efficacy among various variables. Results CSPCa was detected in 41(28.87%)patients. Binary Logistic regression showed CSPCa was significantly associated with higher PIRADS score(OR=3.521, P<0.001). The prediction model was established as: Logit(P)=1.123×PIRADS score+0.048×phi-6.287. The area under the ROC curve(AUC)of Logit(P)was higher than %fPSA(P=0.011), phi(P=0.041)and PIRADS score(P=0.003), and the differences were statistically significant. The positive predictive value(PPV)and negative predictive value(NPV)of Logit(P)were 62.75% and 96.70%, respectively. Conclusion The mpMRI PIRADS score has high specificity and PPV in prostate tumor screening, but relatively low sensitivity. The prediction model Logit(P)established by PIRADS score combined with phi has higher sensitivity and can effectively reduce the rate of misdiagnosis and unnecessary prostate biopsy of CSPCa.

Key words: Clinical significant prostate cancer, Prostate health index, Prostate imaging reporting and data system, Prostate biopsy, Multiparametric magnetic resonance imaging

CLC Number: 

  • R737.25
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