Diagnostic value of PI-RADS v2.1 combined with clinical indicators for clinically significant cancer in the transitional zone of the prostate / 实用放射学杂志

ABSTRACT

Objective To explore the diagnostic value of combined clinical factors for transitional zone clinically significant prostate cancer(csPCa)in the lesion with category 3 or 4 of prostate imaging reporting and data system version 2.1(PI-RADS v2.1).Methods The data of 251 patients of pathologically confirmed transitional zone lesions were analyzed retrospectively,the age,prostate specific antigen(PSA),prostate volume(PV)and the related derived indicators in patients with csPCa and non-csPCa were analyzed.To determine independent predictors for the diagnosis of csPCa.Receiver operating characteristic(ROC)curve was used to assess the diagnostic efficacy when each factor was applied individually and in combination,and the optimal diagnostic threshold was also calculated.Results There were 188 cases in the non-csPCa group and 63 cases in the csPCa group in 251 patients.Univariate and multivariate logistic regression analysis showed prostate specific antigen density(PSAD)[odds ratio(OR)=3.745]and PV(OR=0.98)were independent predictors of csPCa(P＜0.05),and the optimal diagnostic threshold was:PSAD＞0.22 ng/(mL·cm3),PV≤46.95 cm3,the combined diagnostic performance was higher than that of PI-RADS v2.1 and PV alone[area under the curve(AUC):0.791,0.661,0.703],but comparable to that of PSAD alone,the difference was no statistically significant(Z=1.423,P=0.154 8).Conclusion Combined clinical factors can improve the diagnostic performance for csPCa in the transitional zone in the lesion with category 3 or 4 of PI-RADS v2.l,the value of PSAD and PV should be paid attention to.