The value of prostate specific antigen density in the detection of prostate cancer by the multi-parametric MRI / 中华泌尿外科杂志

ABSTRACT

Objective To evaluate whether prostate specific antigen density(PSAD) could improve the multi-parametric MRI detection of prostate cancer.Methods A total of 110 men from Beijing United Family Hospital and clinics undergoing systematic biopsy + MRI-targeted biopsy from April 2013 to March 2019 were included in the study.The median age was 63.5 years (43.0-84.0 years),median prostate specific antigen (PSA)was 7.0 ng/ml (0.7-43.4 ng/ml),median PSAD was 0.16ng/ml2 (0.03-1.15 ng/ml2),median PI-RADS was 3.5 (2.0-5.0).Results A total of 45 cases of prostate cancer were detected,including 32 cases of clinically significant prostate cancer.Systematic biopsy detected 36 cases of prostate cancer,including 23 cases of clinically significant prostate cancer;MRI-targeted biopsy detected 38 cases of prostate cancer,including 27 cases of clinically significant prostate cancer.For MRI-targeted biopsy,the area under curve (AUC) of PSAD,PI-RADS and PSAD + PI-RADS were 0.807,0.757,0.841 for prostate cancer and were 0.806,0.78,0.862 for clinically significant prostate cancer.PSAD + PI-RADS achieved significantly superior AUC compared with PI-RADS alone for both prostate cancer detection (P =0.0034) and clinically significant prostate cancer detection (P =0.0128).For systematic biopsy + MRI-targeted biopsy,the AUC of PSAD,PI-RADS and PSAD + PI-RADS were 0.765,0.791,0.857 for prostate cancer and were 0.790,0.785,0.853 for clinically significant prostate cancer.PSAD + PI-RADS showed significantly higher AUC compared with P[-RADS for prostate cancer detection (P =0.0042) and clinically significant prostate cancer detection(P =0.0170).Conclusions For prostate biopsy na(i)ve men,PSAD + PI-RADS showed significantly higher predictive value than PI-RADS alone for prostate cancer and clinically significant prostate cancer detection either by MRI-targeted biopsy or by systematic biopsy + MRI-targeted biopsy.