PI-RADS v2.1 score combined with PSA density for diagnosis of clinically significant prostate cancer in the PSA grey zone by MRI-TRUS cognitivefusion-guided transperineal targeted prostate biopsy.
- Author:
Yue LI
1
;
Shan ZHOU
1
;
Jing CHEN
1
;
Fei MAO
2
;
Xiao-Bing NIU
2
;
Li SUN
1
;
Ming XU
1
;
Jin-Tao LIU
3
Author Information
1. Department of Ultrasound, Huai'an First Hospital Affiliated to Nanjing Medical University, Huai'an, Jiangsu 223001, China.
2. Department of Urology, Huai'an First Hospital Affiliated to Nanjing Medical University, Huai'an, Jiangsu 223001, China.
3. Department of Radiology, Huai'an First Hospital Affiliated to Nanjing Medical University, Huai'an, Jiangsu 223001, China.
- Publication Type:Journal Article
- Keywords:
PI-RADS v2.1 score;
prostate-specific antigen density;
grey zone;
MRI-TRUS cognitive fusion-guided transperineal targeted prostate biopsy;
clinically significant prostate cancer
- MeSH:
Humans;
Male;
Prostatic Neoplasms/diagnostic imaging*;
Retrospective Studies;
Prostate-Specific Antigen;
Magnetic Resonance Imaging;
Image-Guided Biopsy;
Prostate/pathology*;
Aged;
Middle Aged
- From:
National Journal of Andrology
2025;31(1):50-54
- CountryChina
- Language:Chinese
-
Abstract:
OBJECTIVE:To assess the value of the Prostate Imaging Reporting and Data System version 2.1 (PI-RADS v2.1) score combined with PSA density (PSAD) in the diagnosis of clinically significant prostate cancer (CSPCa) in the PSA grey zone by MRI-TRUS cognitive fusion-guided transperineal targeted prostate biopsy.
METHODS:This retrospective study included 327 male patients with total PSA (tPSA) levels of 4-10 μg/L undergoing MRI-TRUS cognitive fusion-guided transperineal targeted prostate biopsy in our hospital between January 2021 and December 2023. According to the pathological results, we divided the patients into a CSPCa (n = 44) and a non-CSPCa group (n = 283), collected their clinical and imaging data, and subjected them to statistical analysis.
RESULTS:The age, tPSA level, PSAD and PI-RADS score were significantly higher, while the free PSA (fPSA) level, f/tPSA ratio and prostate volume remarkably lower in the CSPCa than in the non-CSPCa group (P<0.05). The areas under the curve (AUCs) of PSAD, PI-RADS score and their combination were 0.772, 0.730 and 0.801, with sensitivities of 63.63%, 70.45% and 72.73%, and specificities of 84.10%, 75.62% and 83.75%, respectively (P<0.01). With PSAD 0.2 μg/(ml·cm3) as the best cut-off value and based on the PI-RADS scores, the patients were divided into two groups for analysis. In the patients with PI-RADS scores 2 and 5, the AUCs were 0.534 and 0.643, with sensitivities of 16.67% and 63.64%, and specificities of 85.14% and 64.29%, with no statistically significant differences (P= 0.784, P= 0.228), and in those with PI-RADS scores 3 and 4, the AUCs were 0.794 and 0.843, with sensitivities of 57.14% and 80.00%, and specificities of 87.14% and 81.82%, with statistically significant differences (P= 0.009, P<0.001).
CONCLUSION:PI-RADS v2.1 score combined with PSAD can effectively improve the diagnostic efficiency of CSPCa in the PSA grey zone by MRI-TRUS cognitive fusion-guided transperineal targeted prostate biopsy and serve as a guide for selection of prostate biopsy.
