Prostate imaging reporting and data system V2.1 combined with prostate specific antigen-related parameters for predicting transition zone prostate cancer in patients with prostate specific antigen levels of 4-20 ng/mL
10.3969/j.issn.1002-1671.2025.09.020
- VernacularTitle:前列腺影像报告和数据系统V2.1联合前列腺特异性抗原相关指标对前列腺特异性抗原4～20 ng/mL患者移行带前列腺癌的预测价值
- Author:
Ningning JIANG
1
;
Junbo CHEN
;
Fang YANG
;
Junguang WANG
Author Information
1. 宁波市泌尿肾病医院放射科,浙江 宁波 315100
- Publication Type:Journal Article
- Keywords:
prostate cancer;
transition zone;
magnetic resonance imaging;
prostate specific antigen density;
prostate specific antigen
- From:
Journal of Practical Radiology
2025;41(9):1517-1521
- CountryChina
- Language:Chinese
-
Abstract:
Objective To explore the diagnostic performance of prostate imaging reporting and data system(PI-RADS)V2.1 score combined with prostate specific antigen(PSA)-related parameters in transition zone prostate cancer(PCa)in patients with PSA levels of 4-20 ng/mL.Methods The clinical data of 129 patients who underwent prostate biopsy were retrospectively analyzed,including age,total prostate specific antigen(tPSA),free prostate specific antigen(fPSA),f/t PSA,prostate volume(PV),and prostate specific antigen density(PSAD).Among 129 patients,52 were diagnosed with transition zone PCa and 77 with benign prostate hyperplasia.The MRI images of all patients were scored according to the PI-RADS V2.1 criteria.The clinical and imaging parameters between transition zone PCa and benign prostate hyperplasia were compared using univariate logistic regression analysis.Independent predic-tors were identified via multivariate logistic regression,and a combined predictive model was constructed.Diagnostic performance of the model was evaluated using the receiver operating characteristic(ROC)curves.Results Univariate logistic regression analysis showed that the transition zone PCa exhibited significantly higher PI-RADS V2.1 score,tPSA,and PSAD than the benign prostate hyperplasia(P＜0.05).Multivariate logistic regression analysis identified PI-RADS V2.1 score and PSAD were independent predictors for predicting transition zone PCa(P＜0.05).Optimal diagnostic thresholds were PI-RADS V2.1 score＞3 points and PSAD＞0.23 ng/mL2.The combined prediction model achieved an area under the curve(AUC)of 0.863,outperforming PI-RADS V2.1 score(AUC=0.821)and PSAD(AUC=0.779)alone(P＜0.05).Conclusion The combination of PI-RADS V2.1 score and PSAD has a high predictive value for transition zone PCa in patients with PSA levels of 4-20 ng/mL.Thresholds of PI-RADS V2.1 score＞3 points and PSAD＞0.23 ng/mLL2 significantly improve diagnostic accuracy.
