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Open Access 01-05-2020 | Prostate Cancer | Original Article

Combining prostate health index and multiparametric magnetic resonance imaging in the diagnosis of clinically significant prostate cancer in an Asian population

Authors: Po-Fan Hsieh, Wei-Juan Li, Wei-Ching Lin, Han Chang, Chao-Hsiang Chang, Chi-Ping Huang, Chi-Rei Yang, Wen-Chi Chen, Yi-Huei Chang, Hsi-Chin Wu

Published in: World Journal of Urology | Issue 5/2020

Abstract

Objective

To evaluate the practicability of combining prostate health index (PHI) and multiparametric magnetic resonance imaging (mpMRI) for the detection of clinically significant prostate cancer (csPC) in an Asian population.

Patients and methods

We prospectively enrolled patients who underwent prostate biopsy due to elevated serum prostate-specific antigen (PSA > 4 ng/mL) and/or abnormal digital rectal examination in a tertiary referral center. Before prostate biopsy, the serum samples were tested for PSA, free PSA, and p2PSA to calculate PHI. Besides, mpMRI was performed using a 3-T scanner and reported in the Prostate Imaging Reporting and Data System version 2 (PI-RADS v2). The diagnostic performance of PHI, mpMRI, and combination of both was assessed.

Result

Among 102 subjects, 39 (38.2%) were diagnosed with PC, including 24 (23.5%) with csPC (Gleason ≥ 7). By the threshold of PI-RADS ≥ 3, the sensitivity, specificity, positive predictive value (PPV), and negative predictive value (NPV) to predict csPC were 100%, 44.9%, 35.8%, and 100%, respectively. By the threshold of PHI ≥ 30, the sensitivity, specificity, PPV, and NPV to predict csPC were 91.7%, 43.6%, 33.3%, and 94.4%, respectively. The area under the receiver operator characteristic curve of combining PHI and mpMRI was greater than that of PHI alone (0.873 vs. 0.735, p = 0.002) and mpMRI alone (0.873 vs. 0.830, p = 0.035). If biopsy was restricted to patients with PI-RADS 5 as well as PI-RADS 3 or 4 and PHI ≥ 30, 50% of biopsy could be avoided with one csPC patient being missed.

Conclusion

The combination of PHI and mpMRI had higher accuracy for detection of csPC compared with PHI or mpMRI alone in an Asian population.

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Title: Combining prostate health index and multiparametric magnetic resonance imaging in the diagnosis of clinically significant prostate cancer in an Asian population
Authors: Po-Fan Hsieh
Wei-Juan Li
Wei-Ching Lin
Han Chang
Chao-Hsiang Chang
Chi-Ping Huang
Chi-Rei Yang
Wen-Chi Chen
Yi-Huei Chang
Hsi-Chin Wu
Publication date: 01-05-2020
Publisher: Springer Berlin Heidelberg
Keywords: Prostate Cancer
Magnetic Resonance Imaging
Magnetic Resonance Imaging
Prostate Cancer
Published in: World Journal of Urology / Issue 5/2020
Print ISSN: 0724-4983
Electronic ISSN: 1433-8726
DOI: https://doi.org/10.1007/s00345-019-02889-2

At a glance: The STEP trials

Springer Medicine

Combining prostate health index and multiparametric magnetic resonance imaging in the diagnosis of clinically significant prostate cancer in an Asian population

Abstract

Objective

Patients and methods

Result

Conclusion

At a glance: The STEP trials

Springer Medicine

Abstract

Objective

Patients and methods

Result

Conclusion

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