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World Journal of Urology

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Open Access 01-09-2021 | Prostate Cancer | Original Article

PHI density prospectively improves prostate cancer detection

Authors: Carsten Stephan, Klaus Jung, Michael Lein, Hannah Rochow, Frank Friedersdorff, Andreas Maxeiner

Published in: World Journal of Urology | Issue 9/2021

Abstract

Purpose

To evaluate the Prostate Health Index (PHI) density (PHID) in direct comparison with PHI in a prospective large cohort.

Methods

PHID values were calculated from prostate-specific antigen (PSA), free PSA and [− 2]proPSA and prostate volume. The 1057 patients included 552 men with prostate cancer (PCa) and 505 with no evidence of malignancy (NEM). In detail, 562 patients were biopsied at the Charité Hospital Berlin and 495 patients at the Sana Hospital Offenbach. All patients received systematic or magnetic resonance imaging (MRI)/ultrasound fusion-guided biopsies. The diagnostic accuracy was evaluated by receiver operating characteristic (ROC) curves comparing areas under the ROC-curves (AUC). The decision curve analysis (DCA) was performed with the MATLAB Neural Network Toolbox.

Results

PHID provided a significant larger AUC than PHI (0.835 vs. 0.801; p = 0.0013) in our prospective cohort of 1057 men from 2 centers. The DCA had a maximum net benefit of ~ 5% for PHID vs. PHI between 35 and 65% threshold probability. In those 698 men within the WHO-calibrated PSA grey-zone up to 8 ng/ml, PHID was also significantly better than PHI (AUC 0.819 vs. 0.789; p = 0.0219). But PHID was not different from PHI in the detection of significant PCa.

Conclusions

Based on ROC analysis and DCA, PHID had an advantage in comparison with PHI alone to detect any PCa but PHI and PHID performed equal in detecting significant PCa.

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Title: PHI density prospectively improves prostate cancer detection
Authors: Carsten Stephan
Klaus Jung
Michael Lein
Hannah Rochow
Frank Friedersdorff
Andreas Maxeiner
Publication date: 01-09-2021
Publisher: Springer Berlin Heidelberg
Keywords: Prostate Cancer
Magnetic Resonance Imaging
Magnetic Resonance Imaging
Prostate Cancer
Published in: World Journal of Urology / Issue 9/2021
Print ISSN: 0724-4983
Electronic ISSN: 1433-8726
DOI: https://doi.org/10.1007/s00345-020-03585-2

At a glance: The STEP trials

Springer Medicine

PHI density prospectively improves prostate cancer detection

Abstract

Purpose

Methods

Results

Conclusions

At a glance: The STEP trials

Springer Medicine

Abstract

Purpose

Methods

Results

Conclusions

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