Utility of Combining Prostate Health Index and Magnetic Resonance Imaging for the Diagnosis of Prostate Cancer

IF 2.2 3区医学 Q3 UROLOGY & NEPHROLOGY International Journal of Urology Pub Date : 2025-03-17 DOI:10.1111/iju.70024

Yoshitaka Sekine, Yuji Fujizuka, Shun Nakazawa, Yusuke Tsuji, Akira Ohtsu, Yoshiyuki Miyazawa, Seiji Arai, Masashi Nomura, Hidekazu Koike, Hiroshi Matsui, Kei Shibuya, Kazuto Ito, Hayato Ikota, Kazuhiro Suzuki

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Abstract

Objective

In this study, we compared the prostate health index (PHI) and the Prostate Imaging Reporting and Data System (PI-RADS) before prostate biopsy and evaluated the utility of combining them in the diagnosis of prostate cancer (PC).

Methods

Between November 2021 and March 2023, 105 patients admitted to Gunma University Hospital for prostate biopsy after undergoing both MRI and PHI measurements were enrolled in this study. We investigated the diagnostic impacts of [−2]proPSA related indexes on clinically significant PC (csPC) and the complementary effects of PHI and PI-RADS.

Results

The median of PHI was 59.9, and 72 patients (69%) were diagnosed with PC. The receiver operating characteristic (ROC) curve for patients diagnosed with PC indicated an area under the curve (AUC) of 0.816 for PHI and 0.753 for PI-RADS. For PHI, when the sensitivity was 90% and 95%, the specificity was 51.5% and 45.5%, respectively. Both are higher than those of the conventional PSA-related indices. In addition, the ROC curve in patients with a diagnosis of csPC (n = 67) indicated an AUC of 0.793 for PHI and 0.746 for PI-RADS. Furthermore, if biopsy was restricted to patients with PI-RADS ≥ 4 or PHI ≥ 38.1, 21% of unnecessary biopsies could be avoided, with only one (1.5%) patient with csPC being missed.

Conclusions

PHI is more available for detecting csPC than PSA and PSA F/T. Moreover, there is a possibility that unnecessary prostate biopsies can be avoided by combining PHI and PI-RADS.

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前列腺健康指数与磁共振成像在前列腺癌诊断中的应用

目的：本研究比较前列腺活检前前列腺健康指数（PHI）与前列腺影像报告与数据系统（PI-RADS），并评价两者结合在前列腺癌（PC）诊断中的价值。方法：在2021年11月至2023年3月期间，105例在接受MRI和PHI测量后入住群马大学医院进行前列腺活检的患者被纳入本研究。我们研究了[-2]proPSA相关指标对临床显著PC （csPC）的诊断作用以及PHI和PI-RADS的互补作用。结果：PHI的中位值为59.9,72例（69%）被诊断为PC。诊断为PC的患者的受试者工作特征（ROC）曲线显示，PHI的曲线下面积（AUC）为0.816，PI-RADS为0.753。对于PHI，当灵敏度为90%和95%时，特异性分别为51.5%和45.5%。两者均高于传统的psa相关指标。此外，诊断为csPC的患者（n = 67）的ROC曲线显示PHI的AUC为0.793，PI-RADS的AUC为0.746。此外，如果活检仅限于PI-RADS≥4或PHI≥38.1的患者，则可以避免21%的不必要活检，只有1例（1.5%）csPC患者被遗漏。结论：与PSA和PSA F/T相比，PHI对csPC的检测更有效。此外，将PHI和PI-RADS结合使用，有可能避免不必要的前列腺活检。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

International Journal of Urology 医学-泌尿学与肾脏学

CiteScore

4.70

自引率

11.50%

发文量

340

审稿时长

3 months

期刊介绍： International Journal of Urology is the official English language journal of the Japanese Urological Association, publishing articles of scientific excellence in urology. Submissions of papers from all countries are considered for publication. All manuscripts are subject to peer review and are judged on the basis of their contribution of original data and ideas or interpretation.