Diagnosis of Prostate Imaging Reporting and Data System Version 2.1 Combined with PSAD for Clinically Significant Prostate Cancer in the Gray Zone of Prostate-Specific Antigen
Diagnosis of Prostate Imaging Reporting and Data System Version 2.1 Combined with PSAD for Clinically Significant Prostate Cancer in the Gray Zone of Prostate-Specific Antigen
Purpose To explore the diagnostic value of prostate imaging report and data system 2.1(PI-RADS v2.1)combined with prostate-specific antigen density(PSAD)for clinically significant prostate cancer(csPCa)in prostate-specific antigen(PSA)gray area(4-10 ng/ml)based on two-center data.Materials and Methods The clinical and imaging data of patients with PSA gray zone prostate disease who underwent multi-parametric magnetic resonance imaging and all pathological data in the First Medical Center(center 1)and the Sixth Medical Center(center 2)of the Chinese PLA General Hospital from January 2017 to May 2022 were retrospectively selected and analyzed.The patients from center 1 were used as the training group(220 cases),and the patients from center 2 were used as the test group(50 cases).Logistic regression was used to determine the independent predictors of csPCa in the training group,and the diagnostic efficacy of multi-parameter combination for csPCa was analyzed,which was further verified in the test group.Results There were significant differences in prostate volume,PSAD and PI-RADS v2.1 scores between the csPCa and non-csPCa groups in the training group(Z=-6.468,6.589,75.676,all P＜0.001).Logistic regression analysis showed that PI-RADS v2.1 score and PSAD were the independent risk factors for csPCa(both P＜0.001).The area under the curve of the Logistic regression model composed of PI-RADS v2.1 and PSAD for predicting csPCa in the PSA gray zone was 0.860(95％CI 0.808-0.903)in the training group and 0.906(95％CI 0.790-0.970)in the test group,respectively.The area under the curve of Logistic regression model was significantly higher than that of PI-RADS v2.1 and PSAD,respectively,with statistically significant difference(both P＜0.05).When the PI-RADS v2.1 score was low or moderate risk and PSAD＜0.15 ng/ml2,csPCa in the training group and the test group was with low detection rate.Conclusion PI-RADS v2.1 score and PSAD may be the independent risk factors for predicting csPCa in the PSA gray zone.The combined application of the two methods is better than the single method in the diagnosis of csPCa in the PSA gray zone,with benefits for clinical biopsy decision-making.
关键词
前列腺肿瘤/磁共振成像/前列腺影像报告和数据系统/前列腺特异性抗原
Key words
Prostate neoplasms/Magnetic resonance imaging/Prostate imaging report and data system/Prostate-specific antigen
维普
万方数据