PI-RADS v2.1 score combined with PSA density for diagnosis of clinically significant prostate cancer in the PSA grey zone by MRI-TRUS cognitivefusion-guided transperineal targeted prostate biopsy
LI Yue
ZHOU Shan
CHEN Jing
MAO Fei
NIU Xiao-bing
SUN Li
XU Ming
LIU Jin-tao
Abstract：Objective:To assess the value of the Prostate Imaging Reporting and Data System version 2.1(PI-RADS v2.1)score combined with PSA density(PSAD)in the diagnosis of clinically significant prostate cancer(CSPCa)in the PSA grey zone by MRI-TRUS cognitive fusion-guided transperineal targeted prostate biopsy.Methods:This retrospective study included 327 male pa-tients with total PSA(tPSA)levels of 4-10 μg/L undergoing MRI-TRUS cognitive fusion-guided transperineal targeted prostate biop-sy in our hospital between January 2021 and December 2023.According to the pathological results,we divided the patients into a CSP-Ca(n=44)and a non-CSPCa group(n=283),collected their clinical and imaging data,and subjected them to statistical analy-sis.Results:The age,tPSA level,PSAD and PI-RADS score were significantly higher,while the free PSA(fPSA)level,f/tPSA ratio and prostate volume remarkably lower in the CSPCa than in the non-CSPCa group(P＜0.05).The areas under the curve(AUCs)of PSAD,PI-RADS score and their combination were 0.772,0.730 and 0.801,with sensitivities of 63.63％,70.45％and 72.73％,and specificities of 84.10％,75.62％and 83.75％,respectively(P＜0.01).With PSAD 0.2 μg/(ml·cm3)as the best cut-off value and based on the PI-RADS scores,the patients were divided into two groups for analysis.In the patients with PI-RADS scores 2 and 5,the AUCs were 0.534 and 0.643,with sensitivities of 16.67％and 63.64％,and specificities of 85.14％and 64.29％,with no statistically significant differences(P=0.784,P=0.228),and in those with PI-RADS scores 3 and 4,the AUCs were 0.794 and 0.843,with sensitivities of 57.14％and 80.00％,and specificities of 87.14％and 81.82％,with statistically signif-icant differences(P=0.009,P＜0.001).Conclusion:PI-RADS v2.1 score combined with PSAD can effectively improve the di-agnostic efficiency of CSPCa in the PSA grey zone by MRI-TRUS cognitive fusion-guided transperineal targeted prostate biopsy and serve as a guide for selection of prostate biopsy.
Keywords：PI-RADS v2.1 scoreprostate-specific antigen densitygrey zoneMRI-TRUS cognitive fusion-guided transperine-al targeted prostate biopsyclinically significant prostate cancer
Publication Date：2025-01-19
Online Publishing Date：2025-08-15(First online date of this platform, not the publication date of the document)
Pages：5( 50-54 )