Unlocking precision enhancing prostate cancer detection and reducing unnecessary biopsies with combined prostate-speci c antigen density and PI-RADS score | [Journal of College of Physicians and Surgeons--Pakistan : JCPSP • 2024]

Author(s):

1. Nurullah Hamidi: Department of Urology, University of Health Sciences, Ankara Oncology Training and Research Hospital,Ankara,Turkiye

2. Tuncel Uzel: Department of Urology, University of Health Sciences, Ankara Oncology Training and Research Hospital,Ankara,Turkiye

3. Aykut Demirci: Department of Urology, University of Health Sciences, Ankara Oncology Training and Research Hospital,Ankara,Turkiye

4. Halil Basar: Department of Urology, University of Health Sciences, Ankara Oncology Training and Research Hospital,Ankara,Turkiye

Abstract:

Objective: To determine clinically signi cant prostate cancer (csPCa) detection rate by combining the prostate-speci c antigen density (PSAD) and prostate imaging-reporting and data system (PI-RADS) scores. Study Design: Descriptive study. Place and Duration of the Study: Department of Urology, University of Health Sciences, Ankara Oncology Training and Research Hospital, from January 2018 to April 2023. Methodology: Patients who underwent prostate biopsies after multiparametric magnetic resonance imaging (mpMRI) were included in the study. PI-RADS 4 and 5 lesions were considered as MR positive. The cut-o values for PSAD were also determined to evaluate csPCa. csPCa detection rates were evaluated by grouping the patients based on the PSAD and mpMRI ndings. Results: PSAD cut-o value of 0.165 ng/mL/mL (sensitivity 80%, speci city 72%) was detected to predict csPCa (AUC = 0.81, 95% CI:0.756-0.866, p<0.001). csPCa detection rate was low (3%) in patients who have low PI-RADS scores (1-3) and a PSAD <0.165 ng/mL/mL. On the other hand, csPCa detection rate was high (50.5%) in patients who have a high PI-RADS score (4-5 lesions) and with a PSAD e0.165 ng/mL/mL. Conclusion: csPCa detection rates are low in patients with PI-RADS 1-3 lesions and low PSAD values. Unnecessary biopsy may be avoided in these patients.

Page(s): 1205-1210

DOI: 10.29271/jcpsp.2024.10.1205

Published: Journal: Journal of College of Physicians and Surgeons--Pakistan : JCPSP, Volume: 34, Issue: 10, Year: 2024

Keywords:

Prostate cancer , Gleason score , PIRADS , Prostatespeci c antigen , Prostatespeci c antigen density

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