Value of prostate specific antigen density in clinical decision-making for prostate imaging reporting and data system v2 category 3 lesions / 中国医学影像技术

ABSTRACT

Objective To explore the value of prostate specific antigen density (PSAD) in clinical decision making for patients with prostate imaging reporting and data system version 2 (PI-RADS v2) category 3 lesions.Methods Totally 54 patients with PI-RADS v2 category 3 lesions who underwent prostate biopsy before MRI were enrolled and divided into prostate cancer (PCa) group (n=11) and benign group (n=43) according to biopsy results.Then clinical data and imaging features,including total prostate specific antigen (TPSA),free prostate specific antigen (FPSA),FPSA/TPSA ratio (F/T),PSAD,prostate volume and the volume of index lesion were collected and statistically analyzed between the two groups.ROC curve was used to evaluate the diagnostic efficacy of PSAD in predicting malignant and benign lesions in patients with PI RADS v2 category 3 lesions.Results PSAD had statistical difference (P=0.006),whereas TPSA,FPSA,F/T,prostate volume and the volume of index lesion showed no statistical differences between PCa group and benign group (all P＞0.05).ROC curves showed that area under the curve was 0.771(P＜0.05).Using the optimal threshold of PSAD-0.25 ng/ml2,the sensitivity and specificity of PSAD in predicting PCa and benign lesions was 72.73 ％ (8/11) and 74.42％(32/43),respectively.Conclusion PSAD is an effective index to predict the risk of PCa in patients with PI-RADS v2 category 3 lesions.Using the threshold of PSAD=0.25 ng/ml2 to screen high risk patients for prostate biopsy,the positive rate could be improved and unnecessary biopsies could be avoided.