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Prostate imaging-reporting and data system version 2 in combination with clinical parameters for prostate cancer detection: a single center experience

  • Urology - Original Paper
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Abstract

Purpose

The diagnostic performance of the Prostate Imaging Reporting and Data System version 2 (PI-RADS v2) has been challenged due to its lower diagnostic accuracy and higher false-positive rates for prostate cancer detection. This study aimed to analyze the diagnostic performance of PI-RADS v2 in combination with clinical parameters in patients with suspected prostate cancer.

Material and Methods

A total of 424 men with suspicion of prostate cancer were retrospectively analyzed. Logistic regression analyses were performed to identify predictors of clinically significant prostate cancer defined as a Gleason score of 3 + 4 or greater. The prediction performance was compared with prostate specific antigen (PSA), free/total PSA ratio (f/t PSA), PSA density (PSAD), PI-RADS v2 alone, and PI-RADS v2 plus PSAD using receiver operating characteristics (ROCs).

Results

In total, 231 out of 424 cases (54.48%) were pathologically diagnosed as prostate cancer. The percentage of clinically significant prostate cancer was higher in patients with PI-RADS v2 score of 4 or greater compared to PI-RADS v2 score of less than 4 (90.86% vs. 55.88%, P < 0.001). Age, PSA level, f/t PSA, PSAD, and PI-RADS v2 were significant independent predictors of clinically significant prostate cancer. The ROC area under the curve of PI-RADS v2 plus PSAD (0.952) was larger compared with PSA (0.845), f/t PSA (0.719), PSAD (0.920), and PI-RADS v2 alone (0.885).

Conclusion

PI-RADS v2 in combination with PSAD may help detect clinically significant prostate cancer and provide benefit in making the decision to biopsy men at suspicion of prostate cancer.

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Data availability

The datasets generated during and/or analysed during the current study are available from the corresponding author on reasonable request.

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Funding

The author(s) received no financial support for the research, authorship, and/or publication of this article.

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Authors and Affiliations

  1. Department of Radiation Oncology, The First Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou, China

    Lei Wang

  2. Department of Urology, Zhongnan Hospital of Wuhan University, Wuhan, 430071, China

    Yi Luo, Tongzu Liu & Xing Huang

  3. Department of Radiology, Zhongnan Hospital of Wuhan University, Wuhan, China

    Ming Deng

  4. Center for Evidence-Based and Translational Medicine, Zhongnan Hospital of Wuhan University, Wuhan, China

    Xing Huang

Authors
  1. Lei Wang
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  2. Yi Luo
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  3. Tongzu Liu
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  4. Ming Deng
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  5. Xing Huang
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Contributions

LW conceptualization, methodology, formal analysis, investigation, writing—original draft, supervision. YL formal analysis, resources, methodology. TL resources, data curation, validation. MD methodology, Data curation, investigation. XH conceptualization, methodology, investigation, writing–review & editing, Supervision.

Corresponding author

Correspondence to Xing Huang.

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Conflict of interest

The authors declare that there is no potential conflict of interest.

Ethical approval

All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki Declaration and its later amendments or comparable ethical standards. This study was approved by the Ethics Committee of Zhongnan Hospital of Wuhan University (number 2022-03-22).

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All authors gave informed consent for the publication of this study.

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Supplementary Information

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11255_2023_3631_MOESM1_ESM.tif

Supplementary file1 mpMRI images in a 66-year-old man with PCa. T2WI showed a hypointense nodule in the right peripheral zone (arrow) (a). The lesion was hyperintense on DWI (arrow) (b). ADC map showed a focal area of diffusion restriction, measuring 2.0 cm in the longest diameter (arrow) (c). DCE image also shows a focal area of enhancement at the same site (arrow) (d). Therefore, the overall PI-RADS v2 score was 5, indicating a very high probability of clinically significant PCa. On the biopsy specimen, it was diagnosed as clinically significant PCa with Gleason score of 4 + 4(TIF 3118 KB)

11255_2023_3631_MOESM2_ESM.tif

Supplementary file2 Univariate (a) and multivariate (b) analyses of the clinical parameters for clinically significant prostate cancer (TIF 929 KB)

Supplementary file3 (DOCX 15 KB)

Supplementary file4 (DOCX 15 KB)

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Wang, L., Luo, Y., Liu, T. et al. Prostate imaging-reporting and data system version 2 in combination with clinical parameters for prostate cancer detection: a single center experience. Int Urol Nephrol 55, 1659–1664 (2023). https://doi.org/10.1007/s11255-023-03631-z

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  • DOI: https://doi.org/10.1007/s11255-023-03631-z

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