The combination of prostate health index and multiparametric magnetic resonance imaging in prostate cancer diagnosis: efficacy analysis in different PSA ranges and its clinical decision-guiding value
Abstract
This study aims to investigate the diagnostic accuracy of prostate health index (PHI) in combination with multi-parametric magnetic resonance imaging (mpMRI) for the detection of prostate cancer (PCa). Furthermore, the study also seeks to evaluate the diagnostic performance of this combined approach across various PSA levels, with the goal of developing a personalized biopsy protocol. This retrospective study enrolled 120 patients who underwent PSA, PHI, and mpMRI tests prior to prostate biopsy and were divided into the PCa group and the benign prostatic hyperplasia (BPH) group. Patients with ISUP >2 were classified as clinically significant prostate cancer (csPCa). MpMRI images were interpreted according to the Prostate Imaging Reporting and Data System, version 2. Diagnostic accuracy of each indicator was assessed using receiver operating characteristic (ROC) curve analysis. Independent predictors were identified through univariate and multivariate logistic regression analyses. Furthermore, the diagnostic performance of PHI, mpMRI, and their combination was evaluated. Based on the pathological biopsy results, 48 (40%) were diagnosed with PCa, while 72 (60%) patients had a benign lesion. The area under the curve (AUC) of PHI and PI-RADS score for PCa diagnosis was 0.747 and 0.790, respectively, both significantly higher than that of PSA (0.645) (p 10 ng/ml subgroup, PHI did not provide additional diagnostic benefits when used combined with PI-RADS score, with a diagnostic…
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