Scientific Reports (Mar 2021)

The Prostate Health Index aids multi-parametric MRI in diagnosing significant prostate cancer

  • Yu-Hua Fan,
  • Po-Hsun Pan,
  • Wei-Ming Cheng,
  • Hsin-Kai Wang,
  • Shu-Huei Shen,
  • Hsian-Tzu Liu,
  • Hao-Min Cheng,
  • Wei-Ren Chen,
  • Tzu-Hao Huang,
  • Tzu-Chun Wei,
  • I-Shen Huang,
  • Chih-Chieh Lin,
  • Eric Y. H. Huang,
  • Hsiao-Jen Chung,
  • William J. S. Huang,
  • Tzu-Ping Lin

DOI
https://doi.org/10.1038/s41598-020-78428-6
Journal volume & issue
Vol. 11, no. 1
pp. 1 – 7

Abstract

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Abstract To evaluate the performance of the Prostate Health Index (PHI) in magnetic resonance imaging-transrectal ultrasound (MRI-TRUS) fusion prostate biopsy for the detection of clinically significant prostate cancer (csPCa). We prospectively enrolled 164 patients with at least one Prostate Imaging Reporting and Data System version 2 (PI-RADS v2) ≥ 3 lesions who underwent MRI-TRUS fusion prostate biopsy. Of the PSA-derived biomarkers, the PHI had the best performance in predicting csPCa (AUC 0.792, CI 0.707–0.877) in patients with PI-RADS 4/5 lesions. Furthermore, the predictive power of PHI was even higher in the patients with PI-RADS 3 lesions (AUC 0.884, CI 0.792–0.976). To minimize missing csPCa, we used a PHI cutoff of 27 and 7.4% of patients with PI-RADS 4/5 lesions could have avoided a biopsy. At this level, 2.0% of cases with csPCa would have been missed, with sensitivity and NPV rates of 98.0% and 87.5%, respectively. However, the subgroup of PI-RADS 3 was too small to define the optimal PHI cutoff. PHI was the best PSA-derived biomarker to predict csPCa in MRI-TRUS fusion prostate biopsies in men with PI-RADS ≥ 3 lesions, especially for the patients with PI-RADS 3 lesions who gained the most value.