The role of PSA density among PI-RADS v2.1 categories in avoiding unnecessary biopsy of the transition zone in patients with PSA 4 to 20 ng / mL
This article was originally published here
Biomed Res Int. October 11, 2021; 2021: 3995789. doi: 10.1155 / 2021/3995789. Electronic collection 2021.
OBJECTIVE: To assess the role of prostate specific antigen density (PSAD) in different categories of reports and prostate imaging data version 2.1 (PI-RADS v2.1) in order to avoid unnecessary biopsy in transition zone (TZ) patients with a PSA ranging from 4 to 20 ng / mL.
Materials and Methods: In this retrospective, single-center study, 333 biopsy-naive patients with TZ lesions who underwent biparametric magnetic resonance imaging (bp-MRI) were analyzed from January 2016 to March 2020. Multivariate logistic regression analyzes were performed to determine predictors of clinically significant prostate cancer (cs-PCa). The Receiver Operating Characteristic (ROC) curve was used to compare diagnostic performance.
RESULTS: PI-RADS v2.1 and PSAD were independent predictors of TZ cs-PCa in patients with a PSA of 4 to 20 ng / mL. 0.9% (2/213), 10.0% (7/70) and 48.0% (24/50) of PI-RADS v2.1 1-2, 3 and 4-5 scores had TZ cs- PCa. However, for patients with a PI-RADS v2.1 1-2 score, there was no obvious change in the detection of TZ cs-PCa (0.8% (1/129), 1.3% (1/75) and 0.0% (0/9)) in combination with different stratifications of PSAD (PSAD P = 0.039) or PSAD (0.803, P
CONCLUSIONS: For TZ patients with 4-20 ng / mL PSA, the PI-RADS v2.1 score ≤ 2 may avoid unnecessary biopsy regardless of the PSAD. A PI-RADS v2.1 score ≥ 3 may avoid unnecessary biopsy after combination with PSAD. PI-RADS v2.1 combined with PSAD could greatly improve diagnostic performance.
PMID: 34671673 | PMC: PMC8523253 | DOI: 10.1155 / 2021/3995789