Diagnostic value of MRI-based PSA density in predicting transperineal sector-guided prostate biopsy outcomes

被引：16

作者：

MacAskill, Findlay ^{[1
]}

Lee, Su-Min ^{[1
,2
]}

Eldred-Evans, David ^{[3
]}

Wulaningsih, Wahyu ^{[4
]}

Popert, Rick ^{[3
,5
]}

Wolfe, Konrad ^{[6
]}

Van Hemelrijck, Mieke ^{[4
]}

Rottenberg, Giles ^{[5
,7
]}

Liyanage, Sidath H. ^{[8
]}

Acher, Peter ^{[1
,5
]}

机构：

[1] Southend Univ Hosp, Dept Urol, Westcliff On Sea, Essex, England

[2] Weston Gen Hosp, Dept Urol, Weston Super Mare, Somerset, England

[3] Guys Hosp, Dept Urol, London, England

[4] Kings Coll London, Div Canc Studies, Canc Epidemiol Grp, London, England

[5] London Bridge Hosp, London, England

[6] Southend Univ Hosp, Dept Pathol, Westcliff On Sea, Essex, England

[7] Guys Hosp, Dept Radiol, London, England

[8] Southend Univ Hosp, Dept Radiol, Westcliff On Sea, Essex, England

来源：

INTERNATIONAL UROLOGY AND NEPHROLOGY | 2017年 / 49卷 / 08期

关键词：

Prostate-specific antigen; Prostatic neoplasms; Prostate volume; Prostate biopsy; Magnetic resonance imaging; ANTIGEN DENSITY; TRANSRECTAL ULTRASOUND; INTEROBSERVER VARIABILITY; VOLUME MEASUREMENT; CANCER; MEN; ACCURACY; RISK;

D O I：

10.1007/s11255-017-1609-8

中图分类号：

R5 [内科学]; R69 [泌尿科学（泌尿生殖系疾病）];

学科分类号：

1002 ; 100201 ;

摘要：

Prostate-specific antigen (PSA) density (PSAD) has potential to increase the diagnostic utility of PSA, yet has had poor uptake in clinical practice. We aimed to determine the diagnostic value of magnetic resonance imaging-derived PSAD (MR-PSAD) in predicting transperineal sector-guided prostate biopsy (TPSB) outcomes. Men presenting for primary TPSB from 2007 to 2014 were considered. Histological outcomes were assessed and defined as: presence of any cancer or significant cancer defined as presence of Gleason 4 and/or maximum tumour core length (MCCL) 4 mm (G4); or Gleason 4 and/or MCCL 6 mm (G6). Sensitivity, specificity and positive and negative predictive values were calculated, and receiver operating characteristics (ROC) curves were generated to compare MR-PSAD and PSA. Six hundred fifty-nine men were evaluated with mean age 62.5 +/- 9 years, median PSA 6.7 ng/ml (range 0.5-40.0), prostate volume 40 cc (range 7-187) and MR-PSAD 0.15 ng/ml/cc (range 0.019-1.3). ROC area under the curve (95% CI) was significantly better for MR-PSAD than PSA for all cancer definitions (p < 0.001): 0.73 (0.70-0.76) versus 0.61 (0.57-0.64) for any cancer; 0.75 (0.71-0.78) versus 0.66 (0.62-0.69) for G4; and 0.77 (0.74-0.80) versus 0.68 (0.64-0.71) for G6. Sensitivities for MR-PSAD < 0.1 ng/ml/cc were 85.0, 89.9 and 91.9% for any, G4 and G6 cancer, respectively. MR-PSAD may be better than total PSA in determining risk of positive biopsy outcome. Its use may improve risk stratification and reduce unnecessary biopsies.

引用

页码：1335 / 1342

页数：8