MP45-02: A prospective study of the prostate health index density and multiparametric magnetic resonance imaging in diagnosing clinically significant prostate cancer

Gang Song*, Yuanchong Chen, Beijing, China, People's Republic of

Introduction: To evaluate the predictive performance of the Prostate Health Index (PHI) and PHI density (PHID), for clinically significant PCa (csPCa) in patients with a Prostate Imaging Reporting and Data System (PI-RADS) score = 3.

Methods: Patients tested for total prostate-specific antigen (tPSA, = 100 ng/mL), free PSA (fPSA), and p2PSA at our institution were prospectively enrolled. Possible predictive factors of csPCa were analyzed using the receiver operating characteristic (ROC) curve. Results were expressed as area under the curve (AUC) with 95% confidence intervals (CI). The cutoff values of PHI and PHID were determined.

Results: We enrolled 204 patients in this study. The prevalence of csPCa in the PI-RADS = 3 subgroup (N = 81) was 19.75% (16/81). Age, tPSA, F/T, prostate volume, PSA density, PHI, PHID, and PI-RADS score were significantly associated with csPCa. PHID (AUC: 0.841 [95% CI: 0.736–0.947]) was the best predictor of csPCa. PHID > 0.956 was set as the threshold of suspicious csPCa with a sensitivity of 87.50% and a specificity of 72.31%, avoiding 95.92% of unnecessary biopsies but missing 12.50% csPCa. A threshold of PHI = 52.83 showed the same sensitivity but a rather lower specificity of 64.62% that avoided 95.45% of unnecessary biopsies.

Conclusions: PHI and PHID have the best predictive performance of csPCa in patients with PI-RADS score =3. A threshold value of PHID = 0.956 may be used as the criterion for biopsy in these patients.

Source of Funding: Beckman Coulter