Abstract：Objective: To investigate the value of diagnosis for clinically significant prostate cancer(sPCa) by combining bi-parametric magnetic resonance imaging(B-MRI) with prostate specific antigen density(PSAD) on the basis of the prostate imaging reporting and data system verison 2.0(PI-RADS V2). Methods: Eighty of prostate cancer, 47 patients of benign prostate hyperplasia(BPH) and 4 of prostatitis that were confirmed by biopsy pathology in our hospital were scanned with 3.0T B-MRI(T2WI and DWI). Two diagnostic physicians respectively assessed examination by using the PI-RADS V2 score, double-blinded to the indication for the MR imaging. All of the results were recorded. To collect the value of prostate specific antigen(PSA), prostate volume and to calculate the value of PSAD. Using the pathological results as the golden standard, the data of different group were analyzed using method of statistics. Results: The average values of PSAD and PI-RADS V2 score were 1.19±0.88, 3.90±1.00 in PCa group and 0.38±0.40, 2.30±0.55 in non-PCa group respectively. The difference of two groups were statistically significant(PSAD, t=10.10, P<0.05; PI-RADS, t=5.91, P<0.05). The area under ROC curve for PSAD and PI-RADS V2 were 0.794, 0.894. The diagnostic sensitivity was 98.68%, the specificity was 30%, the positive predictive value(PPV) was 68.18%, the negative predictive value(NPV) was 94.12% for sPCa with the cutoff point 0.15 of the PSAD. The diagnostic sensitivity was 90.67%, the specificity was 69.23%, the PPV was 81.00%, the NPV was 83.72% for sPCa with the cutoff point 0.15 of the PI-RADS V2. When PI-RADS V2 score and PSAD combined, a PI-RADS V2 score of 3 and PSAD≥0.15, or PI-RADS V2 score≥4 and PSAD≥0.15, the detection of sPCa were 72%, 92%. When a PI-RADS V2 score<3 and PSAD≥0.15, or PI-RADS V2 score≥4 and PSAD<0.15, the detection of sPCa were 20%, 25%. In contrast, when a PI-RADS V2 score≤3 and PSAD<0.15, there was no sPCa detected. Conclusion: It is very useful to predict biopsy outcome and provides even more accuracy in detecting clinically sPCa when combining B-MRI PI-RADS V2 with PSAD. Patients with a PI-RADS V2 score of ≤3 and PSA density of <0.15 may avoid unnecessary biopsies.
刘 艳，柏根基. 双参数MRI PI-RADS联合PSAD对前列腺癌的诊断价值[J]. 中国临床医学影像杂志, 2018, 29(3): 197-201.
LIU Yan, BO Gen-ji. Diagnostic value of bi-parametric MRI of PI-RADS as an adjunct to PSAD detection of prostate cancer. JOURNAL OF CHINA MEDICAL IMAGING, 2018, 29(3): 197-201.
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