Detection of prostate cancer in the PSA gray zone using prostate-specific antigen mass ratio combined with PI-RADS score
Background: The study aimed to assess the diagnostic performance of prostate-specific antigen mass ratio (PSAMR) in combination with the Prostate Imaging Reporting and Data System (PI-RADS) score for detecting prostate cancer (PCa) in patients presenting with mildly elevated prostate-specific ant...
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| Main Authors: | , , , , , , |
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| Format: | Article |
| Language: | English |
| Published: |
MRE Press
2025-07-01
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| Series: | Journal of Men's Health |
| Subjects: | |
| Online Access: | https://oss.jomh.org/files/article/20250730-588/pdf/JOMH2025032102.pdf |
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| Summary: | Background: The study aimed to assess the diagnostic performance of
prostate-specific antigen mass ratio (PSAMR) in combination with the Prostate
Imaging Reporting and Data System (PI-RADS) score for detecting prostate cancer
(PCa) in patients presenting with mildly elevated prostate-specific antigen (PSA)
levels (4–10 ng/mL). Methods: A retrospective analysis
was conducted involving 208 patients with PSA levels between 4 and 10 ng/mL who
underwent multiparametric magnetic resonance imaging (mpMRI) and transrectal
ultrasound-guided transperineal prostate biopsy. PSA-derived parameters and
PI-RADS scores were incorporated into logistic regression models to predict the
presence of PCa. Diagnostic accuracy was assessed using receiver operating
characteristic (ROC) curve analysis. Additionally, Spearman’s correlation
analysis was performed to determine the relationship between each parameter and
the prediction model with disease severity ratings. Results: Of the 208
patients, PCa was confirmed by biopsy in 62 cases. The combination of PSAMR and
PI-RADS score yielded an area under the ROC curve (AUC) of 0.874 (95% confidence
interval (CI): 0.821–0.916, p < 0.001), which was higher than the
AUCs for PSAMR or PI-RADS score alone, indicating superior diagnostic accuracy.
Correlation analysis also revealed that the combined model had the strongest
association with disease severity. The order of correlation coefficients was as
follows: PSAMR combined with PI-RADS score (Model A) > Prostate-specific
antigen density (PSAD) combined with PI-RADS score (Model B) > PI-RADS score
alone > PSAMR alone > PSAD alone. Conclusions: The combination of
PSAMR and PI-RADS score significantly enhances the accuracy of PCa detection in
patients with PSA levels of 4–10 ng/mL. This approach may contribute to more
effective screening strategies while minimizing unnecessary biopsies.
Furthermore, given their positive correlation with disease severity, PSAMR and
PI-RADS scores together may also assist in predicting PCa progression risk. |
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| ISSN: | 1875-6867 1875-6859 |