Using the Prostate Imaging Reporting and Data System version 2 （PI-RIDS v2） to detect prostate cancer can prevent unnecessary biopsies and invasive treatment

作     者：Chang Liu Shi-Liang Liu Zhi-Xian Wang Kai Yu Chun-Xiang Feng Zan Ke Liang Wang Xiao-Yong Zeng 

作者机构：Department of Urology Tongji Hospital Tongji Medical College Huazhong University of Science and Technology Wuhan 430030 China Department of RadiologyTongji Hospital Tongji Medical College Huazhong University of Science and Technology Wuhan 430030 China 

出 版 物：《Asian Journal of Andrology》 (亚洲男性学杂志（英文版）)

年 卷 期：2018年第20卷第5期

页      面：459-464页

核心收录：

学科分类：0710[理学-生物学] 12[管理学] 1201[管理学-管理科学与工程(可授管理学、工学学位)] 07[理学] 071002[理学-动物学] 

主　　题：diagnosis multiparametric magnetic resonance imaging prostate cancer Prostate Imaging Reporting and Data Systemversion 2 prostate-specific antigen prostate-specific antigen density 

摘      要：Prostate cancer （PCa） is one of the most common cancers among men globally. The authors aimed to evaluate the ability of the Prostate Imaging Reporting and Data System version 2 （PI-RADS v2） to classify men with PCa, clinically significant PCa （CSPCa）, or no PCa, especially among those with serum total prostate-specific antigen （tPSA） levels in the ＂gray zone＂ （4-10 ng ml-1）. A total of 308 patients （355 lesions） were enrolled in this study. Diagnostic efficiency was determined. Univariate and multivariate analyses, receiver operating characteristic curve analysis, and decision curve analysis were performed to determine and compare the predictors of PCa and CSPCa. The results suggested that PI-RADS v2, tPSA, and prostate-specific antigen density （PSAD） were independent predictors of PCa and CSPCa. A PI-RADS v2 score L≥4 provided high negative predictive values （91.39% for PCa and 95.69% for CSPCa）. A model of PI-RADS combined with PSA and PSAD helped to define a high-risk group （PI-RADS score = 5 and PSAD L≥0 15 ng ml-1 cm-3, with tPSA in the gray zone, or PI-RADS score L≥4 with high tPSA level） with a detection rate of 96.1% for PCa and 93.0% for CSPCa while a low-risk group with a detection rate of 6.1% for PCa and 2.2% for CSPCa. It was concluded that the PI-RADS v2 could be used as a reliable and independent predictor of PCa and CSPCa. The combination of PI-RADS v2 score with PSA and PSAD could be helpful in the prediction and diagnosis of PCa and CSPCa and, thus, may help in preventing unnecessary invasive procedures.