PHI Density Prospectively Improves Prostate Cancer Detection

Overview

Journal World J Urol

Specialty Urology

Date 2021 Jan 20

PMID 33471165

Citations 8

Authors

Carsten Stephan

Klaus Jung

Michael Lein

Hannah Rochow

Frank Friedersdorff

Andreas Maxeiner

Affiliations

Soon will be listed here.

Abstract

Purpose: To evaluate the Prostate Health Index (PHI) density (PHID) in direct comparison with PHI in a prospective large cohort.

Methods: PHID values were calculated from prostate-specific antigen (PSA), free PSA and [- 2]proPSA and prostate volume. The 1057 patients included 552 men with prostate cancer (PCa) and 505 with no evidence of malignancy (NEM). In detail, 562 patients were biopsied at the Charité Hospital Berlin and 495 patients at the Sana Hospital Offenbach. All patients received systematic or magnetic resonance imaging (MRI)/ultrasound fusion-guided biopsies. The diagnostic accuracy was evaluated by receiver operating characteristic (ROC) curves comparing areas under the ROC-curves (AUC). The decision curve analysis (DCA) was performed with the MATLAB Neural Network Toolbox.

Results: PHID provided a significant larger AUC than PHI (0.835 vs. 0.801; p = 0.0013) in our prospective cohort of 1057 men from 2 centers. The DCA had a maximum net benefit of ~ 5% for PHID vs. PHI between 35 and 65% threshold probability. In those 698 men within the WHO-calibrated PSA grey-zone up to 8 ng/ml, PHID was also significantly better than PHI (AUC 0.819 vs. 0.789; p = 0.0219). But PHID was not different from PHI in the detection of significant PCa.

Conclusions: Based on ROC analysis and DCA, PHID had an advantage in comparison with PHI alone to detect any PCa but PHI and PHID performed equal in detecting significant PCa.

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