Diagnostic value comparison of the combination of prostate-specific membrane antigen-body PET/MR and the prostate health index with each alone in early diagnosis of prostate cancer  

作　　者：Jiacheng Liu Xiaoyi Lin Da Huang Miao Zhang Ao Liu Xiaohao Ruan Jingrong Jiang Hai Huang Lu Chen Danfeng Xu 

机构地区：[1]Department of Urology,Ruijin Hospital,Shanghai Jiao Tong University School of Medicine,Shanghai,China [2]Department of Laboratory Medicine,Ruijin Hospital,Shanghai Jiao Tong University School of Medicine,Shanghai,China [3]Department of Nuclear Medicine,Ruijin Hospital,Shanghai Jiaotong University School of Medicine,Shanghai,China [4]Shanghai Yuye Medical Technology Co.Ltd,Shanghai,China

出　　处：《Asian Journal of Urology》2024年第4期555-562,共8页亚洲泌尿外科杂志（英文）

基　　金：supported by the National Key Research and Development Program of China(2021YFC2009300 and 2021YFC2009305 to Xu D);Science and Technology Commission of Shanghai Municipality(20Y11904700 to Xu D);National Nature Science Foundation of China(82173045 and 81972405 to Xu D,82072844 and 82272878 to Chen L,82003136 and 82272854 to Huang H);Nature Science Foundation of Shanghai(20ZR1433600,to Chen L);the Shanghai Sailing Program(22YF1440500 to Huang D);the Science and Technology Innovation Action Plan of Shanghai(1Y11904500 to Huang H).

摘　　要：Objective:This study aimed to figure out whether the combination of the prostate health index(PHI)and prostate-specific membrane antigen(PSMA)-PET/MR could improve the diagnostic accuracy for prostate cancer(PCa)than that of each individual method used alone.Methods:In this prospective,observational study,41 patients who underwent the systematic prostate biopsy between June 2019 and September 2022 were enrolled.Both the PHI test and ^(18)F-PSMA-1007-PET/MR were performed prior to biopsies.The diagnostic accuracy of different models was compared by logistic regression,areas under the curve(AUCs)of the receiver operating characteristic,and net reclassification index(NRI).Results:Among the 41 patients,14(34.1%)were pathologically diagnosed with PCa.The PHI in the PCa group was significantly higher than that in the benign group(44.4 vs.35.0,p=0.048).Similarly,all the patients in the PCa group received positive results of ^(18)F-PSMA-1007-PET/MR,of which the positive rate was significantly higher than that in benign group(100%vs.62.96%,p=0.025).The ^(18)F-PSMA-1007-PET/MR provided additional diagnostic values to the PHI(AUC:0.802 vs.0.692,p=0.025).However,there was no significant difference between the combination model and the ^(18)F-PSMA-1007-PET/MR alone(AUC 0.802 vs.0.685,p=0.071).The optimal PHI cutoff of the combination model is 32,with which the model could significantly reduce unnecessary biopsies(NRI:22.22%,95%confidence interval:6.54%–37.90%,p=0.005).However,among patients with the PHI of≥43.5,there was no significant difference between the combination model and the PHI alone(NRI:11.11%,95%confidence interval:−0.74%–22.97%,p=0.066).Conclusion:The combination of the PHI and ^(18)F-PSMA-1007-PET/MR outperforms the PHI alone for predicting PCa,especially in avoiding unnecessary biopsies.However,for patients with the PHI of≥43.5,the addition of ^(18)F-PSMA-1007-PET/MR to the PHI does not yield additional benefits.

关 键 词：Prostate cancer Prostate-specific membrane antigen Prostate health index Prostate biopsy Diagnosis 

分 类 号：R737.25[医药卫生—肿瘤]