Combining prostate health index and multiparametric magnetic resonance imaging in the diagnosis of clinically significant prostate cancer in an Asian population

Hsieh, Po Fan; Li, Wei Juan; Lin, Wen Han; Han, Chang; Chang, Chao Hsiang; Huang, Chi Ping; Yang, Chi‐Rei; Chen, Wen Chi; Chang, Yi Huei; Wu, Hsi Chin

doi:10.1007/s00345-019-02889-2

Cited by 48 publications

(44 citation statements)

References 31 publications

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“…Hsieh et al [30] confirmed that adding phi to mp-MRI improved the predictive accuracy and clinical net benefit for 102 Asian subjects undergoing first biopsy. ROC curve analysis for the identification of csPCa showed that AUC of the combination phi-imaging was significantly higher (0.87) than phi alone (0.73, p = 0.002) and mp-MRI alone (0.83, p = 0.035).…”

Section: Multi-parametric Mri (Mp-mri)mentioning

confidence: 94%

Beyond PSA: The Role of Prostate Health Index (phi)

Ferro

Cobelli

Lucarelli

et al. 2020

IJMS

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Background: Widespread use of prostate specific antigen (PSA) in screening procedures allowed early identification of an increasing number of prostate cancers (PCas), mainly including indolent cancer. Availability of different therapeutic strategies which have a very different impact on the patient's quality of life suggested a strong need for tools able to identify clinically significant cancer at diagnosis. Multi-parametric magnetic resonance showed very good performance in pre-biopsy diagnosis. However, it is an expensive tool and requires an experienced radiologist. In this context, a simple blood-based test is worth investigating. In this context, researchers focused their attention on the development of a laboratory test able to minimize overdiagnosis without losing the identification of aggressive tumors. Results: Recent literature data on PCa biomarkers revealed a clear tendency towards the use of panels of biomarkers or a combination of biomarkers and clinical variables. Phi, the 4Kscore, and Stockholm3 as circulating biomarkers and the Mi-prostate score, Exo DX Prostate, and Select MD-X as urinary biomarker-based tests have been developed. In this scenario, phi is worthy of attention as a noninvasive test significantly associated with aggressive PCa. Conclusions: Literature data showed that phi had good diagnostic performance to identify clinically significant (cs) PCa, suggesting that it could be a useful tool for personalized treatment decision-making. In this review, phi potentialities, limitations, and comparisons with other blood-and urinary-based tests were explored.

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Section: Multi-parametric Mri (Mp-mri)mentioning

confidence: 94%

Beyond PSA: The Role of Prostate Health Index (phi)

Ferro

Cobelli

Lucarelli

et al. 2020

IJMS

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“…If biopsies were restricted to patients with PI-RADS ≥ 3 lesions and PHI ≥ 30, 50% of the biopsies could have been avoided with only one csPCa being missed. Of note, patients with negative mpMRI (n = 35) would also have received systematic prostate biopsies in their series 21 .…”

Section: Discussionmentioning

confidence: 99%

The Prostate Health Index aids multi-parametric MRI in diagnosing significant prostate cancer

Fan

Pan

Cheng

et al. 2021

Sci Rep

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To evaluate the performance of the Prostate Health Index (PHI) in magnetic resonance imaging-transrectal ultrasound (MRI-TRUS) fusion prostate biopsy for the detection of clinically significant prostate cancer (csPCa). We prospectively enrolled 164 patients with at least one Prostate Imaging Reporting and Data System version 2 (PI-RADS v2) ≥ 3 lesions who underwent MRI-TRUS fusion prostate biopsy. Of the PSA-derived biomarkers, the PHI had the best performance in predicting csPCa (AUC 0.792, CI 0.707–0.877) in patients with PI-RADS 4/5 lesions. Furthermore, the predictive power of PHI was even higher in the patients with PI-RADS 3 lesions (AUC 0.884, CI 0.792–0.976). To minimize missing csPCa, we used a PHI cutoff of 27 and 7.4% of patients with PI-RADS 4/5 lesions could have avoided a biopsy. At this level, 2.0% of cases with csPCa would have been missed, with sensitivity and NPV rates of 98.0% and 87.5%, respectively. However, the subgroup of PI-RADS 3 was too small to define the optimal PHI cutoff. PHI was the best PSA-derived biomarker to predict csPCa in MRI-TRUS fusion prostate biopsies in men with PI-RADS ≥ 3 lesions, especially for the patients with PI-RADS 3 lesions who gained the most value.

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“…Adding PHI to mpMRI leads to increased predictive accuracy of csPCa and a reduction of up to 50% in unnecessary biopsies (for men with PI-RADS 3-5 and PHI ≥ 30). Moreover, combination AUC outperforms PHI and mpMRI alone (AUC were 0.87, 0.73 and 0.83, respectively [101].…”

Section: Biomarkers and Mpmrimentioning

confidence: 94%

Prostate Cancer Liquid Biopsy Biomarkers’ Clinical Utility in Diagnosis and Prognosis

Matuszczak

Schalken

Salagierski

2021

Cancers

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Prostate cancer (PCa) is the most common cancer in men worldwide. The current gold standard for diagnosing PCa relies on a transrectal ultrasound-guided systematic core needle biopsy indicated after detection changes in a digital rectal examination (DRE) and elevated prostate-specific antigen (PSA) level in the blood serum. PSA is a marker produced by prostate cells, not just cancer cells. Therefore, an elevated PSA level may be associated with other symptoms such as benign prostatic hyperplasia or inflammation of the prostate gland. Due to this marker’s low specificity, a common problem is overdiagnosis, which leads to unnecessary biopsies and overtreatment. This is associated with various treatment complications (such as bleeding or infection) and generates unnecessary costs. Therefore, there is no doubt that the improvement of the current procedure by applying effective, sensitive and specific markers is an urgent need. Several non-invasive, cost-effective, high-accuracy liquid biopsy diagnostic biomarkers such as Progensa PCA3, MyProstateScore ExoDx, SelectMDx, PHI, 4K, Stockholm3 and ConfirmMDx have been developed in recent years. This article compares current knowledge about them and their potential application in clinical practice.

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Combining prostate health index and multiparametric magnetic resonance imaging in the diagnosis of clinically significant prostate cancer in an Asian population

Cited by 48 publications

References 31 publications

Beyond PSA: The Role of Prostate Health Index (phi)

Beyond PSA: The Role of Prostate Health Index (phi)

The Prostate Health Index aids multi-parametric MRI in diagnosing significant prostate cancer

Prostate Cancer Liquid Biopsy Biomarkers’ Clinical Utility in Diagnosis and Prognosis

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