Mp49-08 Usefulness of Free Psa Ratio to Enhance Detection of Clinically Significant Prostate Cancer in Patients With Pirads <3 and Psa ≤10

You have accessJournal of UrologyProstate Cancer: Detection & Screening IV (MP49)1 May 2024MP49-08 USEFULNESS OF FREE PSA RATIO TO ENHANCE DETECTION OF CLINICALLY SIGNIFICANT PROSTATE CANCER IN PATIENTS WITH PIRADS <3 AND PSA ≤10 Kevin Kang, Chang Rae Park, Ji Eun Heo, Kwang Suk Lee, Won Sik Jang, Won Sik Ham, Woong Kyu Han, Jang Hwan Kim, Young Deuk Choi, Jongsoo Lee, and Kevin Kang Kevin KangKevin Kang , Chang Rae ParkChang Rae Park , Ji Eun HeoJi Eun Heo , Kwang Suk LeeKwang Suk Lee , Won Sik JangWon Sik Jang , Won Sik HamWon Sik Ham , Woong Kyu HanWoong Kyu Han , Jang Hwan KimJang Hwan Kim , Young Deuk ChoiYoung Deuk Choi , Jongsoo LeeJongsoo Lee , and Kevin KangKevin Kang View All Author Informationhttps://doi.org/10.1097/01.JU.0001008696.31772.28.08AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookLinked InTwitterEmail Abstract INTRODUCTION AND OBJECTIVE: Recently, it is a protocol in most institutions to perform a prostate biopsy according to the results after taking a prostate MRI. The necessity of biopsy in PIRADS score less than 3 is described differently in each guideline. Therefore, we tried to reconsider the usefulness of the free PSA ratio (PSA%), which can easily and inexpensively obtain results, in patients with PIRADS<3 and PSA≤10 ng/mL or less. METHODS: We analyzed 1,435 prostate biopsies performed by a single operator between April 2018 and January 2023 at a single institution. For PSA and free PSA, the results on the day of biopsy or within 1 month were used, and all biopsies were performed after prostate MRI. Clinically significant cancer (CSC) was defined as Gleason grade group≥2, and screening performance of PSA% was calculated using ROC curve. RESULTS: The median age was 65 years (61-71), the PSA median was 5.06 ng/mL (4.0-7.1), and the PSA% median was 18% (13.5-21.7). Among the total analyzed subjects, PIRADS<3 and PSA≤10ng/mL were 208 (15%), and within the group CSC detection rate was 18%. When using the ROC curve for CSC detection, the cut-off PSA% was 17.6% and the AUC was calculated as 0.757 (95% CI, 0.674-0.841). (Figure 1) In the group with PSA% higher than the cutoff value, only 5 patients (4%) were diagnosed with CSC, and in the lower group, 32 patients (34%) were diagnosed with CSC (Table 1). CONCLUSIONS: In patients with PIRADS<3 and PSA≤10ng/mL, if PSA% cut-off value of 17.6% was used, unnecessary biopsy could be reduced by 52% (109/208), and 34% (32/94) of subjects whose biopsy could be delayed due to PIRADS results was able to be early diagnosed as CSC. Download PPT Source of Funding: None © 2024 by American Urological Association Education and Research, Inc.FiguresReferencesRelatedDetails Volume 211Issue 5SMay 2024Page: e785 Advertisement Copyright & Permissions© 2024 by American Urological Association Education and Research, Inc.Metrics Author Information Kevin Kang More articles by this author Chang Rae Park More articles by this author Ji Eun Heo More articles by this author Kwang Suk Lee More articles by this author Won Sik Jang More articles by this author Won Sik Ham More articles by this author Woong Kyu Han More articles by this author Jang Hwan Kim More articles by this author Young Deuk Choi More articles by this author Jongsoo Lee More articles by this author Kevin Kang More articles by this author Expand All Advertisement PDF downloadLoading ...