PI-RADS category and biopsy-confirmed clinically significant prostate cancer in a selected Ecuadorian multiparametric MRI cohort: a cross-sectional diagnostic study
Cross-sectional diagnostic study demonstrates high detection of significant prostate cancer at PI-RADS 4 or greater, highlighting its utility in prebiopsy risk stratification.
Key Points
To evaluate the diagnostic performance of PI-RADS categories, prostate-specific antigen (PSA), and PSA density for identifying clinically significant prostate cancer in a selected cohort.
Retrospective, single-center, cross-sectional diagnostic study of 141 men evaluated for suspected prostate cancer between September 2022 and September 2023.
Primary analytical cohort included N=36 patients undergoing multiparametric MRI with PI-RADS scoring and combined systematic and MRI-targeted biopsies.
Primary outcome was clinically significant prostate cancer (csPC; ISUP grade group ≥2), evaluated across PI-RADS categories and thresholds (≥3 and ≥4).
Clinically significant prostate cancer was detected in 0/1 PI-RADS 2, 0/4 PI-RADS 3, 15/21 PI-RADS 4, and 9/10 PI-RADS 5 patients.
At a threshold of PI-RADS ≥4, specificity was 41.7% (5/12; 95% CI, 15.2%–72.3%), positive predictive value was 77.4% (24/31; 95% CI, 58.9%–90.4%), and overall accuracy was 80.6% (29/36).
Areas under the receiver operating characteristic curve for predicting csPC were 0.776 for PI-RADS category, 0.816 for PSA, and 0.833 for PSA density.