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• Clinical Article •
Study on the diagnostic value of combined models based on PSAD and mp-MRI in clinically significant prostate cancer
XIN Jianying  ZHANG Wenxuan  HAN Yu  GONG Ping  XU Aixia  WANG Xizhen 

Cite this article as: XIN J Y, ZHANG W X, HAN Y, et al. Study on the diagnostic value of combined models based on PSAD and mp-MRI in clinically significant prostate cancer[J]. Chin J Magn Reson Imaging, 2025, 16(2): 72-76, 141. DOI:10.12015/issn.1674-8034.2025.02.011.


[Abstract] Objective To evaluate the value of prostate specific antigen density (PSAD) combined with multi-parameter magnetic resonance imaging (mp-MRI) used in diagnosing clinically significant prostate cancer (csPCa).Materials and Methods Retrospective analysis of clinical and imaging data of 105 patients with suspected PCa and pathological findings were selected, prostate specific antigen (PSA) detection and mp-MRI were performed before surgery. Based on pathological results and Gleason score, patients were divided into csPCa and non-csPCa groups. Parameters of mp-MRI including apparent diffusion coefficient (ADC), Begin time of enhancement (T0), Brevity of enhancement, wash in rate (WIR) and PSAD were compared between the two groups, combined diagnostic models were constructed by binary logistic regression, and receiver operating characteristic (ROC) curves were used to evaluate the diagnostic efficacy of each parameter and model for csPCa.Results The ADC and T0 in csPCa group were lower than those in non-csPCa group, while the PSAD, WIR and Brevity of enhancement were opposite, and all differences reach statistical significance (P < 0.05). The area under the curve (AUC) for the diagnosis of csPCa in PSAD, ADC and WIR were 0.902 (0.829 to 0.952), 0.890 (0.814 to 0.942) and 0.812 (0.724 to 0.882) respectively with higher diagnostic efficacy, the clinical diagnostic boundaries were 0.47 ng/(mL·cm3), 0.82 × 10-3 mm2/s, 50.33 s-1, the sensitivities were 79.1%, 67.4%, 100.0%, and the specificities were 100.0%, 100.0% and 54.8%, respectively. The AUC, sensitivity and specificity of any two and multi-parameter combined diagnosis of csPCa by WIR, PSAD and ADC: WIR + PSAD 0.929 (0.862 to 0.970), 83.7%, 96.8%; ADC + PSAD 0.940 (0.877 to 0.977), 90.7%, 91.9%; WIR + ADC 0.935 (0.870 to 0.974), 79.1%, 95.2%; WIR + PSAD + ADC 0.955 (0.896 to 0.986), 90.7%, 91.9%, respectively. ROC curve contrast analysis revealed significant differences in AUC between WIR + PSAD + ADC, ADC + PSAD, WIR + ADC combined diagnostic models and ADC, WIR single parameter diagnosis of csPCa (P < 0.05); the AUC of WIR+PSAD model was different from that of WIR in the diagnosis of csPCa statistically (P < 0.05).Conclusions PSAD combined with mp-MRI has a high diagnostic value for csPCa, progressively, the combined diagnostic model based on the key indicators can be used to predict csPCa.
[Keywords] clinically significant prostate cancer；prostate specific antigen density；multi-parameter magnetic resonance imaging；diffusion weighted imaging；dynamic contrast-enhanced；diagnostic efficacy

XIN Jianying   ZHANG Wenxuan   HAN Yu   GONG Ping   XU Aixia   WANG Xizhen*  

Medical Imaging Center, Affiliated Hospital of Shandong Second Medical University, Weifang 261031, China

Corresponding author: WANG X Z, E-mail: zhen94320@aliyun.com

Conflicts of interest   None.

Received  2024-08-13
Accepted  2025-02-10
DOI: 10.12015/issn.1674-8034.2025.02.011
Cite this article as: XIN J Y, ZHANG W X, HAN Y, et al. Study on the diagnostic value of combined models based on PSAD and mp-MRI in clinically significant prostate cancer[J]. Chin J Magn Reson Imaging, 2025, 16(2): 72-76, 141. DOI:10.12015/issn.1674-8034.2025.02.011.

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