Diagnosis Value Of BP-MRI Combined Clinical Predictors For Prostate Cancer

Objective Prostate Cancer(PCa)has an increasing morbidity and mortality rate among middle-aged and elderly men worldwide.Currently,an ideal clinical prostate cancer detection protocol has not been proposed.The aim of this study was to assess diagnostic efficacy of BP-MRI and BP-MRI combined with Clinical predictors vs MP-MRI for prostate cancer(PCa)based on the prostate imaging reporting and data system version 2.1(PI-RADS v2.1).Methods This study retrospectively analyzed 171 patients with clinically suspected prostate cancer who underwent MP-MRI examination before systematic biopsy in our hospital from January 2020 to May 2022.The prostate MR images of all lesions were scored by the two schemes of MP-MRI and BP-MRI based on PI-RADS v2.1.Combined with the results of pathology,the lesions were divided into three groups: all lesions group,lesions located in peripheral zone(PZ)group and lesions located in transition zone(TZ)group.BP-MRI,MP-MRI and clinical predictors such as: prostate specific antigen(PSA)、free prostate specific antigen f PSA(f PSA)、prostate-specific antigen density(PSAD)、age and prostate volume(PV)were analyzed by univariate and multivariate analysis,and the independent predictors were established.Drawing the receiver operating characteristic(ROC)curve,the diagnostic performance of the two schemes and BP-MRI combined with independent predictors was compared by analyzing the area under the curve(AUC)and Z test.Result For all of the lesions(PZ + TZ),The BP-MRI,MP-MRI,age,PSAD,and f/t PSA were the independent predictors of PCa,There was no statistical difference in the diagnostic efficacy between BP-MRI and MP-MRI(AUC=0.888,0.886,P>0.05).Combined model and the combination of BP-MRI and f/t PSA or PSAD and age(AUC=0.937,0.924,0.915,0.892)had higher diagnostic efficience than MP-MRI(AUC=0.886).The difference between the AUC value of these combined models and MP-MRI was statistically significant(P<0.05);PSAD had a larger AUC than the other predictors alone(AUC=0.837),the AUC for the combination of BP-MRI and independent predictors is significantly superior to using BP-MRI score and independent predictors alone(P<0.05),and compared with the age index,combining BP-MRI and PSAD and f / t PSA had a higher diagnostic efficacy and showed a statistically significant difference.For lesions in the peripheral zone(PZ)or transition zone(TZ),the two schemes of MP-MRI and BP-MRI were the independent predictors,There was no statistical difference in the diagnostic efficacy between BP-MRI and MP-MRI(AUC=0.821,0.817;0.964,0.964 P>0.05).Conclusion BP-MRI has equivalent diagnostic efficacy for PCa to MP-MRI,Combining BP-MRI with f/t PSA or PSAD can improve diagnostic efficacy and avoid clinically unnecessary biopsies.