ArticleProstate cancer and prostatic diseases2023
PSA density is complementary to prostate MP-MRI PI-RADS scoring system for risk stratification of clinically significant prostate cancer.
Article in Prostate cancer and prostatic diseases, 2023. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 29 papers, 1 of them a synthesis that pooled it.
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Who cites it
29 citing papers in PubMed, 1 synthesis or guideline pooled it, 38 citations in OpenAlex.
- Magnetic Resonance Imaging, Clinical, and Biopsy Findings in Suspected Prostate Cancer: A Systematic Review and Meta-Analysis.JAMA network open · 2024Pooled it
- Residents and Consultants Have Equal Outcomes When Performing Transrectal Fusion Biopsies: A Randomized Clinical Trial.Current oncology (Toronto, Ont.) · 2024Trial
- Utility of PSA density velocity in diagnosing prostate cancer on prostate MR.Abdominal radiology (New York) · 2026Article
- Clinical and MRI characteristics of germline pathogenic variant carriers diagnosed with prostate cancer.European radiology · 2026Article
- Reference values for PSA, PSA density, and MRI prostate volume in healthy German men.European radiology · 2026Article
- Evaluation of MRI-based risk models versus PI-RADS version 2.1 and arterial spin labeling perfusion imaging strategy for clinically significant prostate cancer.Quantitative imaging in medicine and surgery · 2026Article
- Integrating Prostate-Specific Antigen Density and Prostate Imaging Reporting and Data System Scores to Optimize Detection of Clinically Significant Prostate Cancer: A Multivariable Risk Model Approach.Journal of clinical laboratory analysis · 2026Article
- Incremental value of prostate-specific antigen density beyond PI-RADS and conventional MRI features for predicting the highest ISUP grade group in patients with prostate cancer diagnosed at initial systematic prostate biopsy.American journal of cancer research · 2026Article
- Clarifying the clinical role of biparametric MRI: reflections on diagnostic equivalence and patient-level stratification.Prostate cancer and prostatic diseases · 2025Article
- Analysis of gray zone PSA and PSAD correlated with PIRADS v2.1 in the MRI-US fusion prostate biopsy era: a retrospective bi-centre study.International urology and nephrology · 2025Article
- Personalized prostate biopsy protocols: enhancing cancer detection through tailored approaches-a narrative review.Translational andrology and urology · 2025Review
- PI-RADSv2.1 combined with PSA density for optimizing prostate biopsy decisions: a retrospective analysis.Frontiers in oncology · 2025Article
- Multimodal approach to optimize biopsy decision-making for PI-RADS 3 lesions on multiparametric MRI.Clinical imaging · 2025Article
- Upgrading of Grade Group 1 Prostate Cancer at Prostatectomy: Germline Risk Factors in a Prospective Cohort.Cancer epidemiology, biomarkers & prevention : a publication of the American Association for Cancer Research, cosponsored by the American Society of Preventive Oncology · 2024Article
- Transition-zone PSA-density calculated from MRI deep learning prostate zonal segmentation model for prediction of clinically significant prostate cancer.Abdominal radiology (New York) · 2024Article
- Interpreting Prostate MRI Reports in the Era of Increasing Prostate MRI Utilization: A Urologist's Perspective.Diagnostics (Basel, Switzerland) · 2024Review
- Long-term follow-up results of multiparametric prostate MRI and the prognostic value of PI-RADS: a single-center retrospective cohort studyDiagnostic and interventional radiology (Ankara, Turkey) · 2024Article
- Deep-learning-based reconstruction of T2-weighted magnetic resonance imaging of the prostate accelerated by compressed sensing provides improved image quality at half the acquisition time.Quantitative imaging in medicine and surgery · 2024Article
- Evaluation of Proclarix in the diagnostic work-up of prostate cancer.BJUI compass · 2024Article
- The value of adjusted PSAD in prostate cancer detection in the Chinese population.Frontiers in oncology · 2024Article
Corrections and comments
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Authors and funding
12 authors at 2 institutions in 1 country.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundWhile prostate multiparametric-magnetic resonance imaging (MP-MRI) has improved the diagnosis of clinically significant prostate cancer (CSPC), the complementary use of prostate-specific antigen (PSA) levels to risk-stratify for CSPC requires further study. The objective of this project was to determine if prostate MP-MRI and PSA can provide complementary insights into CSPC risk stratification.
methodsIn an IRB-approved study, pathologic outcomes from patients who underwent MR/US fusion-targeted prostate biopsy were stratified by various parameters including PSA, PSA density (PSAD), age, race, and PI-RADS v2 score. CSPC was defined as a Gleason score ≥7. Logistic regression was used to determine odds ratios (OR) with 95% confidence intervals (CI). P values were reported as two-sided with p < 0.05 considered statistically significant. ROC curves were generated for assessing the predictive value of tests and sensitivity + specificity optimization was performed to determine optimal testing cutoffs.
resultsA total of 327 patients with 709 lesions total were analyzed. PSAD and PI-RADS scores provided complementary predictive value for diagnosis of CSPC (AUC PSAD: 0.67, PI-RADS: 0.72, combined: 0.78, p < 0.001). When controlling for PI-RADS score, age, and race, multivariate analysis showed that PSAD was independently associated with CSPC (OR 1.03 per 0.01 PSAD increase, 95% CI 1.02-105, p < 0.001). The optimal cutoff of PSAD ≥ 0.1 ng/ml/cc shows that a high versus low PSAD was roughly equivalent to an increase in 1 in PI-RADS score for the presence of CSPC (4% of PI-RADS ≤3 PSAD low, 6% of PI-RADS 3 PSAD high vs. 5% of PI-RADS 4 PSAD low, 22% of PI-RADS 4 PSAD high vs. 29% of PI-RADS 5 PSAD low, 46% of PI-RADS 5 PSAD high were found to have CSPC).
conclusionsPSAD with a cutoff of 0.1 ng/ml/cc appears to be a useful marker that can stratify the risk of CSPC in a complementary manner to prostate MP-MRI.
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