ArticleJournal of clinical urology2023
Re-evaluating the diagnostic efficacy of PSA as a referral test to detect clinically significant prostate cancer in contemporary MRI-based image-guided biopsy pathways.
Article in Journal of clinical urology, 2023. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 9 papers, 1 of them a synthesis that pooled it.
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Who cites it
9 citing papers in PubMed, 1 synthesis or guideline pooled it, 9 citations in OpenAlex.
- Diagnostic Performance of Prostate-specific Antigen Density for Detecting Clinically Significant Prostate Cancer in the Era of Magnetic Resonance Imaging: A Systematic Review and Meta-analysis.European urology oncology · 2024Pooled it
- [Current status of prostate cancer screening research].Beijing da xue xue bao. Yi xue ban = Journal of Peking University. Health sciences · 2026Review
- PSA density for clinically significant prostate cancer detection: a retrospective cohort study on the influence of age and prostate volume.World journal of urology · 2026Article
- Comprehensive biochemical insights into derivatives of PSA and glycosylation-specific changes in PSA: role in diagnosis and management of prostate cancer.Clinical proteomics · 2026Review
- Article
- Irreversible electroporation for partial gland ablation: clinical application and outcomes.Prostate international · 2026Review
- Diagnostic value of the abnormal digital rectal examination in the modern MRI-based prostate cancer diagnostic pathway.Journal of clinical urology · 2024Article
- Urinary symptoms and prostate cancer-the misconception that may be preventing earlier presentation and better survival outcomes.BMC medicine · 2022Article
- Alternatives for MRI in Prostate Cancer Diagnostics-Review of Current Ultrasound-Based Techniques.Cancers · 2022Review
Corrections and comments
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Authors and funding
13 authors at 7 institutions in 1 country.
Funding
No grant is acknowledged in the PubMed record.
Abstract
Introduction: Modern image-guided biopsy pathways at diagnostic centres have greatly refined the investigations of men referred with suspected prostate cancer. However, the referral criteria from primary care are still based on historical prostate-specific antigen (PSA) cut-offs and age-referenced thresholds. Here, we tested whether better contemporary pathways and biopsy methods had improved the predictive utility value of PSA referral thresholds. Methods: PSA referral thresholds, age-referenced ranges and PSA density (PSAd) were assessed for positive predictive value (PPV) in detection of clinically significant prostate cancer (csPCa - histological ⩾ Grade Group 2). Data were analysed from men referred to three diagnostics centres who used multi-parametric magnetic resonance imaging (mpMRI)-guided prostate biopsies for disease characterisation. Findings were validated in a separate multicentre cohort. Results: Data from 2767 men were included in this study. The median age, PSA and PSAd were 66.4 years, 7.3 ng/mL and 0.1 ng/mL Conclusion: The introduction of MRI-based image-guided biopsy pathways does not appear to have altered PSA diagnostic test characteristics to positively detect csPCa. We find no added value to PSA age-referenced ranges, while PSAd offers better PPV and the potential for a single clinically useful threshold (⩾0.10) for all age groups. Level of evidence: IV.
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