ArticleAmerican journal of cancer research2026
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.
Article in American journal of cancer research, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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Abstract
objectiveTo evaluate the incremental value of prostate-specific antigen density (PSAD) beyond the Prostate Imaging Reporting and Data System (PI-RADS) score and conventional magnetic resonance imaging (MRI) features for predicting the highest International Society of Urological Pathology (ISUP) grade group at initial systematic biopsy.
methodsThis retrospective study included 171 patients with prostate cancer diagnosed by initial systematic biopsy between February 2022 and February 2026. All patients underwent 3.0-T multiparametric MRI within 15 days before biopsy. The highest ISUP grade group across all biopsy cores was the primary outcome. A baseline model, an MRI-extended model, and a combined model incorporating PSAD were sequentially developed using proportional odds ordinal logistic regression. Internal validation was performed with 2,000 bootstrap resamples. Firth logistic regression and sensitivity analyses were used to assess robustness.
resultsThe numbers of patients with ISUP grade groups 1-5 were 26, 10, 9, 40, and 86, respectively; 135 patients (78.9%) had grade group ≥3. Median PSAD increased from 0.20 ng/mL
conclusionsPSAD was independently associated with the highest biopsy ISUP grade group and provided incremental predictive information beyond PI-RADS and conventional MRI features. PSAD may also aid in identifying patients with low PI-RADS scores but high pathological grade groups, although external validation is required.
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