The Prostate Health Index adds predictive value to multi-parametric MRI in detecting significant prostate cancers in a repeat biopsy population.

摘要: Both multi-parametric MRI (mpMRI) and the Prostate Health Index (PHI) have shown promise in predicting a positive biopsy men with suspected prostate cancer. Here we investigated value of combining both tests requiring repeat biopsy. PHI scores were measured undergoing re-biopsy an mpMRI image-guided transperineal approach (n = 279, 94 negative mpMRIs). The was assessed for ability to add all or only significant cancers (Gleason ≥7). In this study adding improved overall cancer prediction (AUC 0.71 0.75) compared mpMRI + PSA alone 0.64 0.69 respectively). At threshold ≥35, PHI + mpMRI demonstrated NPV 0.97 excluding tumours. men, again cancers; AUC 0.76 vs 0.63 (mpMRI + PSA). Using PHI≥35, 1/21 missed 31/73 (42%) potentially spared (NPV 0.97, sensitivity 0.95). Decision curve analysis clinically relevant utility across probabilities 5–30%. summary, adds predictive performance detection has particular determining need mpMRI.