Value Of PI-RADS Version 2 Scores And PSA Levels For The Diagnosis Of Prostate Cancer

Objective: To explore the value of Prostate Imaging Reporting and Data System Version 2(PI-RADS V2)and serum prostate specific antigen(PSA)for the diagnosis of prostate cancer(PCa).Methods: 932 males who underwent multi-parametric MRI(MP-MRI)in our hospital from December 2015 to October 2018 due to patients referred for suspicion of prostate cancer on the basis of increased serum prostate-specific antigen level,abnormal digital rectal examination,or family history of prostate cancer.613 of them were subsequently undergoing MRI-TRUS cognitive registration TRUS targeted Biopsy(COG-TB).245 patients with prostate cancer confirmed by biopsy.In addition,the PSA levels were measured before biopsy.The PI-RADS V2 score was assessed by two imaging physicians with more than 10 years of experience in prostate MRI diagnosis.Spearman correlation analysis was used to analyze the correlations between the PI-RADS V2 scores,PSA levels and prognostic Gleason grade groups of 245 cases.Receiver operating characteristic curve(ROC)analysis was used to analyze the efficacy of PI-RADS V2 and PSA in the diagnosis of clinically significant prostate cancer(s PCa),in addition,ROC was performed to analyze the efficacy of PI-RADS V2 in peripheral zone(PZ)and transitional zone(TZ).Results: The correlation coefficient between the PI-RADS V2 scores and the prognostic Gleason grade groups was r=0.703(p<0.01);the correlation coefficient between the PSA level and the prognostic Gleason grade groups was r=0.446(p<0.01).When using PI-RADS V2 for the diagnosis of clinically s PCa,the area under the curve(AUC)was 0.942,the optimal diagnostic threshold was 4 category,the sensitivity was 0.949,and the specificity was 0.806,P<0.01;When using the PSA level for the diagnosis of clinically s PCa,the AUC was 0.786,the optimal diagnostic threshold was13.23ng/ml,the sensitivity was 0.836,and the specificity was 0.581,P<0.01.In the peripheral zone(PZ),when using PI-RADS V2 for the diagnosis of clinically s PCa,the AUC was 0.924,the optimal diagnostic threshold was 4 category,the sensitivity was0.947,and the specificity was 0.765,P<0.01;In the transitional zone(TZ),when using PI-RADS V2 for the diagnosis of clinically s PCa,the AUC was 0.964,the optimal diagnostic threshold was 4 category,the sensitivity was 0.950,and the specificity was0.857,P<0.01.Conclusions: Significant positive correlation were found between the PI-RADS V2 score and prognostic Gleason grade groups,some extent positive correlation were found between PSA and prognostic Gleason grade groups.PI-RADS V2 performs better than PSA level and is slightly better for diagnosing TZ lesions than PZ lesions.PSA has certain value for the diagnosis of clinically s PCa.