Multi-parameter MRI In The Diagnosis Of PSA Gray Area Prostate Cancer Patients

Objective(s):This study reviewed the results of multi-parametric MRI in patients with prostate-specific antigen(PSA)at 4-10 ng/ml(grey area),and then analyzed the agreement between them and the pathological results of transrectal ultrasound-guided prostate biopsy.To study the diagnostic value of multi-parameter MRI in patients with PSA gray area prostate cancer(PCa)of different ages,aiming to improve the early diagnosis efficiency of prostate cancer.Methods:This study selected 118 patients with urology from the Second Affiliated Hospital of Kunming Medical University from January 2017 to December 2018,who had a PSA of 4-10 ng/ml and complete clinical data.All patients underwent needle biopsy.3.0T multi-parametric MRI was performed and evaluated by PI-RADS v2 score.The pathological results of transrectal guided prostate biopsy were taken as the standard,and the diagnostic value of 3.0T multi-parametric MRI in prostate cancer was investigated by sensitivity,specificity,positive predictive value,negative predictive value,Yoden index and receiver operating characteristic curve.Results:The mean age of the patients was 69.6±9.29 years,and the mean PSA was 7.19±1.78 ng/ml.Of the total of 118 patients,44 were diagnosed with prostate cancer by multiparametric MRI.The rate of detection for prostate cancer was approximately 37.3%,sensitivity was 76.19%,specificity was 84.21%,and the Yoden index was 0.604,the positive predictive value was 72.73%,and the negative predictive value was 86.49%.After transrectal ultrasound-guided prostate biopsy,42 patients were diagnosed with prostate cancer after pathological examination.The detection rate was 35.6%.The consistency of multi-parametric MRI findings and clinical pathological findings was good,Kappa value=0.5.98,p<0.001.For patients of different ages(51-60 years old,61-70 years old,71-80 years old,81-90 years old),the coincidence rates were 76.2%,80.0%,82.1%,89.5%.Kappa consistency test analyzed the consistency of multi-parametric MRI findings and clinical pathology results in all age groups.The Kappa values were 0.400,0.540,0.632 and 0.789,respectively,and the corresponding p values were 0.049,<0.001,<0.001 and<0.001.The results showed that the results of multi-parametric MRI and clinical pathology were consistent.The ROC curve was used to analyze the diagnostic ability of the overall sample and multi-parametric MRI in all age groups.The results showed that in the 51-60 age group,the diagnostic power of MRI was low,AUC=0.757,but p=0.117>0.05.In the 61-90 year old group,with the increase of the patient's age,multi-parametric MRI diagnosis The efficacy was gradually improved.The AUC was 0.770 in the 61-70 age group,0.813 in the 71-80 year old group,and 0.894,in the 81-90 year old group.The p values were 0.002,0.005,and 0.004,respectively.Conclusion(s):1,Patients with PSA in the gray area,the sensitivity of multi-parametric MRI diagnosis of prostate cancer is about 76.19%,the specificity is about 84.21%,and the coincidence rate with puncture is about 81.36%,2.Patients of different ages(51-60 years old,61-70 years old,71-80 years old 81-90 years old),with the increase of age,the compliance rate of prostate multi-parameter MRI results and puncture pathological results is getting higher and higher.And its AUC value gradually increases,and the diagnostic power of nuclear magnetic resonance is gradually improved.3.Multi-parameter MRI can help improve the early diagnosis efficiency of prostate cancer and reduce excessive puncture,which has certain clinical application value.