Photo Credit: Mr. Suphachai Praserdumrongchai

The following is a summary of “Clinical-imaging metrics for the diagnosis of prostate cancer in PI-RADS 3 lesions,” published in the July 2024 issue of Urology by Kang et al.

Investigating the feasibility and efficacy of clinical-imaging metrics for diagnosing prostate cancer (PCa) and clinically significant prostate cancer (csPCa) within lesions categorized as prostate imaging-reporting and data system (PI-RADS) category 3 was the focus of this retrospective analysis.

A total of 202 patients with PI-RADS 3 lesions were retrospectively analyzed and categorized into benign, non-csPCa, and csPCa groups. Clinical-imaging metrics including apparent diffusion coefficient (ADC), T2-weighted imaging signal intensity (T2WISI), coefficient of variation of ADC and T2WISI, prostate-specific antigen density (PSAD), ADC density (ADCD), prostate-specific antigen lesion volume density (PSAVD), and ADC lesion volume density (ADCVD) were measured and calculated. Univariate and multivariate analyses identified risk factors associated with PCa and csPCa. Receiver operating characteristic curve (ROC) analysis and decision curve analysis were performed to assess independent risk factors’ diagnostic efficacy and net benefit.

Among the cohort, 133 patients had benign disease, 25 had non-csPCa, and 44 had csPCa. Age, PSA, and lesion location did not significantly differ (P > 0.05) among the groups. T2WISI and ADC coefficient of variation (ADCcv) were identified as independent risk factors for PCa within PI-RADS 3 lesions, achieving an area under the curve (AUC) of 0.68. ADC emerged as an independent risk factor for csPCa in PI-RADS 3 lesions, with an AUC of 0.65. Decision curve analysis demonstrated a net benefit for patients across various probability thresholds.

T2WISI, ADCcv, and ADC showed promising potential in improving the diagnosis of PCa and csPCa within PI-RADS 3 lesions. These findings underscore the utility of integrating clinical imaging metrics to enhance diagnostic accuracy and guide clinical decision-making in patients with ambiguous imaging findings.

Source: sciencedirect.com/science/article/abs/pii/S1078143924005258