Predictive parameters of prostate carcinoma in negative multiparametric prostate magnetic resonance imaging patients

Abstract

Purpose: The aim of this study was to evaluate the predictors of prostate cancer and clinically significant prostate cancer in prostate-specific antigen grey zone patients with pre-biopsy negative multiparametric prostate magnetic resonance imaging. Materials and Methods: The study analyzed data from 227 patients with negative pre-biopsy multiparametric prostate magnetic resonance imaging results. The detection rates of prostate cancer and clinically significant prostate cancer were calculated, and simple and multiple logistic regression were used to evaluate the predictors of prostate cancer and clinically significant prostate cancer. Results: The overall prostate cancer rate was 18.9% and the clinically significant prostate cancer detection rate was 8.8%. Multivariate analysis revealed that prostate-specific antigen density and abnormal digital rectal examination were the independent predictive factors for prostate carcinoma, while age and abnormal digital rectal examination were the independent predictive factors for clinically significant prostate carcinoma. Prostate-specific antigen density with the cutoff value of > 0,12 ng/ml/cc had the highest area under curve values for clinically significant prostate carcinoma followed by prostate volume with a cutoff value of ≤ 46 cc. Conclusion: Based on the findings of the study, the cutoff value of prostate-specific antigen density of > 0,12 ng/ml/cc and prostate volume ≤ 46 cc might be considered for biopsy decision in grey zone patients regardless of multiparametric prostate magnetic resonance results. However, further studies with larger cohorts are required to validate these recommendations.