Prostate Health Index density improves detection of clinically significant prostate cancer

Abstract

Based on the present prospective single-centre experience, PHI density could be used to avoid 38% of unnecessary biopsies, while failing to detect only 2% of clinically significant cancers.

Use of the Prostate Health Index and Density in 3 Outpatient Centers to Avoid Unnecessary Prostate Biopsies

“…Since then, only 2 more studies on PHID were published [12,13]. In a study in 118 patients in 2017, Tosoian et al [13] determined thus far the highest value for PHID in the ROC analysis with an AUC of 0.84 and a PHID median of 1.21 for clinically significant PCa. For PHI and t-PSA, AUCs of 0.76 and 0.52, respectively, were determined.…”

Whom to Biopsy

“…One study evaluated phi density in 118 men with PSA greater than 2 ng/mL that were undergoing prostate biopsy. 26 For the detection of clinically significant PCa, phi density demonstrated a higher AUC than PSA, PSA density, %fPSA, the product of %fPSA and prostate volume, and phi. Other studies have evaluated phi in conjunction with multiparametric MRI (mpMRI), with one finding a negative predictive value of 97% for clinically significant PCa in men undergoing repeat biopsy.…”

Prostate cancer biomarkers: new scenarios in the multi‐parametric magnetic resonance imaging era

“…Tosoian et al. in the present study explored the utility of prostate health index (PHI) density for detection of clinically significant prostate cancer in a contemporary cohort of men presenting for diagnostic evaluation of prostate cancer. Very interestingly the authors hypothesised that, similar to PSA density, PHI density could further improve upon the discriminative ability of PHI to detect prostate cancer.…”

“…They showed, albeit in a small sample size, that PHI density could further improve upon the discriminative ability of PHI and appears to be superior to PSA and other PSA derivatives for the identification of clinically significant disease .…”

“…Tosoian et al. report that PHI density could be used to avoid 38% of unnecessary biopsies, while failing to detect only 2% of clinically significant cancers. If the specificity of the PHI density score is higher than that of PHI or PSA, then fewer patients will undergo unnecessary MRI, thus increasing the efficiency of the diagnostic pipeline for prostate cancer.…”