Correlation Between PSA Density and Multiparametric Prostate MRI in the Diagnosis of Prostate Cancer

Objective: In the diagnosis of prostate cancer, only digital rectal examination and prostate -specific antigen (PSA) testing cause unnecessary prostate biopsies, excessive cost, and treatment burden. Therefore, PSA density (PSAD) and multiparametric magnetic resonance imaging (mp-MRI) of the prostate are becoming common. In this study, we aimed to investigate the predictiveness of PSAD and mp-MRI of the prostate in the diagnosis of prostate cancer, which are non-invasive diagnostic methods. Materials and Methods: The files of 193 patients who applied to the urology outpatient clinic for approximately 5 years were reviewed and evaluated retrospectively. Serum PSAD values and prostate imaging reporting and data system (PIRADS) scores were recorded. Prostate biopsies were performed. The cut-off value for PSAD was 0.15 ng/mL/cc. Patients with <0.15 were divided into group 1, and those with >= 0.15 were divided into group 2. Patients with a PIRADS score of 3 were divided into the suspicious group, and patients with a PIRADS score of 4 or 5 were divided into the risky group. Results: Prostate volume, PSA, and PSAD were significantly different between the benign and malignant groups. PSAD was positively correlated with the PIRADS score. Of the 123 patients with a PIRADS score of 3, 82.9% had benign prostatic enlargement (BPE) and 17.1% had prostate cancer. Of the 70 patients with a PIRADS score of 4 or 5, 45.7% had BPE and 54.3% had prostate cancer (p<0.001). Clinically significant prostate cancer rates were significantly different between the PSA score groups and were also different for PIRADS (p<0.001). The sensitivity and specificity of PSAD in the diagnosis of prostate cancer were 67.8% and 64.9%, respectively. The sensitivity and specificity of the PIRADS score in the diagnosis of prostate cancer were 64.4% and 76.1%, respectively. When these two parameters were used in combination, the specificity was 87.3% and the sensitivity was 81.4% in the presence of at least one. Conclusion: According to the data of the study, it was concluded that PSAD and PRIDAS scores are complementary diagnostic methods in the diagnosis of prostate cancer and are indispensable elements in the diagnosis. PSAD and PRIDAS scores are important diagnostic parameters in making the biopsy decision in the diagnosis of prostate cancer and help to prevent unnecessary prostate biopsies.