GIÁ TRỊ KẾT HỢP PHÂN LOẠI PI‑RADS TRÊN CỘNG HƯỞNG TỪ ĐA THÔNG SỐ THEO PHIÊN BẢN 2.1 VÀ TỶ TRỌNG PSA TRONG CHẨN ĐOÁN UNG THƯ TUYẾN TIỀN LIỆT

Abstract

Objective: Assessment of clinical effectiveness when combining multiparametric MRI (mpMRI) on patients with prostate biopsy at E Hospital. Subjects and methods: A cross‑sectional descriptive study was conducted on 128 male patients suspected of having PCa, who underwent mpMRI of the prostate followed by transrectal ultrasound‑guided 12‑core prostate biopsy. MRI images were analyzed according to PI‑RADS v2.1 classification, in conjunction with PSA density (PSAD). MRI and PSAD findings were compared with histopathological results of the biopsy. Results: Among 128 patients, 59 (46,1%) were confirmed to have PCa on histopathology. Mean PSAD values were significantly higher in the cancer group compared with the non‑cancer group (p < 0.05). mpMRI demonstrated high sensitivity in detecting PCa, particularly in patients with PI‑RADS 4-5 lesions. When PI‑RADS scores were combined with PSAD (threshold 0.15 ng/mL/cm³), diagnostic specificity and accuracy markedly improved, while reducing unnecessary negative biopsies, especially in patients with PI‑RADS 3 lesions. Conclusions: Both PI‑RADS v2.1 scoring and PSA density individually exhibit high sensitivity and specificity in detecting clinically significant prostate cancer. However, the combination of PI‑RADS v2.1 and PSA density substantially enhances diagnostic accuracy for clinically significant PCa. This combined approach improves risk stratification and optimizes biopsy indications in clinical practice.