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Date Published: 24/11/2023
Abstract Views: 139
Views pdf: 78
DOI: https://doi.org/10.51298/vmj.v532i1.7253
Issue
Vol. 532 No. 1 (2023)
Section
Các bài báo
How to Cite
Hoàng, Đình Âu, & Trương, T. T. (2023). EVALUATION OF BIOPSY PERFORMANCE ACCORDING TO CANCER RISK BASED ON PI-RADS V2.1 CLASSIFICATION AND DENSITY PSA FOR THE PROSTATIC TRANSITION ZONE CANCER. Vietnam Medical Journal, 532(1). https://doi.org/10.51298/vmj.v532i1.7253

EVALUATION OF BIOPSY PERFORMANCE ACCORDING TO CANCER RISK BASED ON PI-RADS V2.1 CLASSIFICATION AND DENSITY PSA FOR THE PROSTATIC TRANSITION ZONE CANCER

Đình Âu Hoàng1,, Thị Thanh Trương1
1 Hanoi Medical University Hospital

Main Article Content

Abstract

Purpose: To evaluate the performance of risk-adapted biopsies for prostate cancer based on PI-RADS v2.1 classification and density PSA (PSAd) to reduce not necessary biopsy rates in the diagnosis of prostate transition zone cancer. Material and methods: A cross-sectional descriptive study on 67 male patients with suspected prostate cancer (by clinical examination or high PSA), who underwent prostate magnetic resonance imaging, and had prostate biopsies under transrectal guided ultrasound at Hanoi Medical University Hospital from 10/2021 to 05/2023. The transition zone lesion nodules were classified according to PIRADS v2.1, compared with PSAd risk group included low (≤ 0.10 ng/ml/cm3), intermediate (0.11-0.19 ng/ml/cm3) and high risk (≥  0.20 ng/ml/cm3) and with histopathological results. Result: The mean age of the group of patients in the study was 66.6±3.3, the oldest was 83, the youngest was 42. Mean total PSA concentration (PSAt) was 32.2±28.7ng/ml. Mean volume prostate was 56.9±40.2 cm3. PSAd concentration was 0.73±0.67 ng/ml/cm3. The results of MRI scan and classification according to PI-RADS v2.1 showed that the number of PI-RADS categories 2, 3, 4, 5 nodules was 2, 27, 13, 25. The number of nodules in the low, intermediate and high risk PSAd group were 6, 10, 51, respectively. Biopsy results of these nodules showed that there were 32 cancerous nodules, accounting for 47.8%. The percentage of cancer in the low, intermediate and high risk PSAd group was 0%, 10% and 60.8%, respectively. The combination of the PI-RADS v2.1 classification with the PSAd risk groups showed that all PIRADS categories 2 nodules were noncancerous. All PIRADS categories 3 nodules with low- and intermediate-risk PSAd were noncancerous, only 3/17 PIRADS categories 3 nodules with high-risk PSAd were cancerous (accounting for 17.7%). The number of PIRADS 4 nodules that are cancers with low, intermediate, and high risk PSAd levels was 0/1 (0%), 1/2 (50%) and 5/10 (50%), respectively. All PIRADS categories 5 nodules with low and intermediate-risk PSAd levels were noncancerous, and all PIRADS categories 5 nodules with high-risk PSAd levels were cancerous (100%). Conclusion: With high-risk PSAd levels, 100% of PIRADS categories 5 nodules, 50% of PIRADS categories 4 nodules, and 17.7% PIRADS categories 3 nodules were prostate cancer. Combining PSAd and PIRADS v2.1 can reduce the rate of unnecessary biopsies.

Article Details

Keywords

density PSA, PIRADS v2.1, prostate cancer, transition zone.

References

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