Peculiarities of early prostate cancer diagnostics

Kononenko O.A. 1, Havryliuk O.M.1, Voylenko O.A.1, Stakhovsky O.E.1, Pikul M.V. 1, Vitruk Y.V.1, Vukalovich P.S.1, Tymoshenko A.V.1, Harbar R.F.2, Koshel D.O. 1, Grechko B.O1, Vitruk V.Y.2, Stakhovsky E.O.1

Summary. Prostatic multi-parametric magnetic resonance imaging (mpMRI) has been developed to improve the early diagnosis of prostate cancer (PCa). The study aimed to evaluate the efficacy (sensitivity and specificity) of mpMRI in the diagnosis of PCa, by comparing the results of mpMRI (Prostate Imaging Reporting and Data System — PI-RADS) with the results of pathological reports. Materials and methods. Retrospective cross-sectional analysis of 139 men with suspected PCa who underwent multifocal biopsy of the prostate at the National Cancer Institute and the Center for Modern Urology between 2020 and 2022. All patients underwent a systemic biopsy of the prostate gland from 12 points, in combination with a cognitive targeted biopsy (2–3 biopsies in the area of ​​the suspected lesion according to mpMRI data). Results. The average age of the patients was 66±8 (65–67) years; M±SD (95% confidence interval). Median PSA level — 10.6 (6.9; 18.7) ng/ml, Me 25–75%. The sensitivity of mpMRI (proportion of true positive cases of PCa) was 87%; specificity (proportion of false negative cases of PCa) — 27%. The frequency of false positives is 73%. The frequency of false negatives is 13%. Prevalence (proportion of the population with PCa) is 70%. Predictability of a positive result is 74%. The probability of a negative result is 46%. The diagnostic accuracy of the method is 69%. Conclusion. The interpretation of mpMRI within the framework of PI-RADS remains subjective, therefore the clinical data of the patient should be taken into account.

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