Prostate cancer: PHI density testing could avoid 38% of unnecessary biopsies
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Prostate health index (PHI) density more accurately detected clinically-significant prostate cancer (PCa) than percentage free PSA (%fPSA), PHI, PSA density (PSAD), and the product of %fPSA and prostate volume (%fPSA*volume).
Why this matters
PHI density is a relatively simple measure.
On biopsy, 47 (39.8%) had clinically-significant PCa.
Men with clinically-significant PCa were more frequently African-American (P=.045), had lower %fPSA and prostate volume, and higher PHI, PSAD, and PHI density (all P<.001).
At a threshold of 0.43, PHI density had sensitivity of 97.9% and specificity of 38.0% for detection of significant disease.
PHI density <0.43 had negative predictive value of 96.4%.
PHI density 0.43 conferred 100% sensitivity for Gleason score ≥7 disease.
Prevalence of clinically-significant PCa increased from 3.6% ...