Prostate Specific Antigen Density Normalized by Volume Fractions from Hybrid Multi-dimensional MRI Can Improve Prostate Cancer Diagnosis

Motivation: Prostate specific antigen(PSA) and PSA density (PSAD) are inadequate for PCa screening. Goal(s): Our goal was to combine PSA and MRI measures from Hybrid Multi-dimensional MRI (HM-MRI) to improved PCa diagnosis. Approach: Blood PSA level, prostate volume from mpMRI and tissue volumes (epithelium, lumen) from HM-MRI were used to measure PSAD and PSAD normalized by tissue type (nPSAD). Results: nPSADepithelium is significantly lower and nPSADlumen is significantly higher in cancer patients compared to benign subjects. The diagnostic accuracy of nPSAD to detect subjects with PCa, was significantly higher than conventional PSAD, and further improved by combining nPSAD with tissue composition measures from HM-MRI. Impact: We introduce a new cancer biomarker that combines PSA (blood-based biomarker) with tissue composition from HM-MRI. nPSADlumen and nPSADepithelium improve PCa diagnosis. These new biomarkers may signal effects of PCa on normal prostate and may indicate cancer aggressiveness.