Enhancing the Diagnostic Performance of Prostate Cancer with PSA in the Range of 4–10 ng/mL Using Amide Proton Transfer Texture Features

Motivation: The diagnosis of benign and malignant prostate lesions with t-PSA levels between 4 and 10 ng/mL presents challenges for clinical practice. Goal(s): To identify if amide proton transfer texture features can enhance the accuracy of prostate cancer(PCa) screening with t-PSA in 4-10 ng/mL. Approach: Amide proton transfer,Texture analysis,Logistic regression, ICCs, Spearman correlation, Mann-Whitney U test and the Delong test Results: The combination of PI-RADS V2.1 with MTRasym (3.5 ppm) and APTw-based texture features significantly improves the screening capability for PCa with a t-PSA in 4-10 ng/mL. MTRasym (3.5 ppm), APTw-based texture features, and PI-RADS V2.1 are independently associated with PCa. Impact: MTRasym (3.5 ppm) and APTw textural features might improve the mpMRI screening diagnostic performance of PCa, which could reduce unnecessary biopsies.