Association of Prostate Imaging Reporting and Data System (PI-RADS) Score and Prostate-Specific Antigen Density (PSAD) With Prostate Biopsy Histology Outcomes: A Retrospective Study
The median patient age was 68.7 years, median PSA 8.20 ng/mL, and median PSAD 0.17 ng/mL<sup>2</sup>. About 30.1% of biopsies were benign, with malignancies in 69.9% (34.7% Gleason 6; 65.3% Gleason ≥7). High PSAD (≥0.15 ng/mL<sup>2</sup>) and high PI-RADS (4-5) independently are strongly associated with Gleason ≥7 cancers (OR 5.63 and 95% CI 3.54-8.96; OR 9.14 and 95% CI 4.36-19.19; both p<0.001). PI-RADS 3 demonstrated non-significant trends. Age was an independent predictor of clinically significant cancer but not Gleason 1 disease (OR 1.04; 95% CI 1.01-1.07; p=0.01) Conclusions: Elevated PSAD and high PI-RADS scores are strongly associated with Gleason ≥7 cancers. PSAD also adds discriminatory value in PI-RADS 3 lesions.
Authors
- Kirsty Rhodes (ORCID: https://orcid.org/0000-0002-8568-4979)
- Nazir Ismail (ORCID: https://orcid.org/0000-0001-7696-3776)
- Anurag Agarwal (ORCID: https://orcid.org/0000-0002-0332-2166)
- Vignesh Balasubaramaniam (ORCID: https://orcid.org/0009-0008-6517-1317)
- Kliment Donev (ORCID: https://orcid.org/0009-0000-4221-0936)
- A Kailasa
- Shanmugasigamani Kannan
- A Shoker
- Dennis P. Grogan
Institutions
- Betsi Cadwaladr University Health Board (GB)
- Ysbyty Gwynedd Hospital NHS Trust (GB)
Publication Details
- Journal
- Cureus
- Published
- 2025-11-25
- DOI
- https://doi.org/10.7759/cureus.97745
- Primary Topic
- Prostate Cancer Diagnosis and Treatment
- Type
- article
- Field-Weighted Citation Impact
- 0.00