Correlation between Prostate-specific Antigen Density and Multiparametric Magnetic Resonance Imaging with Gleason’s Score in Management of Carcinoma of the Prostate in a Nigerian Tertiary Teaching Hospital

Abstract Background: Prostate cancer (Pca) is a major public health concern. The clinical behavior of Pca ranges from an indolent course to a very aggressive disease state. It is therefore important to identify clinically significant Pca requiring treatment. Aim: The study aims to assess the correlation between prostate-specific antigen density (PSAD), Prostate Imaging Reporting and Data Scoring System (PI-RADS) using PI-RADS v2.1, and Gleason score in the management of Pca. Methods: It is a prospective cross-sectional study involving 91 patients being evaluated for Pca with elevated prostate-specific antigen (PSA) >4 ng/ml and/or abnormal digital rectal examination, who had multiparametric magnetic resonance imaging (mpMRI) using PI-RADS v2.1. All these with PI-RADS score >3 had 12 core TRUS-guided prostate biopsy and lesion-directed biopsy. Histopathological diagnosis was made, and Gleason’s score was determined. Data analyzed using SPSS v 25.0. Correlation between PSAD, PI-RADS, and Gleason score was determined using Spearman’s correlation coefficient. Factors predictive of PSAD, PIRADS, and Gleason were determined using Fisher’s exact or independent Chi-square. Results: The mean age of the study population was 67.3 ± 8.5 years. The median PSA was 18 ng/ml, median prostate volume of 59.2 ml, and PSAD of 0.31. Twenty-one (23.1%), 39 (42.8%), and 31 (34.1%) patients had PI-RADS 3, 4, and 5, respectively, on mpMRI. Majority of patients, 22 (31%) of participants had Gleason score of 6. There was a statistically significant correlation between PIRADS and Gleason score ( r = 0.249; P = 0.036). There was a correlation between PSAD and Gleason score ( r = 0.101, P = 0.401) though not statistically significant. Conclusion: There was a statistically significant correlation between PI-RADS and Gleason’s score.