Effectiveness of PI-RADS of MRI combined with ¹⁸F-PSMA PET/CT in diagnosis of prostate cancer

Background Prostate cancer has become the second most common malignant tumor in older men, and its early screening is particularly important.

Objective  To explore the value of prostate imaging reporting and data system (PI-RADS) score based on magnetic resonance imaging (MRI) combined with molecular prostate specific membrane antigen(miPSMA) score based on 18-fluoro-labeled prostate specific membrane antigen PET/CT imaging (¹⁸F-PSMA PET/CT) in the diagnosis of prostate cancer.

Methods  The MRI of the prostate and ¹⁸F-PSMA PET/CT in 124 cases who underwent prostate puncture biopsy or surgery in Chinese PLA General Hospital from January 2019 to November 2022 were retrospective analyzed by two radiologists and two nuclear medicine physicians independently for PI-RADS score and miPSMA score. According to the pathological results, the efficacy of three different diagnostic models including PI-RADS ≥3, miPSMA ≥2, and PI-RADS ≥3 combined with miPSMA ≥2 were evaluated, respectively.

Results  The mean age of the 124 subjects was 77.74 ± 10.30 years and 100 subjects were diagnosed with prostate cancer. The sensitivity of diagnosing prostate cancer using PI-RADS ≥3, miPSMA ≥2, and PI-RADS ≥3 combined with miPSMA ≥2 as criteria was 99.0%, 96.0%, and 95.0%, the specificity was 33. 3%, 83.3% and 83.3%, the accuracy was 86.3%, 93.5% and 92.7%, and area under the curve (AUC) was 0.662 (0.523-0.800), 0.897 (0.806-0.987) and 0.892 (0.801-0.983), respectively.

Conclusion  PI-RADS≥3 combined with miPSMA ≥2 has a high diagnostic efficacy and can be used as imaging diagnostic model for prostate cancer in clinical practice.