The Diagnostic Value of PI-RADS v2.1 in Patients with a History of Transurethral Resection of the Prostate (TURP)

• Published in: Current Oncology
• Main Authors: Jiazhou Liu, Shihang Pan, Liang Dong, Guangyu Wu, Jiayi Wang, Yan Wang, Hongyang Qian, Baijun Dong, Jiahua Pan, Yinjie Zhu, Wei Xue
• Format: Article
• Language: English
• Published: MDPI AG 2022-09-01
• Subjects: prostate cancer; transurethral resection of the prostate; multiparametric magnetic resonance imaging; prostate-specific antigen
• Online Access: https://www.mdpi.com/1718-7729/29/9/502
• ISSN: 1198-0052; 1718-7729

To explore the diagnostic value of the Prostate Imaging–Reporting and Data System version 2.1 (PI-RADS v2.1) for clinically significant prostate cancer (CSPCa) in patients with a history of transurethral resection of the prostate (TURP), we conducted a retrospective study of 102 patients who underwent systematic prostate biopsies with TURP history. ROC analyses and logistic regression analyses were performed to demonstrate the diagnostic value of PI-RADS v2.1 and other clinical characteristics, including PSA and free/total PSA (F/T PSA). Of 102 patients, 43 were diagnosed with CSPCa. In ROC analysis, PSA, F/T PSA, and PI-RADS v2.1 demonstrated significant diagnostic value in detecting CSPCa in our cohort (AUC 0.710 (95%CI 0.608–0.812), AUC 0.768 (95%CI 0.676–0.860), AUC 0.777 (95%CI 0.688–0.867), respectively). Further, PI-RADS v2.1 scores of the peripheral and transitional zones were analyzed separately. In ROC analysis, PI-RADS v2.1 remained valuable in identifying peripheral-zone CSPCa (AUC 0.780 (95%CI 0.665–0.854; <i>p</i> < 0.001)) while having limited capability in distinguishing transitional zone lesions (AUC 0.533 (95%CI 0.410–0.557; <i>p</i> = 0.594)). PSA and F/T PSA retain significant diagnostic value for CSPCa in patients with TURP history. PI-RADS v2.1 is reliable for detecting peripheral-zone CSPCa but has limited diagnostic value when assessing transitional zone lesions.