To investigate the value of PHI density (PHID) in detecting prostate cancer (PCa) compared to PHI in a large prospective cohort, and to assess its diagnostic capacity for clinically significant PCa (Gleason score ≥ 7).
Key Findings:
PHID showed a higher AUC (0.835) than PHI (0.801) for detecting PCa (p = 0.0013).
PHID outperformed PSA (AUC 0.561), PSA density (AUC 0.726), and %fPSA (AUC 0.753) significantly.
In a subgroup analysis of men with PSA values 1-8 ng/ml, PHID was better than PHI, but the AUC difference was only 0.03.
No significant improvement in AUC for PHID was found when comparing low-risk PCa patients (Gleason score < 7) with higher-risk patients.
Interpretation:
PHID demonstrates improved diagnostic performance for PCa detection compared to PHI, particularly in a large cohort, suggesting its potential utility as a biomarker.
Limitations:
The study included a specific patient population from two hospitals, which may limit generalizability. This limitation should be considered when applying findings to broader populations.
Some subgroup analyses did not show significant differences, indicating potential limitations in the diagnostic capacity of PHID in certain contexts, which may affect its clinical utility.
Conclusion:
PHID is a promising biomarker that enhances prostate cancer detection compared to PHI, particularly in larger cohorts. However, further studies are needed to confirm its utility across diverse populations and to address the limitations identified.
