基于PI-RADSv2.1的双参数磁共振成像联合fPSA/tPSA在鉴别前列腺移行带良恶性结节中的应用

doi:10.3969/j.issn.1006-6233.2025.07.026

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Abstract Objective: To investigate the application value of biparametric magnetic resonance imaging (bp-MRI) based on the Prostate Imaging-Reporting and Data System version 2.1 (PI-RADSv2.1) combined with free prostate-specific antigen (PSA)/total PSA (fPSA/tPSA) in identifying benign and malignant nodules in prostate transitional zone. Methods: A total of 107 patients with nodules in prostate transitional zone who were admitted to the hospital from March 2021 to October 2024 were reviewed. According to the results of pathological diagnosis, the patients were divided into prostate cancer (PCa) group (37 cases) and prostate hyperplasia group (70 cases). fPSA/tPSA, PI-RADSv2.1 scores, general and clinical data were compared between the two groups. Binary logistic regression analysis was used to screen influencing factors. The value of fPSA/tPSA, PI-RADSv2.1 score, and combination of the two in diagnosing benign and malignant nodules in prostate transitional zone was analyzed using the receiver operating characteristic (ROC) curves. Results: There was a statistically significant difference in the grading of PI-RADSv2.1 scores between the two groups (P<0.05). fPSA and tPSA levels of the PCa group were higher than those of the BPH group (P<0.05). However, the proportions of patients with age, hypertension and diabetes in the two groups were similar (P>0.05). Binary logistic regression analysis showed that fPSA/tPSA and PI-RADSv2.1 score were influencing factors of nodules in prostate transitional zone (P<0.05). When fPSA/tPSA and PI-RADSv2.1 score were used to diagnose nodules in prostate transitional zone separately, the area under the curve (AUC) of PI-RADSv2.1 score was the greatest, which was 0.889. With 3 points as the optimal cutoff value, its diagnostic sensitivity and specificity were 86.49% and 88.57%. Based on binary logistic regression analysis, a joint diagnosis model was constructed as follows: logit(p)=-4.327+1.825 * PI-RADSv2.1 score -15.730 * fPSA/tPSA. Hosmer-Lemeshow test showed χ²=7.585, P=0.475. ROC curve showed that the AUC of joint diagnosis was 0.936. With 0.48 as the optimal cutoff value, the sensitivity and specificity of joint diagnosis were 83.78% and 94.29%. Conclusion: Both fPSA/tPSA and PI-RADSv2.1 score can be used for clinical diagnosis of benign and malignant nodules in prostate transitional zone, and diagnostic value of combination of the two is higher.

Key words： Nodule in prostate transitional zone Biparametric magnetic resonance imaging Free prostate-specific antigen Total prostate-specific antigen

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	XIANG Yang
	PENG Chuanyong
	FAN Ju

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XIANG Yang,PENG Chuanyong,FAN Ju. Application of Biparametric Magnetic Resonance Imaging Based on PI-RADSv2.1 Combined with fPSA/tPSA in Identifying Benign and Malignant Nodules in Prostate Transitional Zone[J]. HeBei Med, 2025, 31(7): 1195-1200.

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http://www.hbyxzzs.cn/EN/10.3969/j.issn.1006-6233.2025.07.026 OR http://www.hbyxzzs.cn/EN/Y2025/V31/I7/1195

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