- Prostate health index (PHI) density more accurately detected clinically-significant prostate cancer (PCa) than percentage free PSA (%fPSA), PHI, PSA density (PSAD), and the product of %fPSA and prostate volume (%fPSA*volume).
Why this matters
- PHI density is a relatively simple measure.
- On biopsy, 47 (39.8%) had clinically-significant PCa.
- Men with clinically-significant PCa were more frequently African-American (P=.045), had lower %fPSA and prostate volume, and higher PHI, PSAD, and PHI density (all P<.001).
- At a threshold of 0.43, PHI density had sensitivity of 97.9% and specificity of 38.0% for detection of significant disease.
- PHI density <0.43 had negative predictive value of 96.4%.
- PHI density >0.43 conferred 100% sensitivity for Gleason score ≥7 disease.
- Prevalence of clinically-significant PCa increased from 3.6% in men with PHI density <0.43, to 36.7% with PHI density 0.43-1.21, and 80.0% with PHI density >1.21 (P<.001).
- PHI density demonstrated the highest discriminative ability for clinically-significant disease (AUC, 0.84) compared with PSAD (AUC, 0.70), %fPSA (AUC, 0.75), %fPSA*volume (AUC, 0.79), and PHI (AUC, 0.76).
- Prospective study of 118 patients undergoing biopsy within 6 mo of testing.
- Funding: None specified.
- Single-center experience.
- Small cohort.