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. 2025 Mar;66(2):124-129.
doi: 10.4111/icu.20250007.

Diagnostic value of prostate health index in patients with no index lesion on mpMRI or negative previous combined biopsy

Seong Soo Jeon  1 , Wan Song  1 , Minyong Kang  1 , Hyun Hwan Sung  1 , Hwang Gyun Jeon  1 , Byeong Chang Jeong  1 , Seong Il Seo  1 , Jae Hoon Chung  2
Affiliations

Diagnostic value of prostate health index in patients with no index lesion on mpMRI or negative previous combined biopsy

Seong Soo Jeon et al. Investig Clin Urol. 2025 Mar.

Abstract

Purpose: To assess the effectiveness of the prostate health index (PHI) in patients with no index lesions on multiparametric magnetic resonance imaging (mpMRI) or with negative findings on past prostate biopsy if there was an index lesion on mpMRI.

Materials and methods: Patients without an index lesion on MRI or with a negative result on combined biopsy for index lesions were assessed. Patients who underwent transperineal mapping biopsy among those suspected of having prostate cancer (PCa) due to persistently elevated prostate-specific antigen (PSA) levels were analyzed.

Results: Of the 291 patients, 82 (28.2%) were diagnosed with PCa. Sixty-five of 291 patients had negative finding in previous combined biopsy. In total, 226 patients did not have any index lesions. The mean age of the PCa group was 64.33±8.88 years and that of the non-cancer group was 59.88±10.26 years (p<0.001). The PHI was 46.75±28.22 in the PCa group and 37.74±17.37 in the non-cancer group (p=0.001), and the prostate volume was 41.52±15.77 mL in the PCa group and 50.78±23.97 mL in the non-cancer group (p=0.001). In multivariate analysis, age (odds ratio [OR] 1.096, p<0.001), PHI (OR 1.021, p=0.005), and prostate volume (OR 0.954, p<0.001) were identified as significant factors for PCa detection. The optimal cutoff value of the PHI for PCa detection was 44.6 and the PHI density (PHID) was 0.88.

Conclusions: In patients with elevated PSA levels but no index lesions on mpMRI or negative biopsy findings, PHI and PHID demonstrated significant potential for improving PCa detection.

Keywords: Biopsy; Diagnosis; Prostate cancer.

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Conflict of interest statement

Seong Soo Jeon is supported by a grant from the Beckman Coulter Korea Inc., Seoul, Korea, which had no influence on the present work. The other authors have nothing to disclose.

Figures

Fig. 1
Fig. 1. Area under cover (AUC) of prostate health index (PHI) and PHI density (PHID) for prostate cancer. CI, confidence interval.
See this image and copyright information in PMC

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