To examine the role of PHI in detecting clinically significant cancer among biopsy-naïve men with a PSA between 10-20 ng/mL.
We studied biopsy-naïve men who underwent PHI testing followed by prostate biopsy after a screening PSA of 10-20 ng/mL. We performed logistic regression analysis to determine associations between clinicopathologic characteristics and the outcome of interest, which was the presence of grade group (GG) ≥2 at biopsy. We examined the combined effect of PHI with MRI findings in cancer detection.
There were 456 patients, of whom 304 (66.7%) had cancer at biopsy. The median PHI of patients with GG ≥2 was significantly higher than those without cancer (76.3 vs. 44.2, P<0.001). Patients with PHI ≥55.0 demonstrated an 8.9 times (P=0.001) increased odds of GG ≥2 disease than patients with PHI 0-26.9. Higher PI-RADS scores on MRI were associated with a significant increase in cancer detection. Cancer was diagnosed in zero patients with PHI <36 and PI-RADS 1-2 and in 1 of 22 patients (4.5%) with PHI <36 and PI-RADS 1-3.
PHI was associated with the detection of cancer among biopsy-naïve men with a screening PSA of 10-20 ng/mL. The combined use of PHI and MRI can help triage patients in lower resource settings and reduce unnecessary biopsies.
Urology. 2025 Dec 18 [Epub ahead of print]
Helen Holzbeierlein, Nalin Kundu, Nicole Handa, Jae Woong Jang, Eric V Li, Clayton Neill, Sai Kumar, William J Catalona, Hiten D Patel, Edward M Schaeffer, Ashley E Ross, Ridwan Alam
Department of Urology, Northwestern University Feinberg School of Medicine, Chicago, IL., Department of Urology, Northwestern University Feinberg School of Medicine, Chicago, IL. Electronic address: .