title: MRI-based prostate volume-adjusted prostate-specific antigen in the diagnosis of prostate cancer.
abstract: OBJECTIVE
  To determine whether prostate-specific antigen (PSA) levels adjusted by prostate and zonal volumes estimated from magnetic resonance imaging (MRI) improve the diagnosis of prostate cancer (PCa) and differentiation between patients who harbor high-Gleason-sum PCa and those without PCa.
  
  
  METHODS
  This retrospective study was Health Insurance Portability and Accountability Act (HIPAA)-compliant and approved by the Institutional Review Board of participating medical institutions. T2 -weighted MR images were acquired for 61 PCa patients and 100 patients with elevated PSA but without PCa. Computer methods were used to segment prostate and zonal structures and to estimate the total prostate and central-gland (CG) volumes, which were then used to calculate CG volume fraction, PSA density, and PSA density adjusted by CG volume. These quantities were used to differentiate patients with and without PCa. Area under the receiver operating characteristic curve (AUC) was used as the figure of merit.
  
  
  RESULTS
  The total prostate and CG volumes, CG volume fraction, and PSA density adjusted by the total prostate and CG volumes were statistically significantly different between patients with PCa and patients without PCa (P ≤ 0.007). AUC values for the total prostate and CG volumes, and PSA density adjusted by CG volume, were 0.68 ± 0.04, 0.68 ± 0.04, and 0.66 ± 0.04, respectively, and were significantly better than that of PSA (P < 0.02), for differentiation of PCa patients from patients without PCa.
  
  
  CONCLUSIONS
  The total prostate and CG volumes estimated from T2 -weighted MR images and PSA density adjusted by these volumes can improve the effectiveness of PSA for the diagnosis of PCa and differentiation of high-Gleason-sum PCa patients from patients without PCa.
authors.affiliation: School of Electronic and Information Engineering, Beijing Jiaotong University, Beijing, China.|Department of Radiology, University of Chicago, Chicago, Illinois, USA.
authors.forename: Yahui
authors.initials: Y
authors.lastname: Peng
authors.affiliation: Department of Radiology, University of North Carolina, Chapel Hill, North Carolina, USA.
authors.forename: Dinggang
authors.initials: D
authors.lastname: Shen
authors.affiliation: Department of Radiology, University of North Carolina, Chapel Hill, North Carolina, USA.
authors.forename: Shu
authors.initials: S
authors.lastname: Liao
authors.affiliation: Molecular Imaging Program, National Cancer Institute, National Institutes of Health, Bethesda, Maryland, USA.
authors.forename: Baris
authors.initials: B
authors.lastname: Turkbey
authors.affiliation: Urologic Oncology Branch, National Cancer Institute, National Institutes of Health, Bethesda, Maryland, USA.
authors.forename: Soroush
authors.initials: S
authors.lastname: Rais-Bahrami
authors.affiliation: Urologic Oncology Branch, National Cancer Institute, National Institutes of Health, Bethesda, Maryland, USA.
authors.forename: Bradford
authors.initials: B
authors.lastname: Wood
authors.affiliation: Department of Radiology, University of Chicago, Chicago, Illinois, USA.
authors.forename: Ibrahim
authors.initials: I
authors.lastname: Karademir
authors.affiliation: Department of Pathology, University of Chicago, Illinois, USA.
authors.forename: Tatjana
authors.initials: T
authors.lastname: Antic
authors.affiliation: Department of Radiology, University of Chicago, Chicago, Illinois, USA.
authors.forename: Ambereen
authors.initials: A
authors.lastname: Yousef
authors.affiliation: Department of Radiology, University of Chicago, Chicago, Illinois, USA.
authors.forename: Yulei
authors.initials: Y
authors.lastname: Jiang
authors.affiliation: Urologic Oncology Branch, National Cancer Institute, National Institutes of Health, Bethesda, Maryland, USA.
authors.forename: Peter A
authors.initials: PA
authors.lastname: Pinto
authors.affiliation: Diagnostic Radiology Department, National Institutes of Health, Bethesda, Maryland, USA.
authors.forename: Peter L
authors.initials: PL
authors.lastname: Choyke
authors.affiliation: Department of Radiology, University of Chicago, Chicago, Illinois, USA.
authors.forename: Aytekin
authors.initials: A
authors.lastname: Oto
mesh_terms: D000368:Aged; D014408:Biomarkers, Tumor / Q000097:blood*; D003936:Diagnosis, Computer-Assisted / Q000379:methods*; D006801:Humans; D007089:Image Enhancement / Q000379:methods; D007090:Image Interpretation, Computer-Assisted / Q000379:methods; D021621:Imaging, Three-Dimensional / Q000379:methods; D008279:Magnetic Resonance Imaging / Q000379:methods*; D008297:Male; D008875:Middle Aged; D009929:Organ Size; D017430:Prostate-Specific Antigen / Q000097:blood*; D011471:Prostatic Neoplasms / Q000097:blood* / Q000175:diagnosis*; D015203:Reproducibility of Results; D012680:Sensitivity and Specificity
chemical_list: D014408:Biomarkers, Tumor; D017430:Prostate-Specific Antigen
keywords: image segmentation; magnetic resonance imaging; prostate cancer; prostate volume; prostate-specific antigen; zonal structure