In this subsection, we have verified the Pc detection algorithm on diurnal variations of Pc3 occurrence rate.
Widespread use of prostate-specific antigen (PSA) testing for prostate cancer (PC) detection has led to extensive overdiagnosis and overtreatment.
In this paper we give an overview of the mpMRI technique, its performance in PC detection, and in the assessment of tumour aggressiveness and size.
Subgroup analysis revealed especially an improvement in PC detection in men with previous negative biopsy than in biopsy-naïve men (relative sensitivity of 1.54 vs 1.10 for clinically significant PC and 1.62 vs 0.97 for any PC) [107].
Tonttila et al. [108] however recently performed a randomized prospective blinded controlled trial and concluded that adding mpMRI before biopsy did not improve PC detection rates as compared to TRUS biopsy alone in patients with elevated PSA.
PC detection rates on mpMRI, thus,depend highly on the Gleason grade and size of the tumour, ranging from 21-29 % for <0.5 ml tumours with Gleason 6 to 100%% for tumours >2 ml with Gleason ≥8 [64].
The present retrospective study was designed to investigate the value of transition zone (TZ) biopsies for prostate cancer (PC) detection rate in a combined contrast enhanced color Doppler targeted (CECD) and gray-scale systematic biopsy (SB) approach.
MpMRI-guided biopsy has a significantly higher PC detection rate and positive core rate as compared to standard random TRUS-guided biopsy or extended systematic biopsies, especially in patients with previous negative biopsy [89, 106, 107, 110, 111, 112, 113, 114].
Ideally, to avoid bias, this set of markers should be uncorrelated with the set of markers used for PC detection, and not associated with the disease risk.
Among the numerous biomarkers that have been tested for PC detection, serum CA19-9 is the most commonly used.
