Giuseppe Cutaia, Roberto Cannella, Giuseppe Coraci, Federica Vernuccio, Pierpaolo Purpura, Claudio Leto, Sara Rubino, Mauro Calamia, Elisabetta Raitano, Leonardo Salvaggio, Giuseppe La Tona, Massimo Midiri, Giuseppe Salvaggio
The purpose of this study was to assess whether Immune CompleX Predictive Index (iXip) improves diagnostic accuracy of multiparametric prostate MRI (mpMRI) for clinically significant prostate cancer. This study included 72 patients (mean age: 68±8 years) with suspicion of prostate cancer and available iXip score. mpMRI images were evaluated by two radiologists according to the PI-RADS v2.1. Reference standard was based on fusion biopsy and standard transperineal 12-point biopsy. Diagnostic accuracy of iXip, mpMRI and their combination were calculated. Optimal cutoff of iXip with sensitivity and specificity was identified using the Youden index. Patients with clinically significant prostate cancers had significantly higher iXip values compared to patients without clinically significant prostate cancers (median 0.411 vs 0.273; p=0.026). The AUROC for iXip was 0.795 (95% CI 0.579-1.000, p=0.026). Sensitivity and specificity were 75% and 100% respectively for mpMRI alone, and 100% and 80% respectively for mpMRI combined with iXip > 0.375. The combination of mpMRI with a cutoff value of iXip > 0.375 has a very high sensitivity for the diagnosis of prostate cancer and a moderately high specificity.