Original Articles
Vol. 16 (2021)

DIAGNOSTIC ACCURACY OF IXIP INDEX AND PROSTATE MRI IN THE DIAGNOSIS OF PROSTATE CANCER: PRELIMINARY RESULTS ON A COMBINED APPROACH

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Published: October 15 2025
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Giuseppe Cutaia
cutaiagiuseppe7@gmail.com
Section of Radiology, Department of Biomedicine, Neuroscience and Advanced Diagnostics (Bi.N.D.), University of Palermo. Via del Vespro 129, 90127 Palermo, Italy; Department of Health Promotion, Mother and Child Care. Internal Medicine and Medical Specialties (PROMISE), University of Palermo, Palermo, Italy, Italy.
Roberto Cannella
Section of Radiology, Department of Biomedicine, Neuroscience and Advanced Diagnostics (Bi.N.D.), University of Palermo. Via del Vespro 129, 90127 Palermo, Italy; Department of Health Promotion, Mother and Child Care. Internal Medicine and Medical Specialties (PROMISE), University of Palermo, Palermo, Italy, Italy.
Giuseppe Coraci
Fondazione HSR G. Giglio, Urology Unit, Cefalù, Italy, Italy.
Pierpaolo Purpura
Fondazione HSR G. Giglio, Radiodiagnostic Unit, Cefalù, Italy, Italy.
Federica Vernuccio
Section of Radiology, Department Biomedicine, Neuroscience of and Advanced Diagnostics (Bi.N.D.), University of Palermo, Via del Vespro 129, 90127, Palermo, Italy, Italy.
Claudio Leto
Section of Radiology, Department of Biomedicine, Neuroscience and Advanced Diagnostics (Bi.N.D.), University of Palermo. Via del 129, 90127 Vespro, Palermo, Italy, Italy.
Sara Rubino
Section of Radiology, Department of Biomedicine, Neuroscience and Advanced Diagnostics (Bi.N.D.), University of Palermo. Via del 129, 90127 Vespro, Palermo, Italy, Italy.
Mauro Calamia
Section of Radiology, Department of Biomedicine, Neuroscience and Advanced Diagnostics (Bi.N.D.), University of Palermo, Via del Vespro 129, 90127 Palermo, Italy, Italy.
Elisabetta Raitano
Section of Radiology, Department of Biomedicine, Neuroscience and Advanced Diagnostics (Bi.N.D.), University of Palermo, Via del Vespro 129, 90127 Palermo, Italy, Italy.
Leonardo Salvaggio
Section of Radiology, Department of Biomedicine, Neuroscience and Advanced Diagnostics (Bi.N.D.), University of Palermo, Via del Vespro 129, 90127 Palermo, Italy, Italy.
Giuseppe La Tona
Section of Radiology, Department of Biomedicine, Neuroscience and Advanced Diagnostics (Bi.N.D.), University of Palermo, Via del Vespro 129, 90127 Palermo, Italy, Italy.
Massimo Midiri
Section of Radiology, Department of Biomedicine, Neuroscience and Advanced Diagnostics (Bi.N.D.), University of Palermo, Via del Vespro 129, 90127 Palermo, Italy, Italy.
Giuseppe Salvaggio
Section of Radiology, Department of Biomedicine, Neuroscience and Advanced Diagnostics (Bi.N.D.), University of Palermo, Via del Vespro 129, 90127 Palermo, Italy, Italy.
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.

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DIAGNOSTIC ACCURACY OF IXIP INDEX AND PROSTATE MRI IN THE DIAGNOSIS OF PROSTATE CANCER: PRELIMINARY RESULTS ON A COMBINED APPROACH. (2025). EuroMediterranean Biomedical Journal, 16. https://doi.org/10.3269/ebmj.2021.108
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