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Prospective enrollment included 163 patients, with PHI derived from PSA measures and mpMRI reviewed retrospectively. ROC analysis assessed diagnostic performance, and results compared mpMRI alone, PHI alone, and the combination.",{"@graph":69,"@context":123},[70,84,106],{"@type":71,"itemListElement":72},"BreadcrumbList",[73,77,79,82],{"item":74,"name":75,"@type":76,"position":8},"https://docshare.wps.com","Home","ListItem",{"item":78,"name":9,"@type":76,"position":14},"https://docshare.wps.com/document/",{"item":80,"name":35,"@type":76,"position":81},"https://docshare.wps.com/document/healthcare/",3,{"item":83,"name":65,"@type":76,"position":19},"https://docshare.wps.com/document/combining-prostate-health-index-and-multiparametric-magnetic-resonance-imaging-may-better-predict-extraprostatic-extension-after-radical-prostatectomy/436501/",{"url":83,"name":65,"@type":85,"image":86,"author":91,"headline":65,"publisher":94,"fileFormat":97,"inLanguage":63,"description":67,"dateModified":98,"datePublished":99,"encodingFormat":97,"isAccessibleForFree":100,"interactionStatistic":101},"DigitalDocument",{"url":87,"@type":88,"width":89,"height":90},"https://docshare.wps.com/thumbnails/combining-prostate-health-index-and-multiparametric-magnetic-resonance-imaging-may-better-predict-extraprostatic-extension-after-radical-prostatectomy/436501.png","ImageObject",300,407,{"name":92,"@type":93},"WPS_1786070896","Person",{"url":74,"name":95,"@type":96},"DocShare","Organization","application/pdf","2026-10-30","2026-09-29",true,{"@type":102,"interactionType":103,"userInteractionCount":105},"InteractionCounter",{"@type":104},"ViewAction",11,{"@type":107,"mainEntity":108},"FAQPage",[109,115,119],{"name":110,"@type":111,"acceptedAnswer":112},"What is the main purpose of combining PHI and mpMRI in this study?","Question",{"text":113,"@type":114},"To determine whether the combined evaluation of PHI and mpMRI more accurately predicts extraprostatic extension (EPE) before radical prostatectomy than either method alone.","Answer",{"name":116,"@type":111,"acceptedAnswer":117},"How were PHI and mpMRI used to evaluate patients?",{"text":118,"@type":114},"Preoperative blood samples were analyzed for PHI using the formula involving p2PSA, fPSA, and tPSA, and mpMRI was performed and interpreted retrospectively by an experienced uroradiologist.",{"name":120,"@type":111,"acceptedAnswer":121},"What did the ROC results show about predicting EPE?",{"text":122,"@type":114},"The combination of mpMRI and PHI achieved a higher ROC area (0.785) than mpMRI alone (0.717) and PHI alone (0.722), with statistically significant differences reported.","https://schema.org",{"og:url":83,"og:type":125,"og:title":65,"og:site_name":95,"og:description":67},"article",{"robots":127,"canonical":83},"index,follow",{"doc_id":129,"site_id":62},436501,1790718833,{"code":4,"msg":5,"data":132},{"doc_id":129,"user_id":133,"nickname":92,"user_avatar":134,"doc_module":4,"category_id":34,"category_name":35,"doc_title":65,"doc_description":67,"doc_content":135,"file_id":136,"file_url":137,"file_type":138,"file_size":139,"view_count":105,"is_deleted":4,"is_public":8,"is_downloadable":8,"audit_status":8,"page_count":24,"language":140,"language_code":63,"site_id":62,"html_lang":63,"table_of_contents":141,"faqs":142,"seo_title":143,"seo_description":67,"update_tm":144,"read_time":145,"preview_page_count":4},549768072016,"https://ap-avatar.wpscdn.com/davatar_155a257f0dc6eb9ab79c44ca47cae57d","J Chin MedAssoc  \nOriginal article  \nCombining prostate health index and multiparametric magnetic resonance imaging may better predict extraprostatic extension after radical prostatectomy  \nYu-Pin Huanga, Tzu-Ping Lina,b,*, Shu-Huei Shenc,e, Wei-Ming Chengb,d, Tzu-Hao Huanga,b, I-Shen Huanga,b, Yu-Hua Fana,b, Chih-Chieh Lina,b, Eric Y. H. Huanga,b, Hsiao-Jen Chunga,b, Shing-Hwa Lua,b, Yen-Hwa Changa,b, Alex T. L. Lina,b, William J. Huanga,b  \naDepartment of Urology, Taipei Veterans General Hospital, Taipei, Taiwan, ROC; bDepartment of Urology, School of Medicine, College of Medicine, National Yang Ming Chiao Tung University and Shu-Tien Urological Institute, Taipei, Taiwan, ROC; cDepartment of Radiology, Taipei Veterans General Hospital, Taipei, Taiwan, ROC; dDivision of Urology, Department of Surgery, Taipei City Hospital, Zhongxiao Branch, Taipei, Taiwan, ROC; eSchool of Medicine, National Yang Ming Chiao Tung University, Taipei, Taiwan, ROC  \nAbstract  \nBackground: In patients undergoing radical prostatectomy (RP) for prostate cancer (PCa), preoperative prediction of extraprostatic extension (EPE) can facilitate patient selection for nerve-sparing procedures. Since both multiparametric magnetic resonance imaging (mpMRI) and prostate health index (PHI) have shown promise for the diagnosis and prognostication of PCa, we investigated whether a combination of mpMRI and PHI evaluations can improve the prediction of EPE after RP.  \nMethods: Patients diagnosed with PCa and treated with RP were prospectively enrolled between February 2017 and July 2019. Preoperative blood samples were analyzed for PHI (defined as [p2PSA/fPSA] × √tPSA), and mpMRI examinations were performed and interpreted by a single experienced uroradiologist retrospectively. The area under the receiver operating characteristic curve (ROC) was used to determine the performance of mpMRI, PHI, and their combination in predicting EPE after RP.  \nResults: A total of 163 patients were included for analysis. The pathological T stage was T3a or more in 59.5% . Overall staging accuracy of mpMRI for EPE was 72.4%(sensitivity and specificity: 73.2% and 71.2%, respectively) . The area under the ROC of the combination of mpMRI and PHI in predicting EPE (0 .785) was higher than those of mpMRI alone (0 .717; p = 0 .0007) and PHI alone (0 .722; p = 0 .0236) . mpMRI showed false-negative non-EPE results in 26 patients (16%), and a PHI threshold of >40 could avoid undiagnosed EPE before RP in 21 of these 26 patients.  \nConclusion: The combination of PHI and mpMRI may better predict the EPE preoperatively, facilitating preoperative counseling and tailoring the need for nerve-sparing RP.  \nKeywords: Extraprostatic extension; Multiparametric magnetic resonance image; Prostate health index; Prostate-specific antigen; Radical prostatectomy  \n1. INTRODUCTION  \nThe incidence of and mortality rate associated with prostate cancer (PCa) have been increasing worldwide over the past decades,1,2 making PCa a major health concern worldwide. The diagnosis rate of localized or early-stage PCa has been increasing  \n*Address correspondence. Dr. Tzu-Ping Lin, Department of Urology, Taipei Veterans General Hospital, 201, Section 2, Shi-Pai Road, Taipei 112, Taiwan, ROC. E-mail address: [tplin63@gmail.com](tplin63@gmail.com) (T.-P. Lin).  \nConflicts of interest: Dr. William J. Huang, an editorial board member at Journal of the Chinese Medical Association, had no role in the peer review process of or decision to publish this article. The other authors declare that they have no conflicts of interest related to the subject matter or materials discussed in this article.  \nJournal of Chinese Medical Association. (2023) 86: 52-56.  \nReceived April 19, 2022; accepted September 15, 2022.  \ndoi: 10. 1097/JCMA.0000000000000845.  \nCopyright © 2022, the Chinese Medical Association. This is an open access article under the CC BY-NC-ND license ([http://creativecommons.org/licenses/](http://creativecommons.org/licen","cbCaie3lgDH98FMC","https://ap.wps.com/l/cbCaie3lgDH98FMC","pdf",422450,"English","# Abstract\n## Background\n## Methods\n## Results\n## Conclusion\n# Introduction","[{\"question\":\"What is the main purpose of combining PHI and mpMRI in this study?\",\"answer\":\"To determine whether the combined evaluation of PHI and mpMRI more accurately predicts extraprostatic extension (EPE) before radical prostatectomy than either method alone.\"},{\"question\":\"How were PHI and mpMRI used to evaluate patients?\",\"answer\":\"Preoperative blood samples were analyzed for PHI using the formula involving p2PSA, fPSA, and tPSA, and mpMRI was performed and interpreted retrospectively by an experienced uroradiologist.\"},{\"question\":\"What did the ROC results show about predicting EPE?\",\"answer\":\"The combination of mpMRI and PHI achieved a higher ROC area (0.785) than mpMRI alone (0.717) and PHI alone (0.722), with statistically significant differences reported.\"}]","Combining prostate health index and multiparametric magnetic resonance imaging may better predict extraprostatic extension after radical prostatectomy | PDF",1790678215,13]