Related Experiment Video
Updated: May 26, 2026
A Cognitive Fusion-guided Prostate Biopsy Using Multiparametric Magnetic Resonance Imaging and Transrectal Ultrasound
Published on: March 21, 2025
PCA3 score vs PSA free/total accuracy in prostate cancer diagnosis at repeat saturation biopsy
Pietro Pepe1, Francesco Aragona
1Urology Unit, Cannizzaro Hospital, Via Messina 829, Catania, Italy. piepepe@hotmail.com
Aim:
PCA3 score and PSA free/total (F/T) accuracy in PCa diagnosis at repeat saturation prostate biopsy (SPBx) in patients with PSA between 4 and 10 ng/mL was evaluated.
Materials And Methods:
From October 2009 to September 2011 74 men (median 64 years) with persistent high or increasing PSA values, negative DRE, median PSA values of 8.9 ng/mL and primary negative extended biopsy underwent a SPBx (median 28 cores) for persistent suspicion for PCa.
Results:
PCA3 >20 and >35, PSA F/T ≤15%, ≤20% and ≤25% identified 25, 21, 18, 23 and 26 out 27 cancer, respectively. PCA3 cut-off of 20 demonstrated the best accuracy with an AUC-ROC curve of 0.73.
Conclusion:
The NPV equal to 88.9% suggests to use PCA3 cut-off 20 as an exclusion tool; moreover, PCA3 cut-off of 35 combined with PSA F/T ≤15% allows to spare 32.4% of unnecessary repeat biopsies.
