Bioelectric Impedance Analysis Test Improves the Detection of Prostate Cancer in Biopsy Candidates: A Multifeature Decision Support System

Riccardo Bartoletti; Alberto Greco; Tommaso Di Vico; Jacopo Durante; Vincenzo Ficarra; Enzo Pasquale Scilingo; Gaetano Valenza

doi:10.3389/fonc.2021.555277

Bioelectric Impedance Analysis Test Improves the Detection of Prostate Cancer in Biopsy Candidates: A Multifeature Decision Support System

Front Oncol. 2021 Aug 27:11:555277. doi: 10.3389/fonc.2021.555277. eCollection 2021.

Authors

Riccardo Bartoletti¹, Alberto Greco², Tommaso Di Vico¹, Jacopo Durante¹, Vincenzo Ficarra³, Enzo Pasquale Scilingo², Gaetano Valenza²

Affiliations

¹ Department of Translational Research and New Technologies in Medicine and Surgery, University of Pisa, Pisa, Italy.
² Department of Information Engineering & Research Center "E. Piaggio", University of Pisa, Pisa, Italy.
³ Department of Human and Paediatric Pathology "Gaetano Barresi" University of Messina, Messina, Italy.

Abstract

Prostate cancer (PCa) gold-standard diagnosis relies on prostate biopsy, which is currently overly recommended since other available noninvasive tools such as prostate-specific antigen (PSA) multiparametric MRI (mMRI) showed low diagnostic accuracy or high costs, respectively. The aim of the study was to determine the accuracy of a novel Bioelectric Impedance Analysis (BIA) test endorectal probe for the selection of patients candidate to prostate biopsy and in particular the clinical value of three different parameters such as resistance (R), reactance (Xc), and phase angle (PA) degree. One-hundred twenty-three consecutive candidates to prostate biopsy and 40 healthy volunteers were enrolled. PSA and PSA density (PSAD) determinations, Digital Rectal Examination (DRE), and the novel BIA test were analyzed in patients and controls. A 16-core prostate biopsy was performed after a mMRI test. The study endpoints were to determine accuracy of BIA test in comparison with PSA, PSAD levels, and mMRI and obtain prostate cancer (PCa) prediction by BIA test. The Mann-Whitney U-test, the Wilkoxon rank test, and the Holm-Bonferroni's method were adopted for statistical analyses, and a computational approach was also applied to differentiate patients with PCa from those with benign disease. Combined PSA, PSAD, DRE, and trans-rectal ultrasound test failed to discern patients with PCa from those with benign disease (62.86% accuracy). mMRI PIRADS ≥3 showed a sensitivity of 83% and a specificity of 59%. The accuracy in discerning PCa increased up to 75% by BIA test (sensitivity 63.33% and specificity 83.75%). The novel finger probe BIA test is a cheap and reliable test that may help to improve clinical multifeature noninvasive diagnosis for PCa and reduce unnecessary biopsies.

Keywords: bioelectric impedance analysis; computational statistical analysis; multiparametric MRI; prostate cancer diagnosis; prostate specific antigen (PSA); prostate-specific antigen density (PSAD).