{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,28]],"date-time":"2026-09-28T07:57:07Z","timestamp":1790582227879,"version":"4.1.0"},"reference-count":21,"publisher":"Wiley","issue":"9","license":[{"start":{"date-parts":[[2026,9,14]],"date-time":"2026-09-14T00:00:00Z","timestamp":1789344000000},"content-version":"vor","delay-in-days":13,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"},{"start":{"date-parts":[[2026,9,1]],"date-time":"2026-09-01T00:00:00Z","timestamp":1788220800000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Int J of Urology"],"published-print":{"date-parts":[[2026,9]]},"abstract":"<jats:title>ABSTRACT<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Objective<\/jats:title>\n                    <jats:p>To evaluate complementary roles of Prostate Health Index (phi) and multiparametric magnetic resonance imaging (mpMRI) in detection of any prostate cancer (PC) and clinically significant PC (csPC) and to investigate likelihood of risk stratification for recommending prostate biopsy in men with prostate\u2010specific antigen (PSA) \u2264\u200910\u2009ng\/mL.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>This exploratory post hoc analysis of the prospective multicenter PROPHET cohort included 108 Japanese men who underwent prebiopsy mpMRI. All MRI findings were retrospectively reviewed by one specialized radiologist and scored using Prostate Imaging Reporting and Data System (PI\u2010RADS) v2.1. csPC was defined as ISUP grade group (GG) of 2\u20135. Then, the likelihood of risk stratification for detecting any PC and csPC based on PI\u2010RADS categories and a significant [\u22122]proPSA\u2010related index assessed by receiver operating characteristic (ROC) analyses was retrospectively investigated.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>PC was detected in 51 of 108 men (47.2%). The ROC analyses revealed the superiority of phi in detecting PC and csPC. Among men with phi \u2264\u200936.0 and PI\u2010RADS 1\u20133, csPC was detected in 2 of 36 men (5.6%), but no GG 3\u20135 cancers were observed. In contrast, in men with phi &gt;\u200936.0, the risk of detecting PC\/csPC was 42.9% (9\/21)\/23.8% (5\/21), 42.9% (3\/7)\/42.9% (3\/7), and 89.3% (25\/28)\/71.4% (20\/28) in PI\u2010RADS 1\u20132, 3, and 4\u20135, respectively.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>phi and mpMRI have complementary roles for biopsy decision\u2010making in men with PSA \u2264\u200910\u2009ng\/mL. Men with phi \u2264\u200936.0 and PI\u2010RADS 1\u20133 may be candidates for biopsy avoidance, whereas phi &gt;\u200936.0 may be a high\u2010risk group recommending prostate biopsy regardless of mpMRI findings.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Registry and Registration No. of the Study\/Trial<\/jats:title>\n                    <jats:p>\n                      This study was registered with the\n                      <jats:bold>UMIN Clinical Trials Registry (UMIN\u2010CTR), registration number<\/jats:bold>\n                      UMIN000047187.\n                    <\/jats:p>\n                  <\/jats:sec>","DOI":"10.1111\/iju.70625","type":"journal-article","created":{"date-parts":[[2026,9,14]],"date-time":"2026-09-14T18:02:26Z","timestamp":1789408946000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["The Complementary Roles of the Prostate Health Index and Multiparametric Magnetic Resonance Imaging in Optimizing the Detection of Clinically Significant Prostate Cancer in Patients With Prostate\u2010Specific Antigen Levels Below 10\u2009Ng\/\n                    <scp>mL<\/scp>"],"prefix":"10.1111","volume":"33","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-8094-4524","authenticated-orcid":false,"given":"Yoshitaka","family":"Sekine","sequence":"first","affiliation":[{"name":"Department of Urology, Graduate School of Medicine Gunma University  Maebashi Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0007-1050-0454","authenticated-orcid":false,"given":"Gaku","family":"Arai","sequence":"additional","affiliation":[{"name":"Department of Urology Dokkyo Medical University Saitama Medical Center  Koshigaya Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hiroki","family":"Kito","sequence":"additional","affiliation":[{"name":"JCHO Tokyo Shinjuku Medical Center  Tokyo Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-9266-782X","authenticated-orcid":false,"given":"Mikio","family":"Sugimoto","sequence":"additional","affiliation":[{"name":"Department of Urology Kagawa University Faculty of Medicine  Kagawa Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-3306-4858","authenticated-orcid":false,"given":"Masaki","family":"Shiota","sequence":"additional","affiliation":[{"name":"Department of Urology, Graduate School of Medical Sciences Kyushu University  Fukuoka Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hisashi","family":"Hasumi","sequence":"additional","affiliation":[{"name":"Department of Urology and Renal Transplantation Yokohama City University Medical Center  Yokohama 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