In a multicenter prospective study involving 658 men, aged 50 years and older, with total PSA levels between 4 and 10 ng/mL and normal digital rectal examination, PHI demonstrated superior diagnostic performance compared with its individual components—total PSA, %free PSA and [−2]proPSA—in identifying clinically significant PCa, including cases with a Gleason score of 7 or higher. This evidence concerns the gene KLK3 and posterior cortical atrophy.